How to Evaluate a Healthcare ERP Consulting Firm: 7 Questions to Ask Before You Sign

Ward Verschaeve
Jun 29
6 min read

Choosing a healthcare ERP consulting firm is one of the highest-stakes decisions a CFO or COO can make. Get it right and you compress implementation timelines, protect the organization from runaway costs, and walk away with a system your team actually uses. Get it wrong and you inherit six months of delays, a change order pile, and a go-live date that keeps moving.

The challenge is that most consulting firms look similar from the outside. They all have Microsoft certifications on their websites. They all claim industry expertise. They all promise they have done this before.

So how do you tell the difference before you sign the statement of work? These seven questions cut through the surface-level positioning and reveal what really separates a capable healthcare ERP partner from one that will cost you more than the software itself.

Why Healthcare ERP Consulting is Different From General ERP Work

Most ERP consultants are generalists. They have implemented Business Central or Dynamics 365 across manufacturing, professional services, and retail. That breadth sounds reassuring, but healthcare operations have structural complexity that generalist consultants routinely underestimate.

Healthcare organizations commonly manage dozens or hundreds of legal entities under a single operational umbrella. A long-term care provider might operate 50 skilled nursing facilities, each with its own license, billing relationships, and cost center. A dental group like MB2 Dental, which A BC Consulting helped streamline across 250 locations, cannot afford to invoice through 250 disconnected processes. The ERP architecture has to reflect the actual organizational structure, not force the organization to contort itself around a standard chart of accounts.

There is also the compliance dimension. Healthcare finance operates under HIPAA, IFRS 16 lease accounting standards, cost reporting requirements for Medicare and Medicaid, and specific billing rules for different payer types. A consultant who has never built a healthcare multi-entity structure in Business Central, or who has never worked with a solution like Binary Stream's Multi-Entity Management or Property Lease Management, will discover these requirements during your implementation, which means you bear the cost of their learning curve.

The right consulting firm has done this before, specifically in healthcare, and can show you the proof.

Read: How A BC Consulting Transformed Signature Healthcare's Operations, saving them $120,00 in the Process

1. Can you show me healthcare-specific case studies with measurable outcomes?

Not PDFs with logos. Case studies with actual numbers.

The firms worth hiring can point to specific clients, specific problems, and specific results. When evaluating A BC Consulting, for example, prospective clients can review outcomes like Signature HealthCARE scaling to 239 entities in a single Business Central database, saving $120,000 in the process. Or, examples like DynaLIFE centralizing lease management for over 30 locations after years of decentralized, error-prone processes.

If a firm hesitates on this question, or pivots to generic ERP outcome statistics, treat that as a signal. Measurable results are the only reliable evidence of competence.

2. What does your team's healthcare experience look like, and who will actually lead my project?

Many consulting firms present their strongest credentials during the sales process, then hand off the implementation to junior staff. Ask directly: who is the project lead on an engagement of this size, what is their background in healthcare ERP, and will that person be available to you throughout the project?

A BC Consulting is led by Shannon Mullins, a Microsoft MVP with over 20 years of experience across healthcare, finance, and ERP implementation, and a former controller who has sat on the client side of these projects. That accounting background matters in healthcare, where the conversation about entity consolidation, intercompany transactions, and audit trail requirements happens with finance leadership, not IT.

The question of "who leads my project" should produce a name, a biography, and a track record.

3. How do you handle multi-entity management for healthcare organizations?

This is the single most important technical question for any healthcare organization operating more than one site.

Standard Business Central supports multiple companies, but each company is effectively a separate database. Consolidating financials across 30 or 50 or 250 entities using native Business Central requires significant manual intervention, intercompany transactions, shared master data, and consolidated reporting all become painful.

A specialized solution like Binary Stream's Multi-Entity Management (MEM) changes the architecture fundamentally: it allows multiple entities to operate within a single database, with shared vendors, chart of accounts, and intercompany automation. Frankford Hospitals used this approach to overhaul invoice management and audit workflows across their accounting team. Signature HealthCARE consolidated 55+ separate databases down to one.

If a consulting firm does not know what MEM is, or proposes a multi-company native approach without explaining the consolidation tradeoffs, ask why.

4. Is your pricing fixed-fee or time-and-materials, and what happens when scope changes?

This question exposes more risk than almost any other. Time-and-materials contracts are structurally problematic for healthcare ERP implementations because the complexity of the work is difficult to bound upfront. Unanticipated entity configurations, payer-specific billing logic, and data migration surprises all create change order opportunities for the consulting firm and cost exposure for you.

Fixed-fee engagements shift the risk appropriately back to the firm, who now have a direct incentive to scope accurately, staff efficiently, and avoid scope creep. A BC Consulting offers fixed-fee implementation packages for this reason. You know the total cost before work begins.

If a firm quotes time-and-materials, ask them what their typical variance is between initial estimate and final invoice across their last five healthcare implementations. The answer will be instructive.

5. What is your typical go-live timeline, and what causes that number to slip?

Generic ERP implementations for mid-market organizations often take 9 to 18 months. That timeline is not inevitable, it reflects poor scoping, inadequate data preparation, or a consulting methodology that treats discovery as billable hours rather than pre-work.

A BC Consulting targets an 8 to 12 week go-live for structured healthcare implementations. That number is credible because the firm has built standardized healthcare packages, ones pre-configured for common entity structures, lease accounting, and materials management workflows, rather than starting from scratch with each client.

When a firm gives you a timeline, ask them to walk through their standard phases, and ask specifically what has caused timelines to extend on past projects. The quality of that answer tells you how self-aware they are about execution risk.

6. What ISV partners do you work with, and are those partnerships current?

Business Central's native capabilities do not cover all of healthcare's operational needs. The firms that deliver the best healthcare implementations work with a vetted set of independent software vendors (ISVs) whose products integrate with Business Central at a certified level.

For healthcare specifically, the most relevant partners are those who specialize in multi-entity management, property and lease management, and healthcare materials management. Binary Stream is the primary ISV in these categories, and a consulting firm that has an active partnership with Binary Stream and has deployed their solutions in production healthcare environments is materially different from one that has only seen the product in a demo environment.

Ask how many Binary Stream implementations the firm has led, and ask to speak with a reference from one of them.

7. What does post-go-live support look like?

Go-live is not the end, rather it is a moment of transition to a new stage of the relationship. The first month-end close in a new ERP system, the first intercompany reconciliation, the first audit cycle: these are all moments when your team will have questions that cannot wait 48 hours for a support ticket response.

A BC Consulting offers structured post-go-live support plans with defined SLAs: a 4-hour response window for standard issues and a 2-hour response window for emergencies like production outages or month-end posting errors. That specificity matters. A vague "we're here for you after go-live" commitment from a consulting firm is not the same thing as a named support contract with service levels.

Ask what is included in the support plan, what the hourly rate is for issues outside the plan, and whether the team that implemented your system is the same team handling post-go-live support.

What The ERP Healthcare Consulting Evaluation Process Should Look Like

Once you have shortlisted two or three firms, the evaluation process should include a structured demo using your actual entity configuration, a reference call with a healthcare client of similar size and complexity, and a review of the proposed project plan, not just the timeline, but the phase structure, data migration approach, and go-live criteria.

The firms that perform well in this process are the ones that have done it enough times to have a repeatable answer. When a consulting firm can walk you through exactly what Signature HealthCARE's consolidation project looked like, or describe the lease management structure they built for DynaLIFE, you are talking to people who have navigated the specific problems you are about to face.