Last Reviewed: November 14th, 2024

Best Medical Billing Services Of 2024

What are Medical Billing Services?

Medical Billing Services offer a comprehensive solution for healthcare providers to manage and streamline their billing and coding processes. They abate the problems of delayed payments, coding errors, and administrative overload, ultimately boosting the bottom line. Key benefits include increased compliance, reduced claim denials, and better cash flow management. Medical Billing Services typically handle patient billing inquiries, insurance verification, claim submission, and payment processing, thus relieving the healthcare providers of these tasks. Noteworthy emerging features include the incorporation of AI to enhance coding accuracy and analytics for financial forecasting. They are especially valuable to small to medium healthcare practices that lack extensive in-house billing resources. However, some healthcare providers may find the cost of outsourcing and potential loss of control over patient billing data as limitations. In summary, Medical Billing Services offer providers an efficient, compliant, and hassle-free means to handle their billing processes, allowing them to focus on patient care. They contribute to improved financial health and higher patient satisfaction.

What Are The Key Benefits of Medical Billing Services?

  • Increases Revenue Collection
  • Reduces Coding Errors
  • Boosts Billing Compliance
  • Alleviates Administrative Overload
  • Enhances Cash Flow Management
  • Reduces Claim Denials
  • Supports Patient Billing Inquiries
  • Facilitates Easier Insurance Verification
  • Improves Financial Forecasting
  • Allows Focus on Patient Care
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Overall

Based on the latest available data collected by SelectHub for 56 solutions, we determined the following solutions are the best Medical Billing Services overall:

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Why We Picked Tebra Managed Billing

Tebra Managed Billing offers robust functionality for scheduling patients, confirming insurance, managing accounts, storing patient documents and more. It’s user-friendly interface and intuitive options make it easy to use and navigate, increasing productivity. Reporting tool offers easy customization for businesses needs. Reviewers said that customer support is responsive and helpful in solving issues. However, some complained that getting customer service was challenging. Setting up patient billing and insurance was difficult and negatively impacted workflow. Users disliked that the system tended to run slow and was often down for repairs or maintenance.

Pros & Cons

  • Functionality: It provides a comprehensive set of tools, as noted by 96% of users who referred to functionality.
  • User Friendly: It is intuitive and easy to deploy, as noted by 97% of reviewers who refer to ease of use.
  • Report: Around 65% of users said that report functions are easy to customize to meet their organization's needs.
  • Customer Support: Customer services were responsive and helpful, as noted by 56% of users who specified customer support.
  • Billing & Insurance: Nearly 86% of users said that setting up billing and insurance was time-consuming and difficult.
  • Integration: Approximately 81% of reviewers who specified integration said that it offers limited software integrations.
  • System Performance: About 92% of users said that the system runs slow and goes down frequently, affecting productivity.

Key Features

  • Schedule/Calendar: Assign physicians with the correct patient, equipment and exam room. Automatically verify patient eligibility to reduce denials. 
  • Charge Capture: Charges can be billed right away by selecting the patient name and date of service while checking for coding errors to reduce denials and get paid faster. 
  • Claims Tracking: Monitor all claims, check statuses and get reimbursed quickly. Claims can be filtered by provider, patient and date. 
  • Billing Analytics: Measures key performance indicators to come up with other ways to find practice revenue. Improve organization financial health by tracking performance and revenue cycles. 
  • Billing Tasks: Manage all billing tasks in a singular, easy-to-use inbox. Tebra Mobile allows users to view and complete tasks anytime and anywhere. 
  • Agenda Overview: Provides a general review of billing operations and notifies users of any outstanding balances or other important items. 
  • Rules Engine: Helps produce more accurate claims by automatically removing unnecessary or incorrect information. 

Pricing

License/Subscription Cost
  • Users pay a monthly subscription based on the number of users
  • Cost will vary depending on the end user role; physician, non-physician or therapist
Maintenance Cost
  • Included with the subscription cost
  • Offers free how-to articles, video tutorials and feature guides
Installation/Implementation Cost
  • Cost is included in the subscription with zero setup fees and no long-term contracts required
Customization Cost
  • An additional cost is charged for any add-on features or enhancements
  • Each additional module is provided for half the base cost
Data Migration Cost/Change Management/Upfront Switching Cost
  • Cost varies depending on the type of data to be imported
  • $500 for single practice migration and $100 for each additional practice
Recurring/Renewal Costs
  • Cost is equal to the recurring subscription cost paid monthly, based on the number of providers and type of package selected
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Why We Picked WebPT

WebPT has made a significant impact on the physical therapy software landscape, offering a comprehensive suite of tools designed to streamline workflows and enhance patient care. Users consistently highlight its user-friendly interface, robust features, and exceptional customer support as key strengths. One reviewer emphasized the ease of transitioning from paper-based systems to WebPT's cloud-based platform, appreciating its accessibility from any web-enabled device. The software's scheduling capabilities have also received praise, with users noting improvements in patient retention and the ability to synchronize appointments with digital patient records.

While WebPT garners positive feedback, some users mention the learning curve associated with its extensive features. However, the company's commitment to customer support is frequently commended, with users citing responsive and helpful assistance. WebPT distinguishes itself by catering specifically to the needs of rehabilitation therapists, offering specialized documentation, billing codes, and compliance tools. This focus on the therapy sector sets it apart from more generic practice management software. WebPT is ideally suited for physical therapy practices of all sizes seeking an integrated platform to optimize front- and back-office operations. Its comprehensive features, user-friendly design, and industry-specific focus make it a valuable asset for therapists looking to enhance efficiency, improve patient care, and grow their practices.

Pros & Cons

  • User-Friendly: All users mentioning this aspect noted that the solution’s ease-of-use is a key benefit.
  • Accessibility: The platform is web-based, making it highly accessible according to over 95% of users who mention this aspect.
  • Scheduling: About 75% of users who mention scheduling noted that it’s convenient to schedule appointments.
  • Speed: All users referring to speed reported that the product is slow and includes redundant check boxes, which further reduce the speed of working.
  • Functionality: The product is filled with glitches and the site is often down for maintenance, according to 88% of users who mention functionality.

Key Features

  • Analytics and Reporting: Access and work on detailed data tables from a main reporting dashboard. Use easy graphs and charts for valuable business insights. 
  • Interoperability: Facilitates a secure transfer of information between systems, enabling greater efficiency and data unity. Key integrations include Cerner, Epic, McKesson and athenahealth. Includes 24/7/365 monitoring from WebPT. 
  • Web-Based: Users can access the platform from any browser, anywhere. There’s no deployment costs or loss in productivity while the software is installing. 
  • Continuous Updates: Because the software is web-based, it frequently refreshes with new studies, formulas and testing criteria. 
  • Simplified Interface: Built around an intuitive workflow and offers features for a hassle-free experience such as dropdown checklists, auto-completing text boxes and much more. 
  • Home Exercise Program: Engage patients in video exercises with patient-facing functionality and design. Tap into a library of evidence-based therapy exercises available in up to eight different languages. 
  • Listing and Review Management: Improves online presence with a robust facility profile that provides automatic review updates, offers direct responses to reviews and analyses review trends. 
  • Billing: Maximize revenue and save time for quality healthcare with minimum claim errors using Therabill. Includes real-time analytics, detailed activity logs and one invoice from one company. 
  • Patient Outcomes Tracking: Drive faster recovery for patients with a built-in patient outcomes tracking system. Includes a library of industry-accepted tests for concrete performance goals and tracking therapists’ progress. 
  • Scheduling: Manage appointment calendars that sync with patient records and reduce no-shows by 30% by sending automatic reminders. Book remote appointments and launch live two-way video for virtual therapy using Virtual Visits. 
  • Revenue Cycle Management: Submit claims and expedite payments with high first-pass acceptance rate. Offers two RCM options: 
    • RevServe: Completely outsourced service. WebPT handles all billing responsibilities, including A/R management, reporting, collections benchmarking and medicare compliance. 
    • RevEquip: Hybrid model, allowing practices to control things like A/R management, credentialing, case management and more. WebPT offers management of outgoing claims, patient statement submissions, payment EDI management, workflow consultations and more. 
  • Patient Relationship Management: Increase engagement and reduce dropout rates by sending automated email campaigns to past patients and receiving actionable feedback indicating potential dropouts. 
  • Client Mobile App: Clients can access and manage their health data conveniently from a mobile app. 
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Why We Picked TherapyNotes

Stepping into the bustling world of mental health practice management software, TherapyNotes emerges as a prominent contender, lauded for its user-friendly interface and comprehensive features. Feedback from users over the past year paints a picture of a platform that streamlines administrative tasks, allowing practitioners to dedicate more time and energy to their clients. The software's scheduling tools, billing features, and secure communication channels have received consistent praise for their ease of use and effectiveness in optimizing workflows.

