18 Best Medical Billing Services Reviewed for 2024
10 Best Medical Billing Services Shortlist
Here's my pick of the 10 best software from the 18 tools reviewed.
Our one-on-one guidance will help you find the perfect fit.
I know firsthand the many challenges that come with managing a medical practice. The endless stream of paperwork, coding confusion, and financial tracking can feel like a juggling act that takes away from what we all know really matters most: patient care. That's where medical billing services step in.
With a solid medical billing service, you're not just outsourcing and simplifying your daily operations, but also maximizing your practice's profitability. These services work tirelessly to reduce errors, speed up the billing cycle, and ensure you get paid faster and more accurately.
Check out the best and most cost-effective medical billing services I've evaluated and reviewed below.
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What Are Medical Billing Services?
Medical billing services are full service back-office platforms that manage and streamline the complex process of patient billing for healthcare providers. They cater to a broad spectrum of users, from small practices and solo physicians to large hospitals and health systems.
Their main goal is to handle end to end, the medical billing process, from invoicing and coding to claim filing, payment collection, payment posting, accounts receivable and even patient statements. This type of healthcare reimbursement specialist ensures that claims are processed efficiently, optimizing your practice’s cash flow.
Best Medical Billing Services Summary
| Tools | Price | |
|---|---|---|
| RXNT | From $110/month/provider | Website |
| athenahealth | Pricing upon request | Website |
| CareCloud | Pricing upon request | Website |
| Conifer Health | Pricing upon request | Website |
| CodaMetrix | Pricing upon request | Website |
| ChartLogic | Pricing upon request | Website |
| AltuMED | Pricing upon request | Website |
| Change Healthcare | Pricing upon request | Website |
| TruBridge | Pricing upon request | Website |
| CureMD | Pricing upon request | Website |
Compare Software Specs Side by Side
Use our comparison chart to review and evaluate software specs side-by-side.
Compare SoftwareBest Medical Billing Services Reviews
RXNT is a cloud-based integrated healthcare software solution that offers a comprehensive suite of tools designed to streamline healthcare practices, including the billing process. Its user-friendly, cloud-based platform allows for electronic claim submissions, tracking, and management of patient information, which can significantly reduce administrative burdens.
Why I Picked RXNT: RXNT stands out as a top choice for medical billing services due to its comprehensive and user-friendly features, including its centralized billing office (CBO) reporting, which is included at no additional cost. This feature allows users to stay on top of revenue flow, track client productivity, and reduce monthly write-offs, thereby improving overall financial management. Additionally, RXNT's integrated clearinghouse eliminates the need for separate claim uploads and status checks, streamlining the claims management process from charge capture to reimbursement.
Standout features and integrations:
Key features include electronic health records (EHR), electronic prescribing (eRX), telehealth, and practice management. It also offers patient engagement tools to improve communication with patients, including reminders and educational resources, and an intuitive scheduling system that helps manage appointments effectively. RXNT also integrates well with tools such as EMSOW, OneMD, Hospice Tools, and Exym.
athenahealth is a health technology services provider that offers a suite of solutions focusing on streamlining patient engagement and collections. It’s designed to increase efficiency in healthcare practices, allowing more focus on patient care. This strategic balance of patient engagement and financial management makes athenahealth the best choice for practices seeking to optimize both.
Why I Picked athenahealth:
I chose athenahealth for this list due to its dual focus on patient engagement and efficient collections. Its ability to balance these two crucial aspects of healthcare management distinguishes it from other options. I determined that athenahealth would be best for practices looking for a tool that optimizes both patient interaction and revenue flow.
Standout features and integrations:
athenahealth's primary features include electronic health records (EHR), medical billing, patient engagement, and telehealth capabilities. The platform also excels in its robust analytics that provide insights to improve practice performance. athenahealth integrates seamlessly with numerous other health systems, enabling an uninterrupted flow of information that is crucial in modern healthcare delivery.
CareCloud offers an innovative solution to medical practice management with its cloud-based system. Its customizable options make it adaptable to various healthcare practices, reinforcing its position as an optimal choice for those looking for a flexible solution.
Why I Picked CareCloud:
CareCloud appealed to me due to its cloud-based architecture, which allows for more flexibility and accessibility for different practices. Its customizable nature lets it cater to diverse needs, making it unique in the market. It's because of these features that I find CareCloud best suited for those needing cloud-based, customizable practice management.
Standout features and integrations:
Key features of CareCloud include real-time analytics, automated reminders, and patient portal integration, which enhances patient engagement. It also provides electronic health record capabilities and seamless scheduling. CareCloud integrates well with EHR systems, billing systems, and laboratory services, among others, to ensure a comprehensive service.
Conifer Health is a healthcare solutions platform that excels in revenue cycle management, focusing on a patient-centric approach. Their services help healthcare organizations optimize financial performance while keeping patient care at the forefront. This direct emphasis on patient engagement in revenue management makes it the top choice for patient-centric revenue cycle management.
Why I Picked Conifer Health:
I selected Conifer Health for this list primarily because of its unique focus on patient-centered revenue cycle management. It stands out for combining financial optimization with an emphasis on patient care, leading me to judge it as best for a use case where patient engagement in revenue management is vital.
Standout features and integrations:
Conifer Health's standout features include revenue cycle management, patient communication, and health administration solutions. They have a well-designed patient portal that facilitates communication between healthcare providers and patients. Notably, it integrates with multiple health record systems, allowing data to flow across platforms to support revenue management effectively.
