If you've decided to leave Brightree, this step-by-step guide covers everything: the data audit checklist, integrations inventory, a realistic 30/60/90-day timeline, staff transition plan, and a side-by-side workflow comparison against ScriptRelay's autonomous platform.
I've been in DME for over 20 years. I've seen software come and go, watched platforms get acquired, and personally lived through migrations that nearly broke my billing team. When I evaluated Brightree for my operation, I understood exactly what I was getting — a powerful, insurance-billing-first platform that would eventually ask more of my staff than it gave back.
This guide is for operators who've reached the same conclusion I did: Brightree works, but it's working against you. And if you're going to leave, you need to do it right — without dropping a single active order, losing a payer contract, or triggering a denial cascade in month two of your new system.
Let's get specific.
Before you commit to a migration, understand the pressure points clearly. Not because you need justification — you're already reading this — but because understanding the why tells you what to look for in the replacement.
Brightree doesn't publish pricing, which is itself a signal. The industry average for a mid-size DME operation runs $200–$300 per user per month once you've added the modules that feel like they should be included: advanced reporting, patient engagement, analytics, document imaging. That's not a rumor — it's what operators in DME communities consistently report.
A 10-person billing team at $250/user is $2,500/month — $30,000/year — just for the software layer. And that number goes up as you hire, not down as you scale.
Capterra reviewers are blunt: "I do not like the fact that you pay 1 price for the program, but when going through the setup, there are a TON of 'a la cart' items that you need to purchase on top of the regular Brightree cost — this is also never explained when it's being sold to you."
That's not a pricing complaint. That's a trust complaint.
ResMed acquired Brightree for $800 million in 2016. ResMed is also one of the largest manufacturers of CPAP and respiratory therapy equipment in the world — equipment that DME distributors sell and bill through.
You are running your core business operations on infrastructure owned by your largest equipment supplier. Whether or not that creates an actual conflict of interest today, it creates a structural conflict of interest that gets worse as the relationship between ResMed's software and hardware roadmaps converges.
Brightree is opinionated. It was built with a specific workflow in mind, and if your operation diverges from that workflow, you adapt — not the software. If you're running reorder programs, rapid-cycle rentals, or high-volume order intake from multiple referral sources, you've probably already built a manual ops layer on top of Brightree to handle what it won't do automatically. That manual layer has a salary attached to it.
Ask anyone who's been on Brightree for more than 3 years. Support quality prior to the ResMed acquisition and support quality now are not the same. This is consistent across Capterra, G2, and SelectHub reviews from 2024–2026. When something breaks during a billing run at 4pm on a Thursday, "submit a ticket" is not an acceptable answer.
Don't touch a contract or sign an LOI with a new vendor until you've completed this audit. Migration failures happen in the gaps — the data no one thought to export, the integration no one documented, the payer contract that needs re-enrollment.
Work through Brightree's export tools methodically. You need:
Request a full data export from Brightree early. Brightree's offboarding process is not frictionless, and export format compatibility with your new system is something to validate in testing, not in production.
Document every system Brightree connects to:
Each integration is a migration task. Some will re-connect cleanly to your new platform. Some will require vendor calls, new API credentials, or a parallel-run period.
Do not start a migration mid-cycle. Your ideal cutover window is after a clean month-end close, before the next major billing submission batch, and not during Q4 (highest audit activity) or January (payer contract renewals). May–August tends to be the lowest-risk migration window for most DME operations.
Your billing team has Brightree muscle memory. Budget for dedicated training time (minimum 2 weeks of parallel access), reduced throughput for the first 30 days post-cutover (plan for 20–30% slower processing), and a designated super-user on the new platform who can answer floor questions before they escalate to support.
This timeline is realistic. If a vendor tells you they can migrate you in two weeks, they're migrating your data without migrating your operation.
Complete the data audit above — every item. Finalize new vendor selection and execute contract. Request Brightree data export in agreed formats. Map data fields between Brightree schema and new system schema. Inventory all integrations and initiate reconnection conversations. Identify your migration team: who owns patient records, who owns billing, who owns integrations, who owns staff training.
At the end of Day 30, you should have clean exported data in hand and a field mapping document that your new vendor has signed off on.
Load exported data into new system's sandbox environment. Validate record counts: patient count, active order count, open claim count must match source totals. Run test claims through new clearinghouse connection. Test recurring rental triggers on 10–20 sample patients. Process a sample denial batch end-to-end. Complete staff training on core workflows: intake, verification, claim submission, posting, denial management.
At the end of Day 60, your team should be able to process a full day's work in the new system without stopping. If they can't, delay cutover.
Select cutover date and communicate to staff (minimum 2-week notice). Run final Brightree data sync 48–72 hours before go-live to capture incremental changes. Execute cutover: switch primary system, route all new intake to new platform. Keep Brightree in read-only mode for 60 days post-cutover (HIPAA compliance + safety net).
Monitor daily: claim acceptance rate, denial rate vs. Brightree baseline, cash flow pattern. Flag any denial spike in the first 30 days immediately — migrations often surface payer enrollment gaps that weren't visible in the old system.
Patient records and billing history are your highest-risk migration assets. Here's how to handle each category:
Patient Records: Export in HL7 or CSV format. Validate field-by-field mapping (DOB format, insurance ID format, diagnosis codes). Run a sample of 50 patient records through the new system manually before bulk load.
Active Orders: This is your highest operational risk. Every open order must transfer with its current status, delivery date, and equipment codes intact. Assign a billing team member to manually audit the top 100 active orders post-migration.
Payer Contracts and Fee Schedules: Re-enroll with payers directly — don't assume your Brightree payer setup transfers. Contact your top 10 payers by revenue volume before go-live and confirm your NPI, taxonomy code, and billing address are correct in their systems.
Recurring Rentals: Export resupply schedules with next-due dates. Validate that the new system's rental cadence engine picked them up correctly. A missed resupply shipment is a patient satisfaction problem and a revenue problem.
Historical Claims: You need 24 months for audit defense, 6 years for HIPAA records retention. These don't need to be live in the new system — an archived export stored securely is sufficient. But they must be accessible.
The technology transition is 40% of the migration. The people transition is 60%.
Roles most affected:
Training structure that works:
What to tell your team: This is a one-time disruption in exchange for a better daily experience. Set that expectation early. Staff who understand why the migration is happening are more patient with the learning curve than staff who just show up Monday to a different system.
Here's where the platform difference becomes concrete. Three workflows, side by side.
The real question isn't the software cost. It's the total cost of the operation running on top of it — the coordinators running manual verification loops, the billing managers doing denial research from scratch, the ops staff maintaining a manual layer because the platform doesn't do it automatically.
| Cost Factor | Brightree | ScriptRelay |
|---|---|---|
| Per-user licensing | ~$250/user/mo | Flat tier, not per-seat |
| 10-user billing team | ~$2,500/mo | Significantly lower |
| Add-on modules | Extra cost | Included |
| Manual ops layer (staff time) | 2–4 FTE equivalents | Reduced via automation |
| Denial recovery rate | Depends on staff capacity | AI-assisted, consistent |
If ScriptRelay's autonomous workflows eliminate 2 FTE-equivalents of manual work, the ROI math closes faster than any per-seat pricing comparison will show you.
We'll walk through your specific workflows, not a generic product tour.
Anthony Delgado has 20+ years of DME operations experience. ScriptRelay is the autonomous DME operations platform built for distributors who are done managing software instead of managing patients.