While TherapyNotes shines in its core functionalities, some users have noted the absence of a reporting dashboard and limited third-party integrations as areas for potential improvement. However, the software's strengths in facilitating efficient scheduling, secure client communication, and streamlined billing processes appear to outweigh these limitations for many users. The platform's emphasis on ease of use and affordability further distinguishes it from competitors, making it an attractive option for solo practitioners and small to medium-sized practices seeking a comprehensive yet cost-effective solution.

TherapyNotes appears to be an ideal fit for mental health professionals who prioritize a user-friendly experience and value a robust set of features that address the essential aspects of practice management. Its intuitive design and focus on core functionalities make it particularly well-suited for those who prefer a streamlined approach to managing their practice, allowing them to focus on what matters most—providing quality care to their clients.

Pros & Cons

  • Streamlined Notes: The platform offers multiple note templates, which can be customized to fit individual workflows and preferences. This feature can save clinicians time and effort when documenting sessions.
  • Integrated Billing: TherapyNotes includes features for managing billing tasks, such as generating invoices and processing payments. This can simplify the billing process for mental health professionals.
  • Appointment Scheduling: Users can manage their schedules and appointments directly within the platform. Clients can also request appointments online, which can streamline the scheduling process.
  • Client Portal: TherapyNotes provides a secure client portal where clients can access their records, schedule appointments, and communicate with their therapists. This can improve communication and engagement between therapists and clients.
  • Telehealth Capabilities: The platform offers telehealth features, allowing therapists to conduct virtual sessions with clients. This can be a convenient option for clients who are unable to attend in-person appointments.
  • Limited Customization: Users have expressed frustration with the lack of flexibility in tailoring the platform to their specific workflows and preferences. For example, customizing intake forms or treatment plans to align with unique practice needs can be challenging.
  • Billing Challenges: Several users have reported encountering difficulties and a learning curve associated with the billing features, particularly electronic claim submission and managing insurance reimbursements.
  • Customer Support Concerns: Some users have shared feedback regarding occasional delays or challenges in obtaining timely and effective assistance from TherapyNotes customer support, especially during peak hours or with complex technical issues.

Key Features

  • Calendar: Schedule one-time or recurring appointments, access appointment-related notes and send automated reminders to patients. Organize the calendar according to clinicians, specific clients or certain practice locations. Offers a personal to-do list with treatment plans, notes, administrative documents and more. 
  • Electronic Records: Enables quick documentation and notes with speech-to-text software, built-in templates and searchable diagnosis codes. Also gives physicians immediate access to patient records and notes. 
  • Billing: Handles every step of the billing process, including insurance eligibility verification, claim submission and payments. Claims can be automatically swept of any mistakes or coding errors. Supports generating superbills with all necessary information for prompt reimbursement. 
  • Credit Card Processing: Deposit funds automatically to a bank account with the integrated payment processing system. Keeps cards on file for any missed appointment fees or future transactions. 
  • Client Portal: Patients can manage appointments themselves using TherapyPortal on their mobile device. Physicians can communicate with their clients remotely by exchanging messages, video chatting, adding notes and more. Includes configuration of color scheme, logo and welcome message. 
  • Telehealth: Physicians can meet clients online for convenient video sessions. Sessions are encrypted and integrated into TherapyNotes and the patient portal. 
  • Scheduling: Schedule appointments and manage tasks on the to-do list for higher efficiency by connecting the to-do list to records, notes and billing. With quick appointment scheduling, it also allows customization of the calendar view and mobile calendar sync. 
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Why We Picked AdvancedMD

AdvancedMD is an intuitive cloud-based tool. While some users were happy with the system’s integration and customization capabilities, far more users were extremely dissatisfied with other aspects of the system. There were mixed reviews on its reporting capabilities. A significant number of reviewers felt that the sales representatives misled customers noting that they lost money after implementing AdvancedMD and commenting that many features lacked the functionality that they required. Though the add-ons allow users to customize the system, many users complained that the add-ons come at a steep price, making them prohibitive to many users. Users also complained that they were surprised by hidden fees after implementation and felt that customer service was rude and unwilling to help when they called for support. A small number of reviews also noted that upgrades to the system frequently caused downtime and reported discrepancies in their billing that affected customers. While many of the reviews were negative, AdvancedMD remains a popular EHR solution. Due to its high price and difficulty to learn, it is best suited to large practices with the budget for necessary add-ons and internal technical support that is available to help ensure everyone who needs to can use the system.

Pros & Cons

  • Customization: Of the reviews that mentioned the system’s customization, more than 70% were happy with the customizations available as add-ons to the system.
  • Integration: Though only mentioned in 10% of reviews, 85% of those reviews felt the system successfully integrated with their other medical software.
  • User-Friendly: About 55% of users who mentioned its user-friendliness found it easy to use and navigate.
  • Implementation: The vendor does not offer sufficient implementation support, and the system has a steep learning curve, as noted by more than 80% of user reviews that discuss getting the system up and running.
  • Functionality: Though the system offers a robust list of features, 66% of reviews that discuss features felt that the features’ functionality was lacking in some aspects.
  • Price: Of the users who mention price in their review, more than 90% were upset with hidden fees and felt that the system’s high price was not worth the money.
  • Customer Support: Of the reviews that discuss customer service and support, 65% felt that customer support was difficult to contact, rarely had sufficient answers to their questions and often failed to resolve the issues users reported.
  • Performance: About 94% of reviewers that mentioned performance said that the system is slow and buggy, with recurring crashes and connectivity issues.

Key Features

  • Scheduling: Medical scheduling tools allow users to quickly view appointments and patient information by hovering their mouse over the calendar. Additionally, patient visits can be tracked, and recurring appointments can be set while automated patient reminders are sent out, reducing no-shows. 
  • Billing: In addition to collecting patient payments, it is able to verify insurance eligibility automatically while providing users with all the necessary medical billing information in one centralized location.  
  • Clearinghouse: Sweep claims of any coding errors to ensure an accurate claim submission. Any copays, deductibles and additional coverage can be automatically verified prior to a patient’s visit, while on-the-spot insurance checks are also efficient. 
  • Patient Portal: Patients can view lab results, pay bills, message their physicians and request office appointments online using its patient portal. Providers can use the portal to exchange messages with a patient, manage prescription renewal requests and send out alerts and notifications. 
  • E-Prescribing: Electronically prescribe medications — including controlled substances — quickly and easily. Connects facilities to a variety of pharmacies around the US, while users can request refills and access a patient’s medication history anywhere. It uses a combination of personal passphrases and secure tokens to complete DEA-required, two-factor authentication. The AdvancedEPCS system maintains a full DEA audit history. 
  • Telemedicine: Telemedicine features facilitate face-to-face conference conversations and secure transmissions of still images or high-resolution video conference screenshots, and stores them to patient files with HIPAA compliance. Schedule telemedicine appointments and view them in one dashboard calendar. 
  • Smart Dashboard: Automatically prioritize and manage frequent tasks using this role-based dashboard. In addition to health analytics, get alerted on any urgent issues, like abnormal lab results or pending prescriptions and drill down or up into tasks. 
  • Configurable Templates: It can be tailored to a variety of specialties, with note and sub-note templates designed by physicians to optimize workflow while fitting in with a facility’s pre-existing style. 
  • Physician-Oriented Dashboard: It enables physicians to view and schedule appointments, staff and patient messages, referral letters, test results and to-do lists in one location. The physician and their staff can respond to patient appointments or prescription renewal requests, reply to questions or send clinical reports. Its interoffice messaging center also allows physicians to send messages to the staff. 
  • Patient Communication Tools: Select which patients would receive either text or email by choosing from existing criteria or creating a new set. Segment patient lists and send specific messages to enhance patient engagement. It also supports sending sales promotions to patients. 
  • Patient Kiosk Mobile App: Complete intake and consent forms on an iPad. The information is automatically captured and passed to relevant staff to facilitate a faster check-in process for patients. 
  • Health Watcher: HealthWatcher offers auto-alerts and custom healthcare plans to enable patients to follow treatment plans. Its interoperable platform allows it to monitor and trend patient population health. It also allows building custom healthcare plans to manage specific conditions based on factors like age, sex, lab results and diagnosis. 

Pricing

License/Subscription Cost
  • Subscription fee is paid monthly based on the number of users
  • Offers standard plans and pre-configured pricing plans
Maintenance Cost
  • Cost is included with the subscription, covering ongoing upgrades and 24/7 customer support
Installation/Implementation Cost
  • Installation cost is included with the subscription fee
Customization Cost
  • Not included in the subscription cost
  • Cost varies depending on the type of custom service chosen
Data Migration Cost/Change Management/Upfront Switching Cost
  • Depends on the amount of data needed to be migrated as well as the complexity and accuracy of that data
Recurring/Renewal Costs
  • Recurring monthly fee is charged based on the subscription model selected
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Why We Picked Practice Fusion

User reviews from the past year paint a mixed picture. While some users praise its intuitive design and comprehensive features, others express frustration with its customer support and pricing.

Practice Fusion stands out for its user-friendly interface, which makes navigating the system a breeze, especially for those new to electronic health records. Its robust feature set, including charting, e-prescribing, and billing, caters to a wide range of practice needs. However, some users report encountering difficulties with customer support, finding it unresponsive and unhelpful. Additionally, pricing concerns have been raised, with some users finding the system expensive compared to competitors like Athenahealth or Kareo.

Overall, Practice Fusion seems best suited for smaller practices seeking a user-friendly, all-in-one EHR solution. However, practices with more complex needs or those prioritizing responsive customer support might want to explore alternative options.

Pros & Cons

  • Data Safety: All users who mention files and data noted the safety of sensitive medical data as a key benefit.
  • User-Friendly: About 93% of users referencing usability reported that the product is easy to use and navigate.
  • Accessibility: According to 89% of reviews on this aspect, the product is highly accessible due to being web-based.
  • Customer Support: About 95% of reviewers mentioning support indicated that customer service is inefficient and unresponsive.
  • Outdated: Over 85% of users referring to this aspect noted that the product requires updates in terms of tools and features.
  • Speed: Updates, glitches and a crowded interface slow down work, according to 70% of reviews about speed.

Key Features

  • Charting: With efficient charting, speciality-specific templates and automatic favorite lists, physicians can search for diagnosis codes by keywords to track a patient’s health data over time and monitor treatment progress. 
  • Scheduling: Easy scheduling lets patients manage appointments online, including automatic reminders regarding upcoming visits and automated recurring appointments. 
  • E-Prescribing: Order and send prescriptions anywhere, manage medical orders and pharmacy communication electronically, and take care of refill requests for any recurring medications with a two-click prescription refill tool. 
  • Patient Portal: Patients can look at medical information and view lab results at any time. They can also access education materials as well as population health information to better understand their health and treatment. 
  • Billing and Payment: Patients can receive billing statements and update payment information, while physicians can create superbills by automatically pulling information from chart notes. It can also verify insurance providers and scrub claims of any errors before submission. 
  • Labs and Imaging: Integrate with hundreds of labs like LabCorp and Quest as well as imaging services like X-ray, CT scan and ultrasound. 
  • Practice Administration: Consolidate tasks and custom reports, as well as refer patients electronically with their complete medical record. Communicate using secure messages that fulfill meaningful use standards or use HIPAA compliant faxes to go paperless. 
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Why We Picked NueMD

NueMD is a cloud-based practice management software that offers a suite of features, including medical billing, electronic health records (EHR), and appointment scheduling. While NueMD has been a popular choice for some practices, user reviews from the past year suggest that it may not be the best fit for everyone.

One of the biggest strengths of NueMD is its comprehensive suite of features. Users praise the software's ability to handle everything from billing to scheduling, making it a one-stop shop for practice management. However, some users have expressed concerns about the software's user interface, which they find clunky and difficult to navigate. They also complain that the software is not as intuitive as other EHR systems on the market, such as Athenahealth or Kareo. NueMD's customer support has also been a point of contention, with some users reporting long wait times and unhelpful responses.

NueMD's biggest differentiator is its focus on medical billing. The software's billing features are highly regarded by users, who appreciate its ability to streamline the billing process and reduce the number of errors. However, NueMD's billing features are not without their drawbacks. Some users have reported that the software's billing system is not as flexible as other systems on the market, making it difficult to customize for specific practice needs.

Overall, NueMD is a solid EHR system that offers a comprehensive suite of features. However, its clunky user interface, lack of intuitive design, and inconsistent customer support may make it a less desirable option for some practices. NueMD is best suited for practices that are looking for a system with strong billing features and are willing to put in the time and effort to learn the software. It is important to note that AdvancedMD, the company behind NueMD, is sunsetting the software in 2025. This means that practices using NueMD will need to migrate to a different system in the near future.

Pros & Cons

  • Easy to Use: Many users find NueMD's interface intuitive and straightforward, making it easy to navigate and complete tasks efficiently.
  • Strong Customer Support: NueMD is known for its responsive and helpful customer support team, which is available to assist users with any questions or issues they may encounter.
  • Comprehensive Features: NueMD offers a wide range of features that cater to the needs of various medical practices, including scheduling, billing, and patient management.
  • Affordable Pricing: Compared to other EHR systems, NueMD is considered to be a more affordable option, making it accessible to practices of all sizes.
  • Slow Performance: Some users have reported that NueMD can be slow to load, especially during peak hours. This can be frustrating for busy practices, as it can slow down workflow and lead to delays in patient care.
  • Limited Customization: NueMD offers a limited amount of customization, which can be a drawback for practices that have specific needs or workflows. For example, some users have found it difficult to customize the system to meet their specific billing requirements.
  • Poor Customer Support: Some users have reported that NueMD's customer support is not responsive or helpful. This can be a major problem for practices that need assistance with technical issues or have questions about the software.
  • Lack of Mobile App: NueMD does not have a dedicated mobile app, which can be a disadvantage for practices that need to access patient records or perform other tasks on the go. This can be especially challenging for providers who are on call or need to access patient information outside of the office.

Key Features

  • Patient Portal: Communicate with patients remotely and securely. Patients can schedule appointments, receive reminders, access medical history, view lab results, update insurance information and more online. 
  • E-Prescribing: Place medication orders while in a patient's chart with just a few clicks. It automatically sends out alerts of any drug-to-drug or drug-to-allergy interactions to reduce medication errors. 
  • Patient Chart Management: Manage all of a patient’s data, such as allergies, medications and more with ease. Physicians can view summaries of past encounters to follow up on referrals. 
  • e-Labs: Clinicians can order lab results from a patient’s chart, alert other providers of abnormal results and add charges to a patient’s bill in real time. 
  • Student Health: Keep track of an entire campus’ medical history and customize templates. Clinicians can check and edit patient information and print any relative literature. 
  • Claims Management: Claims submitted using NueMD have a 99.9% first-time success rate and typically see an acceptance status within 24 hours. 
  • Scheduling: Manage the schedule for multiple physicians, offices and patients automatically in order to save time. 
  • Medical Practice Management: Reduce no-shows with daily scheduling and file accurate claims for quicker reimbursements. Also includes: 
    •  Patient registration to centralize patient information, including billing details. 
    •  Patient statements and collections to reduce outstanding co-pays. 
    •  Quick reporting and analysis of financial data. 
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Why We Picked RXNT

RXNT is an integrated medical software solution offering Electronic Health Records (EHR) with e-prescription and patient engagement support. The cloud-based platform allows users to use and manage the application from anywhere at any time. It offers a user-friendly interface for easy use, management and customization. Reviewers pointed out that sometimes the system would duplicate the patient's information, making the patient have two profiles that lead to confusion and inconvenience. There are instances where the server lags during peak hours and tends to be slow and glitchy. Overall, they provide responsive and helpful support staff who follow up to ensure that problems are fixed before closing the ticket.

Pros & Cons

  • User-Friendly: Provides a user-friendly interface with color codes that is easy to use and implement as noted by all reviewers who mentioned ease of use.
  • Customer Support: Approximately 89% of users who referred to customer support indicated that support teams are responsive, helpful and would follow-up to ensure that problems are resolved before a ticket is closed.
  • Remote Access: All users who talked about the application liked its ability to RX meds and manage prescriptions from anywhere.
  • Duplicate Profiles: All users who specified duplication said that sometimes it duplicates patient information, giving them two profiles.
  • Program Performance: The system tends to be laggy and glitchy at times, as observed by all reviewers who referred to program performance.
  • Search: Requires multiple trials of keywords and scrolling for the search bar to locate what a user is looking for, as observed by 62% of users who mentioned search.

Key Features

  • Get Paid Faster:  Claim scrubbing, claim alerts, tracking and automatic secondary claim submissions improve financial performance and promote faster reimbursement. 
  • Increase Revenue:  End-to-end claim tracking reduces time taken in accounts receivables and is integrated with your workflow. 
  • Reduce Claim Denials:  Identify and resolve causes of denied claims to accelerate payment and improve cash flow. 
  • Prevent Billing Errors:  The software has built-in claim scrubbing that detects and eliminates errors in billing codes, thus reducing the number of denied or rejected claims. 
  • Customizable Reports:  The custom medical billing system makes displaying and analyzing data simple. The reports are comprehensive, configurable and easy to edit. 
  • Boost Efficiency:  It supports integrated real-time eligibility checks, claim status verification and alerts. Electronic remittance advice (ERA) and resource and patient scheduling with reminders make front and back office administration easy 
  • Better Manage Controlled Substances:  Its e-prescribing solution is EPCS-certified by the DEA. With real-time access to patient medical history, healthcare providers get up-to-date information about previously prescribed medications. 
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Why We Picked DrChrono

So, I got the chance to get a free trial access to DrChrono, and here are the key highlights:

  • The platform stands out for its intuitive design, extensive features and customization capabilities.
  • The software is accessible on any device with internet connectivity.
  • Data import from other EHR systems is supported but with certain limitations.
  • It offers four pricing plans and a free trial is available for potential users.

It's a cloud-based system, which means you can access it from anywhere — your laptop, tablet, even your phone! And it covers everything from electronic health records and patient scheduling to billing and telehealth.

One of the things that really impressed us was how customizable it was. You can create your own templates for notes, forms and even entire workflows. This means you can really tailor it to fit your specific needs and preferences, which can save a ton of time.

And speaking of saving time, they've put a lot of thought into their billing features. They have tools to help you code things correctly, submit claims electronically and even track your payments. Anything that helps you get paid faster and with less hassle is a win, right?

However, learning to navigate the billing and insurance modules could take time. It’s a bit confusing to understand how the billing workflow works and how to set one up. Also, you can’t import billing data from your old EHR system.

If you're looking for a comprehensive, user-friendly system that can be customized to your practice, we'd definitely recommend taking a closer look.

They offer four different pricing plans, so you can find one that fits your budget, and they have a free trial so you can test it out and see if it's a good fit for you. It's always good to try before you buy, right?

We’ve discussed more about the features in the See It in Action section. Do check it out to know how the system works in different scenarios.

Pros & Cons

  • Ease of Use: Navigate patient charts, create shortcuts and access billing info without a steep learning curve.
  • Customization: Tailor the system to your specific needs and preferences like customizing templates, workflows and reports.
  • Easy Medical Coding: Find and assign ICD, CPT and HCPCS codes to patients' bills to save time and reduce coding errors.
  • Contractual Obligations: Canceling subscriptions can be challenging, potentially leading to early termination fees. Automatic renewals may also catch you off guard.
  • Subpar Customer Support: Long wait times, unhelpful responses and unresolved issues from customer representatives might disrupt your processes.
  • Occasional Glitches: System crashes, slow navigation and difficulties with scheduling and other functionalities can cause frustration.

Key Features

  • EHR: Provide better care with features like free draw for visual explanations, custom vitals tracking and access to immunization registries
    • Custom Templates: Tailor forms with specific fields, drop-down menus, checkboxes and even add your practice's logo. This ensures your documentation is consistent, efficient and specialized for your needs (e.g., cardiology forms with specific heart diagrams).
    • Electronic Prescriptions: Send prescriptions electronically to pharmacies directly from the patient chart. Access the drug's formulary tier, prior authorization requirements and alternative medications if the prescribed drug isn’t covered. Access patient PDMP data directly within the EHR to identify potential abuse, misuse or doctor shopping.
    • Free Draw: Upload images (x-rays, scans, photos) or use pre-loaded anatomical diagrams within the patient chart and draw directly on them.
    • Custom Vitals: Create vitals specific to your needs including things like blood glucose and oxygen saturation levels. Capture data in various formats: text, numbers or predefined options using dropdown lists. Access the flowsheet to visualize trends in custom vitals over time.
    • Prior Authorizations: Initiate the ePA request directly from the prescribing workflow. Automatically populate the prior authorization request form with relevant patient information (demographics, insurance details, medication prescribed) pulled from the patient's chart.
    • Lab Orders: Integrate with national, regional and specialty labs like Quest Diagnostics and Labcorp. Create predefined lab panels for common tests or specific conditions. For example, you could create a "lipid panel" or a "prenatal panel" with a single click. View lab results within the patient's chart, organized by date, test type and ordering provider.
    • Medical Speech-to-Text: Use voice to input clinical notes, patient histories and other information. See your spoken words appear as text in real time within the EHR to review and edit the transcription as you go.
    • Immunization Registries: Automatically send your patients' vaccination details to the state IIS, ensuring that records are up-to-date and complete. Retrieve immunization records from the IIS, even if your patient received vaccinations elsewhere to avoid unnecessary duplicate vaccinations and identify potential gaps in their immunization schedule.
  • Practice Management: Save time and reduce errors with appointment management tools, including appointment profiles, insurance eligibility checks, online scheduling and automated reminders.
    • Appointment Profiles: Instead of manually entering the same details (length, reason, etc.) for every appointment of the same type, you create a profile once and it auto-fills the details (duration, reason for visit, exam room and billing codes).
    • Eligibility Checks: Verify your patients’ insurance eligibility in real time — check what services are covered under the plan (e.g., office visits, labs, specialists) and any limitations or exclusions.
    • Online Scheduling: Set specific days and times when each provider is available for appointments. Offer different appointment types online (e.g., new patient, follow-up, consultation) with varying durations. Add buffer time between appointments to prevent scheduling conflicts and allow for patient check-in/check-out.
    • Patient Reminders: Send automated appointment reminders via email, text or SMS. Configure reminders to be sent at various intervals before the appointment like — a few days before, the day before or a few hours before.
  • Medical Billing: Improve your revenue cycle management with tools like billing profiles, medical coding and automated claims submission.
    • Billing Profiles: Combine frequently used CPT, HCPCS, custom codes and ICD-10 codes into a single profile. Attach common modifiers to the codes within the profile (e.g., modifier 25 for a significant, separately identifiable E/M service).
    • Medical Coding: Easily search and select the appropriate codes within the EHR using keywords, code numbers or descriptions. Perform basic code checking to identify potential errors such as invalid codes or missing modifiers.
    • Good Faith Estimates: Generate good faith estimates to help patients understand costs upfront and avoid surprise bills.
    • Claims Submission: Submit electronic claims to insurance companies within the system. Track claim statuses in real time. Scrub claims for errors like missing information or formatting mistakes before submitting them to payers to avoid denials and claim rejections.
    • Denial Resolution: Generate denial analysis reports to identify denial patterns. Edit and submit corrected claims directly within the system. If you disagree with a denial, generate appeal letters and track their statuses.
    • Patient Statements: Generate statements for individual patients or groups of patients based on various criteria (e.g., date range, insurance status, outstanding balance).
  • BI Tools: Get a visual summary of key metrics and performance indicators. Generate customizable reports to:
    • Track revenue, expenses and profitability
    • Analyze claim submission, acceptance, denial and reimbursement rates.
    • Track patient demographics, appointment history and billing information.
    • Analyze appointment scheduling and no-show rates.
  • Mobile Capabilities: Schedule appointments, send patient statements, bill insurance, document patient encounters, access lab results and more from iOS devices like iPad, iPhone and Mac.
  • Telehealth: Patients can join the telehealth visit from their computer, tablet or smartphone using the link provided in their email reminder. Providers can share their screens with patients to review medical records, lab results, X-rays or educational materials.
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Why We Picked NextGen Enterprise

Our research analysts, after evaluating several solutions, awarded NextGen Enterprise with best-in-class honors for Insurance Payments Management, Medical Coding, Medical Billing Services, Notes and Templates, and Deployment Options.

NextGen Enterprise provides EHR, practice management and patient experiene modules that support 2000 workflows and content for 30 specialties including cardiology, dental health, neurology, primary care and more.

Intutive EHR tools make it easy for doctors and nurses to document patient visits. You can even use AI for note-taking. And with the mobile app, you can access patient info and chart on the go.

The platform really shines when it comes to practice management. It automates a ton of time-consuming tasks like eligibility verification and billing, so your staff can focus on what really matters: patient care. Plus, the built-in analytics give practices valuable insights to improve efficiency and, ultimately, the bottom line.

Patient engagement is also a key focus, with the NextGen PxP patient portal empowering patients to actively participate in their healthcare journey. They can schedule appointments, request refills, view test results and even message their doctors securely.

One area that the system lacked was its integrative capabilities. It scored 77 in our analysis, lower than other popular products like athenahealth (93) and Cerner Ambulatory (88). That means you will need to connect barcode scanners, clinical decision support tools, prescription management systems and others via API.

Pros & Cons

  • Improve Patient Care: Get access to complete and up-to-date patient records, including medical histories, allergies, medications and test results for data-driven and informed decision-making.
  • Streamline Routine Workflows: Automate scheduling, billing and documentation processes to reduce administrative burdens and free up time for patient care.
  • Enhance Medication Safety: Set automated alerts to check for drug interactions, allergies and dosage errors to significantly reduce adverse drug event risks.
  • Complex Implementation: Demands time and resources for implementation, customization and staff training.
  • High Initial Costs: Requires significant investment in software, hardware and training.
  • Dependence on Technology: Creates reliance on technology, which can be problematic during system downtimes or technical failures.

Key Features

  • SOAP Notes: Record reasons to visit, social, family and diagnostic histories, vitals, physical exams, assessments/plans, and medications using the SOAP format. Use HPI (history of present illness) templates to document the patient's reason for visit, including onset, duration, severity, associated symptoms, and aggravating/relieving factors.
  • Templates: Use pre-built templates for patient visits, progress notes, procedures, patient intake, consent forms and letters. Tailor these or create new ones to perfectly fit your specific workflows.
  • Ambient Assist: Use smart AI technology to listen in on your patient conversations, capturing key information and automatically creating notes in your system.
  • Mobile App: Review and sign documents, view schedules and see high-level patient overviews (medications, allergies, past medical histories, etc.) Document patient visits using voice-to-text functionality. Save and prescribe frequently used medications with a few clicks.
  • Order Entry: Order labs, diagnostics and immunization from the CPOE bar on the patient’s chart. Click on order search to see your common orders.
  • Regulatory Reporting: Automate MIPS/MACRA data collection and reporting to demonstrate quality measures, improve outcomes and earn incentives. Collect and submit Uniform Data System (UDS) reports for FQHCs and eligible providers to track clinical quality measures and other HRSA-required data.
  • E-Prescribing: Launch the state-run Prescription Drug Monitoring Program (PDMP) database with a single click. Verify formulary coverage and benefits while writing the prescription. Initiate prior authorization requests directly from the prescribing window with pre-populated information. Securely transmit prescriptions to pharmacies nationwide through the Surescripts network.
  • Population Health: Collect patient data from EHRs, lab results, claims and health information exchanges. Use AGC, HCC or ASCVD risk algorithms to sort patients into different risk categories based on their health conditions, demographics and other factors. Analyze this data to look for anything that might be missing or doesn't quite add up. It could be a lab test that wasn't done, a prescription that wasn't filled or a recommended screening that was missed.
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Why We Picked Optum

Optum, a prominent player in the healthcare software arena, has attracted a range of user feedback over the past year, offering valuable insights into its strengths, weaknesses, and overall suitability for different user groups. Optum's users frequently highlight its comprehensive suite of features, encompassing mental health management, appointment scheduling, and medication tracking, as a key strength. This all-in-one approach simplifies healthcare management for individuals juggling multiple health concerns or those seeking a centralized platform. However, some users note that the extensive features can lead to a steeper learning curve, potentially posing challenges for individuals less comfortable with technology or those preferring simpler interfaces.

Optum distinguishes itself through its robust mental health support features, including mood tracking, journaling tools, and access to mental health professionals. This focus on mental well-being caters to a growing demand for integrated mental health solutions within healthcare platforms. Users appreciate the convenience and accessibility of these features, particularly in the context of rising mental health awareness. Conversely, some users mention occasional technical glitches or slow loading times as areas for improvement. Optum's emphasis on mental health support, coupled with its comprehensive features, makes it well-suited for individuals seeking a holistic healthcare management platform that prioritizes both physical and mental well-being. It is particularly beneficial for those with complex healthcare needs or those actively engaged in managing their mental health.

Pros & Cons

  • Extensive Network: Optum boasts a large network of mental health professionals, increasing the likelihood of finding a suitable therapist or psychiatrist in terms of location, specialty, and insurance coverage.
  • Care Coordination: Optum facilitates communication and collaboration among healthcare providers, ensuring a holistic approach to mental health care. This can be particularly beneficial for individuals with complex needs or multiple diagnoses.
  • Virtual Care Options: Optum offers telehealth services, providing convenient access to mental health care from the comfort of home. This can be especially helpful for individuals with mobility issues, busy schedules, or those residing in underserved areas.
  • Limited In-Network Options: Finding mental health professionals within Optum's network can be challenging, especially for specialized care or in underserved areas. This limitation can force individuals to choose between paying out-of-pocket for preferred providers or settling for less suitable options within the network.
  • Preauthorization Requirements: Optum often requires preauthorization for certain mental health services, such as therapy sessions or medication. This process can be time-consuming and may delay access to necessary care, potentially exacerbating symptoms or hindering progress.
  • Claims and Billing Issues: Navigating the complexities of claims and billing processes with Optum can be frustrating for users. Issues such as denied claims, incorrect billing, or difficulty reaching customer service can create additional stress and financial burdens for individuals seeking mental health support.

Key Features

  • Pharmacy Care Services: OptumRx helps physicians improve their prescribing and helps patients receive the most effective medication at the best possible cost. Physicians can also precheck and authorize medications in real time. 
  • Healthcare Delivery: Provide quality primary care, specialty care and post-acute care by focusing more on treating the patients while also optimizing efficiency and lowering costs. 
  • Data and Health Analytics: Automate recognition of high-cost and high-risk patients with data-driven assistance at the point of care. Acquire patients by linking consumer and clinical data and access insights based on patient results. 
  • Population Health: Improve health outcomes and lower costs by using insights from data and analytics. A connected network of over 800 Centers of Excellence enables treatment with greater knowledge from the get-go. 
  • Advisory Services: Insights help healthcare providers against their biggest challenges so they can and empower the health system, increase revenue, engage customers and improve the quality of care.nbsp;
  • Individual and Family Solutions: Individuals can save money while having a greater part in their overall health with different solutions for healthcare, prescriptions and spending. 
  • Claims Administration: Promotes payment integrity with features to edit inaccurate claims, appropriately price bills, assess bill details, recover overpayments and prevent inaccurate billing. 
  • Optum Bank: Makes paying for treatment easier and more efficient with innovative payments solutions, leading to reduced costs without compromising on healthcare quality. Includes: 
    •  Health accounts for employees. 
    •  Hassle-free payment solutions for better healthcare. 
    •  Health account education with courses to educate employees to become better healthcare consumers. 
  • Optum360: Examine opportunities across the revenue cycle to increase margins and prepare for value-based reimbursement. Offers: 
    •  A patient financial experience that places them in the center of the revenue cycle. 
    •  A/R recovery and denial management to improve payment recovery. 
    •  Claims integrity and processing for quick and efficient claims and reimbursement. 
    •  Document and coding to help staff drive financial results proactively. 
  • Risk and Quality Solutions: Driven from the largest Medicare Advantage database in the industry. 
    • Retrospective Solutions: Improves accuracy and completeness with industry analytics. 
    • Prospective Solutions: Standardizes processes on behalf of multiple payers for better patient treatment. 
    • Improving Outcomes: Drives outcomes while reducing costs with people, technology and clinical insights. 

    Limitations

    User feedback at the time of this review indicates that some of the product limitations include:

    •  Not cost-effective for the features offered. 
    •  Runs slower for larger practices. 
    •  Lack of helpful customer support. 

    Suite Support

    mail_outlineEmail: [email protected].
    phonePhone: A list of phone numbers for support are available on the website.
    schoolTraining: Optum offers a training curriculum to help users get the most out of the software.
    local_offerTickets: Sign in to Optum online to submit help requests.

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All Medical Billing Services (56 found)

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DrChrono

by drchrono
DrChrono
DrChrono is a cloud-based EHR and medical billing solution that replaces the chaos of paper charts and separate systems with a single, easy-to-use platform for managing all aspects of a medical practice.For doctors, this means: Effortless Access to Patient Information: Imagine having a patient's medical history — allergies, medications, past visits — at your fingertips. Simplified Appointments and Prescriptions: Schedule appointments and send prescriptions electronically in just a few clicks.For patients, it means: Taking Control of Their Health: Book appointments, communicate with their doctor and access their own records through the patient portal. Staying on Track: Receive automated reminders for appointments and medication refills.And for the practice as a whole, the system helps: Get Paid Faster: Automate billing and insurance claims to reduce errors and speed up payments. Improve Financial Health: Track outstanding payments and identify potential billing issues. Negotiate Better Rates: Gain insights to negotiate more effectively with insurance companies.We tested the system to see how it works in real-world scenarios. Here’s what we think: while mastering the billing module may require some effort and billing data import has limitations, the system’s intuitive interface and accessibility from any device make it a user-friendly option.A free trial and flexible pricing plans allow you to explore its potential and determine the right fit for your practice.
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Buyer's Guide

Medical Billing Services Software Is All About Bridging Gaps Between Health Care Providers and Insurance Companies 

Medical Billing Services BG Intro

Submitting and verifying claims can be a daunting task. If not performed correctly, it can lead to billing errors. And one billing mistake not only frustrates patients but can also jeopardize your practice or medical billing company. We don't want customers to sue you for improper invoicing practices. Even if the error is unintentional, it can attract negative publicity, either for an in-house billing team or billing services company. On the other hand, to keep your clinic or business running, you need to generate revenue. In this complicated cycle, medical billing services software can be your knight in shining armor.

Fear has anchored its place in people's hearts due to the COVID-19 pandemic. A recent survey conducted by the Center for Medicaid and CHIP Services observed that adult Medicaid enrollment rose by 6.3 million people between February 2020 and January 2021. With more people filing for claims, managing them and generating a fair bill has become difficult. Medical billing services solutions help you take the stress out from these processes.

The purpose of this buyer's guide is to provide you with a detailed overview of things to look for while selecting a medical billing service platform.

Executive Summary

  • Medical billing services apps help you automate financial processes.
  • Factors such as integrative solutions, compliance levels, storage capabilities, compatibility and data security are all things you should consider while conducting software comparisons.
  • Major features to look for in medical billing services platforms are patient verification modules, claim scrubbing technology, denial management capabilities and payment tracking functionality.
  • The digital solution should be compliant with HIPAA and ICD standards.
  • Computer-assisted coding has made it possible to eliminate billing mistakes.

What This Guide Covers

What is Medical Billing Services Software?

Medical billing services solutions assist you in automating billing processes. From claim submissions to invoice generation, it handles tasks meticulously. They allow employees to pre-verify patients' insurance coverage, accurately code claims and generate denial reports in order to adhere to medical compliance regulations. You can integrate with existing EHR systems to avoid double entry mistakes. Along with that, they help deliver quality patient care by enabling patients to schedule appointments and pay bills digitally. With a digital solution at your fingertips, you can prevent negative cash flow.

Most of the billing solutions offer services like credentialing, insurance authorizations and contract negotiations. Whether you’re an in-house billing team for a health care organization or a third-party medical billing firm, these solutions help you streamline financial processes and achieve clean claim rates. They also send statements to patients in a timely manner for faster collections. This, in turn, enables you to reduce administrative burdens.

Medical billing applications allow you to submit and upload claims to clearinghouse systems from a single screen. You can also add notes to worklists and generate strategy reports to help rectify A/R issues. They enable you to monitor finances across the enterprise in real time. Incorporating technology into your operations can simplify tedious tasks.

Mistakes To Avoid While Selecting a Medical Billing Services Software

In life, we learn through experiences that it takes years to build trust and just seconds to destroy it. And blind trust is an age-old ruse. As a health care billing services company, it's up to you to gain the trust of medical organizations. You must prove that you have the skill set, diligence and supporting tools to provide clean claims submissions every time. Below we have listed some of the things you can avoid to ensure you don’t spend unnecessarily.

Don’t Judge a Book by Its Cover

Finding a perfect match (medical billing service software) isn’t a simple task. Just focusing on the benefits part and not thinking about potential issues can land us in trouble. That’s why we need to evaluate vendors’ customer support offerings, user reviews and reputation in the medical billing field and propensity for updating the platform.

Ignoring the Fine Print

Skimming through the contract is a bad decision. You can miss reading some really important terms. Carefully go through termination and service level agreement clauses. You can also hire an attorney to spot any potential issues in the contract. This way you keep yourself away from legal troubles.

Unwilling To Communicate With Other Medical Billing Professionals

If it’s too good to be true, it’s better to verify the information provided by vendors. And what better way to do that if not by contacting those billers who are already using the applications. Validate and compare vendor responses with our decision platform.

Compatible Platforms

An anonymous physician once said, "the best medicine is love." Love can survive without compatibility because some partners believe in the idea of being imperfectly perfect together. Wish we could say the same about medical billing services products too. There is no room for imperfections when it comes to billing applications. For the system to suffice your organizational needs, it should be compatible with your devices. Medical billing services products are primarily compatible with:

  • iOS devices
  • Windows
  • Linux

Check your operating system before finalizing a product to help avoid unnecessary expenses.

Medical Billing Regulations

People have come across a lot of news about health care providers performing upcoding and unbundling practices. They are also well-informed about the lawsuits patients file regarding billing errors. Therefore, people have almost lost their faith in medical professionals. We can't blame them, can we? Trust is a two-way street. Blocking the path will end up hurting patients, causing them to retaliate. We don't want to do that for sure!

Medical Billing Services Regulations

Even unintentional errors can cause trouble for your health care practice or medical billing services company. We care about you! That's why we have listed specific laws you should know to avoid legal disputes.

Health Insurance Portability and Accountability Act (HIPAA)

In 1996, President Bill Clinton implemented HIPAA to safeguard patients' information. According to this act, you need to submit claims electronically using ASC X12 005010 format. This format is widely known as "HIPAA 5010." It helps store confidential data securely. You also need to comply with physical, administrative and technical security rules.

  • Physical Safeguards: You need to set alarm systems or digital locks to protect patients' health files.
  • Administrative Safeguards: Ensure that employees are well-versed in safety policies and procedures to execute security measures effectively.
  • Technical Safeguards: Set up firewalls, encrypt files and conduct data backups to protect ePHI (electronic patient health information).

Fraud Claims Act

The Fraud Claims Act makes it a crime to file false claims, whether directly or through insurance. It prevents fraudulent activities like billing patients on false pretenses or charging them for unprovided services. Any violation of this act can cause fines and penalties up to $50,000.

No Surprises Act

Surprise billing is not a new concept in the health care industry. It snatches away the peace of mind that customers deserve, weighing them down with financial burdens. To tackle this, the Biden-Harris administration imposed the No Surprises Act. It prohibits patients from paying providers not included in their health plan network.

Most of the medical billing services products comply with these laws. They come with pre-populated codes and templates, saving you from court trials!

Deployment Methods

In this software selection journey, it's better to know the available deployment options. It helps in implementation processes. Below we have explained the pros and cons of cloud-based and on-premise deployment methods.

Cloud-Based

Cloud servers have gained popularity over the years. They aid medical practitioners in protecting private information securely.

Pros
  • Access files from multiple locations, any time.
  • Protect data leakages, ensuring data integrity.
  • Boost collaboration among employees using granular version controls.
  • Automatically update apps to the latest versions.
  • Perform data backups regularly.
Cons
  • It can be costly, depending on the services you opt for.
  • A bad network can result in performance degradation.
  • Vulnerability to cyber attacks.

On-Premise

On-premise solutions allow you to store documents on a specific infrastructure that you own.

Pros
  • Operate apps without an internet connection.
  • Protect data from third-party networks.
  • Upgrade software whenever you wish to.
Cons
  • Requires extra technicians.
  • Prone to data loss.
  • Doesn't offer scalable solutions.

Primary Benefits

You don’t want to lose your clients’ trust. Billing and claim errors can lead to loss of revenue for you and the healthcare organizations you serve. And repeated errors could mean loss of clientele. Pat Palmer, CEO and founder of Medical Billing Advocates of America, says that his organization finds errors in every three out of four statements while reviewing medical bills. With the right medical billing services system, you can avoid these things. Below we have outlined some of the benefits you can expect from medical billing services software.

Benefits of Medical Billing Services

Eliminate Billing Errors

The right platforms will ensure that claims get submitted accurately and in a timely manner. You can assign tasks to medical coders to resolve coding errors. It also helps you reduce denials and maximize reimbursements.

Boost Cash Flow

A happy client means repeat business. If you charge by percentage for your services, it’s in your interest, as much as your client’s, to get the highest return on claims. With the right medical billing platforms, you can eliminate coding errors using pre-populated coding technology. This prevents negative cash flow and keeps your company running.

Ensure Billing Compliance

Securing patient data is crucial. Violating medical regulations is punishable by law. Medical billing applications help you stay updated about current compliance rules and keep your data confidential.

Reduce Administrative Burden

Manually verifying claims is a tedious task. Lengthy claim submission processes can tire your employees. A digital solution helps your team members relieve stress as well as boost productivity. It can help your workers solve insurance conflicts quickly.

Secure Patient Data

Data breaches might shut your business down. It shows that you don't value patients' confidentiality. The perfect medical billing applications will be HIPAA compliant, ensuring data security. You can also store data on a secure cloud server and access them from a remote location.

Implementation Goals

Goal 1

Bid Farewell to Paper Records

It's decision time! Do you want your data to get misplaced or promote an environmentally unfriendly practice using paper records? EHR integration allows you to access files digitally, ensuring data security. It also makes it possible for you to retrieve information at your fingertips. So, why not make society paperless and reduce carbon footprints?

Goal 2

Automate Processes

Manually storing and analyzing data can invite errors. You might miss copying an element from a code. Going digital can resolve these issues. According to a survey conducted by BDO in January 2021, 93% of health care providers have a digital transitioning strategy or are in the process of creating one. So, let's step into a world of automation.

Goal 3

Boost Productivity

Staff can get irritated by constantly transferring information from one department to another. Cloud-based software enables employees to save data in an accessible location, resulting in high levels of productivity.

Goal 4

Maximize Reimbursements

Billers, as well as coders, play a significant role in providing high-quality patient care. An electronic solution can help you generate precise bills and maximize reimbursements to protect patients from paying extra. It also helps spot coding errors with clearing house integration to ensure your clients and company receive maximum returns.

Basic Features & Functionality

Claim Scrubber

Has your medical coding gone wrong? Claim scrubbing functionality can fix that for you. It assists you in finding coding errors to help generate accurate bills. Assign tasks to coders to resolve issues. Medical billing services platforms are HIPAA compliant, protecting patients' confidential information. You can inspect and edit claims according to CCI and LCD standards. It helps reduce denials and track appeals. Create worklists to store flagged claims.

Eligibility Checker

Most claims get denied due to failure to collect accurate patient information. Medical billing services software helps you verify data using a remote transaction server, allowing you to determine claim coverage through online access. Along with that, you can identify patients' insurance plans. Automatically send reminders to patients via email, text or voice messages.

Electronic Claim Submission

You don't have to file claims manually anymore. You can submit claims electronically by using medical billing services solutions. You can track claim statuses to avoid missing out on deadlines. Generate 837 files and HIPAA-compliant-formatted documents used for transmitting health care claims and upload them to clearinghouse systems.

Remittance and Payment Management

Receive 835 files (electronic remittance advice) directly from your practice’s PM system to update all payment-related information. You can also determine the reasons for claim denials or adjustments.

Denial Management

There are times when insurance companies deny claims. In such cases, you need to be aware of reworking deadlines. With medical billing solutions, you can review codes and decide whether to resubmit claims or bill patients. You can face claim rejections due to a lack of medical data. It could also happen if patients' insurance plans don't cover particular expenses.

A/R Control Center

Create custom worklists to balance pending accounts and filter them based on their priority statuses. You can also track outstanding payments and add notes to them to speed up payment processes. Along with that, generate customized summary and strategy reports to resolve A/R issues. Review, edit and print collection letters as needed.

Charge Capture

Store data about services provided by health care professionals to avoid missing out on essential details. Assign codes such as ICD-10 diagnosis, CPT, service or facility to claims to help speed up work processes.

EHR Integration

Automatically receive data and copay charges from your client’s EHR system to update patient data. You can also color-code schedules and prioritize tasks in real time. Become a MACRA participant to streamline payment processes. Create patient cards to manage and access clinical documentation quickly.

Payer Adjudication

Claim review processes can be longer than you expected. Automatically pull data from the clearinghouse system to check whether your claims were accepted or rejected. Respond to RFIs indicated in 277 files by the reviewer. You must track claim statuses to know the percentage of accepted and rejected claims to help improve claim filing processes.

Clearinghouse Edits

Assure integrity of claims by uploading them into a clearinghouse system before sending them to payers. You can prevent denials and correct errors before it invites trouble. Handle clearinghouse rejections within 24 hours to avoid losing claims.

Cloud-Based

Bid farewell to paper records and store files in a secure, centralized database. Receive alerts when a patient is admitted or discharged from an ER through HIEs (health information exchange). Manage and generate bills for providers by logging into the database.

Advanced Features & Functionality

Payment Processing

Create customized plan groups to build payment plan statements. You can also attach notes and preview them before processing. Post payments to claims using automated ERA processing functionality with just a click. View billing summaries and print statements simultaneously from a single screen.

Reporting

With medical billing services applications, you can generate ad hoc or automated reports. These reports not only help you measure financial performance but also improve administrative efficiency.

Dashboards

Create custom workflows and monitor key performance indicators. You can also schedule appointments, access patient records, track payments and print reports without having to browse through a mountain of files.

Mobile App

Manage and access information in real time using internet-enabled devices. Stay updated about claim statuses and deadlines on the go.

Medical Scheduling

Automatically send reminders to patients to reduce late arrivals. You can switch to snapshot view to see appointment counts. Set recurring appointments to help save time.

Current & Upcoming Trends

The COVID-19 pandemic has shifted health care dimensions completely. The chaotic global pandemic gave rise to technological advancements and pushed the world to switch to digital solutions.

Medical Billing Services Current Trends

Blockchain Technology

Blockchain has positively impacted not only medical billing but also other industries with its robust ledger distribution solutions. According to a recent study conducted by Markets and Markets, blockchain technology is estimated to reach $67.4 billion by 2026. Billing processes are complex in nature and can result in coding errors, incorrect claim filings and duplicate data entries.

With blockchain technology, you can eliminate these challenges. It helps you share confidential information within networked databases. You can store files about executed transactions maintaining data integrity. Its algorithms are designed to save you from data breaches or threats. Only people with authorized access can modify data attributes.

Computer-Assisted Coding

Medical coding is a significant part of billing processes. And it's not possible to memorize each and every code. Thanks to technological advances, we don't have to! CAC (computer-assisted coding) can walk you through financial health care, EHR and transcription systems quickly. It uses natural language processing (NLP) technology to interpret unstructured data using algorithms by embedding codes into files accurately. You can distribute clinical documents in HL7, FHIR or XML interface formats.

Though CAC is a digital system, it requires trained operators to perform processing actions. The U.S Department of Labor forecasts that the employment rate for health care technicians will grow by 15% through 2024. Therefore, digitized systems don't hamper employment opportunities. They make employees tech-savvy, enhancing their knowledge and skills.

Virtual Care

The world continues to fight against one of the worst virus outbreaks (COVID-19). For that reason, it became vital for healthcare industries to adopt digital innovations to deliver high-quality care. Virtual care enables patients to schedule and attend appointments from the comfort of their homes. Along with that, it reduces virus exposure and promotes a contactless future.

People use the terms telehealth and virtual care interchangeably to describe remote health care services. But they differ in some aspects. Telehealth software integrates ICTs (information and communication technologies). It increases access to specialists located far away. Virtual care is a component of telehealth. It is how medical professionals exchange information with patients remotely using smartphones or other mobile devices.

Communication technologies have made it possible for doctors or clinicians to provide the correct diagnosis, monitor patients' vitals and prepare treatment plans in real time. Consumer Technology Association observed that patient outcomes enhance by 49% after using RPM (remote patient monitoring) technology. RPM not only reduces clinical or hospital visits but also helps improve patients' engagement levels. Adam Pellegrini, CEO of Jasper Health, says, "Consumers have shown that they're willing to adopt new ways to take care of their health. That's a win for them and the system."

The Advent of ICD-11

ICD-11 is the recent version of International Classification Diseases approved by the World Health Assembly in May 2019. It will be implemented as the official reporting system by the member states from January 1, 2022. It is a fully electronic version including a reference guide, browser and coding tool. It also includes 55,000 codes assigned for injuries, causes of death and diseases.

ICD-11 has outlined significant sexual and mental health chapters, HIV therapy, gaming, and prolonged grief disorder. You can also request to translate certain documents into your native language.

Artificial Intelligence

Artificial intelligence has transformed healthcare industries radically. It not only helps you access diagnostic resources but also improves billing processes. It’s impossible for you to memorize all medical codes. Miscalculations can negatively impact your business. AI makes your job easier by automating coding operations. It recognizes repeated patterns, making it possible for you to predict outcomes like claim denials or coding errors.

You can automatically translate notes into medical codes by using natural language processing. AI also eases transitions when ICD codes are updated. AI integrated software doesn’t replace medical coders or billers. It aids them in performing their jobs accurately. The U.S. Bureau of Labor Statistics projects that medical coding jobs will grow by 9% between 2020 to 2030. AI runs audits in real time, helping you detect and resolve issues quickly.

Software Comparison Strategy

There are certain things, including integrative solutions, compliance levels, compatible platforms, data security and storage capabilities, that you should consider while comparing software.

  • Integrations simplify your workflows. You don't have to worry about data entry mistakes either. For that reason, we suggest that you look for products that offer integrations with EMR/EHR software, ensuring smooth billing processes by connecting you to your clients.
  • The system must be compliant with HIPAA and ICD standards. You don't want to spend time manually assessing and revising claims with current medical compliance laws. Instead, you can focus on other essential administrative tasks.
  • The solution should be compatible with the devices you own. Most apps are compatible with Linux, Windows and iOS platforms. Research thoroughly to avoid spending on non-compatible products.
  • Disclosing patients' information is a HIPAA violation. Data security should be the top priority. That's why you need a product that can secure data using E2EE (end-to-end encryption).
  • You receive a lot of claim submissions in a day. For that reason, you need platforms that offer unlimited storage capabilities. You can also store data on cloud servers, preventing your system from lagging.

Cost & Pricing Considerations

A penny saved is a penny earned. You don't want to overspend on products that don't match your company's goals. We know how crucial it is to maintain financial viability. That's why we have highlighted a few aspects that you should consider before finalizing your digital application.

The cost of the product depends upon the size of your enterprise and your preferred deployment method. Usually, on-premise billing solutions cost up to $10,000 per month, including ethernet charges, maintenance services, licenses, and computer servers. Cloud-based products cost around $100 - $500 per month per user.

Vendors offer support options via text, email or phone. Some come at an extra cost while few are free. Several providers allow you to submit support tickets through websites. So, it's essential to cross-check if you need to pay additional fees to access those services.

Training materials are often available on a vendor's website. However, some providers might charge you to access it. These contain supplementary courses that give you a detailed overview of the platform.

Some billing apps offer integrations with your existing systems. It might come at an extra cost. You should prepare a requirements checklist including supplementary features you want to add to your current systems.

After considering these factors, talk to other professionals to gain insights about the market's leading medical billing services apps.

Best Medical Billing Services Software

Searching for the right solution can be daunting. No need to worry because we are here to help you throughout the process. Below we have listed some of the medical billing software that will help you automate processes and save time. These solutions are the best medical billing products for health care organizations and not strictly billing services companies.

DrChrono

Compatible with iPhone and iPad devices, DrChrono allows medical practitioners and health care providers to simplify billing processes and effectively manage patients. It offers a team of CPC/CPC-H certified medical billers who help you improve your practice’s profitability and shift your focus from billing to delivering value-based care. The experts review and resubmit claims within 48 hours. They also monitor denials for trends, helping you achieve a clean claim rate. Furthermore, they send patients statements in a timely manner.

The vendor provides services like contract negotiations, re-credentialing, malpractice application submission and network participation to cut down credentialing expenses. You can access the reporting center to gain financial insights. The in-house compliance officer reviews all clinical documentation, saving your practice from legal troubles. Collect patient information using customizable or pre-built forms. Access dashboards to track claim statuses.

You can conduct real time eligibility checks to identify patients' insurance coverage. Annotate on x-rays, diagrams, charts or other files using free drawing functionality. Integrate with Box (HIPAA compliant cloud storage system) to collect and store patients' information securely. You can avoid billing errors by accessing pre-populated medical codes.

DrChrono

Assign and filter tasks using scheduling modules.

CureMD

CureMD provides billing services consisting of a dedicated patient portal, vaccine management system and payment processing, claim scrubbing and appointment scheduling modules. The vendor offers a team of professional billers, helping you eliminate revenue leakages. In the case of denials, the experts add new information into the rules engine, preventing you from making the same mistakes.

You can integrate your existing EHR software to avoid losing essential patient data. It helps streamline financial operations and increase profits. You can also track claim statuses using dashboards.

Stay clear of fines and secure sensitive patient information by complying with MACRA, MIPS and HIPAA standards. Allow patients to check in using mobile devices to lighten the burden on front desk staff. Caters to small and mid-sized medical practices.

CureMD

Access financial overview tab to view statements.

Kareo Billing

Kareo Billing offers a cloud-based solution that focuses on streamlining and optimizing billing operations. The vendor provides a team of medical billing experts, helping you speed up collection processes. You can reduce A/R delays and administrative overhead, eliminate missing charges and gain profits by automating revenue and coding tasks. Generate patient statements, including outstanding balances, to improve payment experiences.

The provider offers a secure messaging platform, helping medical billers and practices communicate effectively. You can build your company’s credibility and increase brand identity with practices by adding the organization’s logo to the platform. The dashboard allows you to view information of all providers and practices to gain better data visibility.

You can submit and process claims electronically, helping you make informed and financial decisions regarding patient care. Furthermore, you can verify patients' insurance plans to simplify claim reviewing tasks.

Kareo Billing

Sort claims using insurance collection tab.

CareCloud Central

CareCloud Central offers an integrated suite that includes medical billing, EHR, practice management, reporting and analytics, and telemedicine modules. It allows you to automate workflows, helping speed up daily operations. The provider offers patient engagement tools, optimizing patient experiences.

The experts help you reduce administrative burdens and boost productivity. The vendor claims to reduce A/R delays by 33%. They also print and send patient statements on your behalf, enabling you to deliver high-quality care. The dedicated account managers keep your organization current with regulatory changes like ICD-11 or MACRA.

Medical billers can take care of labor-intensive tasks like credentialing, payer negotiations and benefits verification. It also enables you to manage and monitor activities and verify patients' insurance eligibility using dashboards. Identify coding mistakes through clearinghouse edits, ensuring error-free claim submissions.

You can send appointment reminders to patients via text or email. Allow patients to submit intake and consent forms through the patient portal. Automatically transfer forms data into charts for quick access.

CareCloud Central

View patients' information using dashboards.

eClinicalWorks

eClinicalWorks provides practice management solutions including medical billing, claim scrubbing, appointment scheduling and revenue management functionalities. A team of billing experts helps you maximize reimbursement with a rules engine, clearinghouse integration and canned reports packages.

Medical billing companies can filter claims and communicate with practices using RCM Console. Dashboards assist you in comparing data and gathering valuable insights to help make better decisions. Produce and send self-pay e-statements to mailing services to increase collections.

Allow patients to make payments electronically. Store patient information on a cloud-based secure server and access them through any internet-supported mobile device. Serves single and multi-specialty practices.

eClinicalWorks

Monitor patient vitals using patient engagement tools

 

 

Questions to Ask Yourself

Before you make a final decision, it’s important to ask internal questions to know whether or not the software will best fit your company’s business model. Here are some questions that you can include in your checklists for starters.

Medical Billing Services Key Questions To Ask

  • Do I need a scalable solution?
  • What are the benefits of switching to a digital solution?
  • Can I access and process claims in real time?
  • Can I trust the software in terms of reliability?
  • Do I need medical coding assistance?
  • Do I need a payment processing app?

Questions to Ask Vendors

Use these questions as a starting point for conversations with vendors:

About the Software

  • Does the software offer reporting functionalities?
  • Does the software provide access to unlimited users?
  • Is the program easy to adapt?
  • What level of data encryption does the solution entail?
  • Is the product HIPAA-compliant?

About the Vendor

  • What support options are available?
  • Does the vendor offer a dedicated knowledge base or training materials?
  • Does the vendor have a reasonable satisfaction rate?
  • How does the vendor handle updates?
  • How many years of experience does the vendor possess in this field?

In Conclusion

If your goal is to simplify claim submissions and generate profits, then medical billing services software is your best bet. It not only streamlines coding processes but also manages denials effectively. You can access all financial information from a centralized database.

Health care dimensions are constantly shifting due to technological innovations. Jonathan Mayhew, Executive Vice President of Transformation at CSV Health, says, "We are seeing health care paradigms shift all around us. Understanding the shift in consumer experience and charting how it can lead to better care will be the big challenge of the decade ahead."

We designed this guide to assist you in your software selection journey. Hope we were able to help!

Product Comparisons

Additional Resources

About The Contributors

The following expert team members are responsible for creating, reviewing, and fact checking the accuracy of this content.

Technical Content Writer
Riya is a Technical Content Writer at SelectHub. She writes content for our construction scheduling and bidding, CMMS and medical billing categories. She's also a part of the social media team where she crafts posts that engage and resonate with our audience. Riya holds a Graduate Degree in Journalism and Mass Communication from Lovely Professional University, Punjab, India. Fueled by a love for black coffee, her day begins and ends with its energizing ritual. Riya enjoys a variety of TV series, including Friends, Suits, American Horror Story, and How to Get Away with Murder. During her free time, you'll find her reading or spending time with her close ones. She believes in magic and is waiting for that day when reality compromises and fairytale swirls around with a smile.
Technical Research By Dhanasri Yasam
Senior Analyst
As a Senior Research Analyst, Dhanasri Yasam works in key categories like EHR, EMR, business intelligence and HR. In her role, she conducts primary research, collects and analyzes empirical data, and draws evidence-based conclusions. She also has extensive experience gathering requirements for client projects. Dhanasri holds a B-tech in Computer Science and Engineering from Dr. M.G.R. Educational and Research Institute, Chennai and an MBA in Finance and Marketing from Aurora's Business School, Hyderabad.
Technical Review By Manan Roy
Principal Analyst
Manan is a native of Tezpur, Assam (India), who currently lives in Kolkata, West Bengal (India). At SelectHub, he works on categories like CRM, HR, PPM, BI, and EHR. He has a Bachelor of Technology in CSE from The Gandhi Institute of Engineering and Technology, a Master of Technology from The Institute of Engineering and Management IT, and an MBA in Finance from St. Xavier's College. He's published two research papers, one in a conference and the other in a journal, during his Master of Technology.
Edited By Ryan McElroy
Content Editor
Ryan McElroy is a Content Editor and Senior Market Analyst at SelectHub who writes and edits content on various software types, along with their broader concepts and the industries they serve, including medical, construction, CMMS, supply chain management and legal. He studied at the University of Missouri (Mizzou) and earned his BA in Journalism in 2016. During his free time, you’ll find Ryan playing video/card/board games, sipping coffee and reading speculative fiction, or listening to music his loved ones often describe as “headache-inducing.”