Codametrix utilizes advanced artificial intelligence to revolutionize medical coding and billing processes. With an AI-driven approach, Codametrix offers an efficient, reliable, and more accurate alternative to traditional manual methods, fitting perfectly for practices looking to optimize their billing process.
Why I Picked Codametrix:
I chose Codametrix for its forward-thinking approach to medical billing. The application of AI to coding and billing addresses common issues such as errors and inefficiencies found in manual methods. Therefore, I believe Codametrix is best for practices seeking to optimize their billing process using AI technology.
Standout features and integrations:
Codametrix's AI-powered coding and billing system stands out for its ability to quickly and accurately process medical bills. The platform uses machine learning to improve accuracy over time, meaning it's constantly learning and evolving. The software also integrates well with a variety of EHR systems, providing a streamlined solution for practices of all sizes.
ChartLogic serves as a robust medical billing service, emphasizing its user-friendly approach to Electronic Medical Records (EMR) integration. Its seamless navigation design and efficient EMR system affirm its suitability for practices seeking simplicity in managing health records.
Why I Picked ChartLogic:
In selecting ChartLogic, I was drawn to its strong emphasis on user-friendly electronic medical records integration. With EMR becoming an integral part of modern medical practice, a system that makes its use easier stands out. Thus, I believe ChartLogic fits the bill for practices that desire easy-to-use EMR integration.
Standout features and integrations:
ChartLogic excels with features such as instant medical billing, EMR/EHR integration, and detailed financial reporting. Moreover, its practice management module ensures smooth workflow management. It integrates effectively with laboratory systems, radiology services, and even pharmacy services, offering a complete suite for practice management.
AltuMED is a healthcare revenue cycle management solution that specializes in robust medical billing management. Their focus is on reducing costs and increasing revenue for healthcare providers by optimizing the billing process, making them an ideal choice for practices looking for comprehensive managed medical billing solutions.
Why I Picked AltuMED:
I selected AltuMED for this list because of its comprehensive and specialized focus on managed medical billing. Compared to other platforms, it offers a more dedicated solution for this aspect of healthcare management. I judged it as the best tool for healthcare providers needing a robust and dedicated billing management solution.
Standout features and integrations:
Key features of AltuMED include end-to-end medical billing management, revenue cycle management, and compliance adherence. These features are critical for ensuring financial stability and regulatory compliance in a healthcare setting. AltuMED also integrates well with a variety of electronic health records (EHR) systems, which aids in creating a cohesive workflow.
Change Healthcare is a robust platform that offers a suite of solutions to manage various aspects of healthcare systems, from revenue cycle management to patient engagement. Their comprehensive approach makes them ideal for healthcare organizations seeking a one-stop-shop for their system needs.
Why I Picked Change Healthcare:
When selecting tools for this list, Change Healthcare's holistic approach made it stand out. I chose it because it offers diverse yet integrated solutions, which are designed to streamline operations and improve patient care in healthcare settings. I determined that it fits best for those seeking comprehensive healthcare system support.
Standout features and integrations:
Change Healthcare's suite of solutions includes key features like medical billing, clinical data exchange, payment integrity, and patient engagement. These features collectively help in simplifying complex processes and improve overall productivity. It also integrates well with various EHR systems, providing a more seamless workflow.
TruBridge is a comprehensive healthcare business management solution that includes a particularly strong focus on medical coding services. It's designed to provide accurate and efficient medical coding to ensure healthcare providers receive appropriate reimbursement, making it an excellent choice for those prioritizing efficient coding services.
Why I Picked TruBridge:
In considering various tools, TruBridge stood out to me due to its dedication to enhancing efficiency and accuracy in medical coding. The platform’s emphasis on helping healthcare providers attain correct reimbursement reflects its utility in this sphere. I determined it to be the best for healthcare providers who prioritize efficient and precise medical coding services.
Standout features and integrations:
TruBridge's key features include its dedicated medical coding services, financial management, and patient engagement tools. These features are crucial in ensuring efficient operations and optimizing revenue collection in a healthcare setting. Furthermore, TruBridge is capable of integrating with various electronic health record systems, aiding in smooth operational flow.
CureMD's medical billing services aim to make the billing process more efficient for healthcare practices. It offers integrated EHR and Practice Management (PM) services, denial management, streamlining the billing process while maintaining an organized patient health record system.
Why I Picked CureMD:
I chose CureMD because of its dual capabilities in Electronic Health Record (EHR) and Practice Management (PM) services. Many services specialize in one or the other, but CureMD excels in both. Its comprehensive approach makes it ideal for practices seeking to improve efficiency in billing as well as patient health record management. Therefore, CureMD stands out as the best choice for integrated EHR and PM services.
Standout features and integrations:
CureMD's standout features include real-time insurance eligibility verification, charge capture, claim submission, and an integrated clearinghouse. Its EHR feature provides comprehensive patient health records, ensuring no details get lost in the shuffle. The service also integrates seamlessly with lab and radiology information systems, pharmacies, and health information exchanges, enhancing the functionality and versatility of the practice.
Other Medical Billing Services
Below is a list of additional medical billing services that we shortlisted, but did not make it to the top 10. Definitely worth checking them out.
- WRSHealth
Best for specialized practice solutions
- Kareo
Best for managing multiple practices and care providers
- DrChrono
Best for telehealth integration
- Vecna
Best mobile check-in and self-service kiosks
- Workbox
Best for therapists
- LMC Practice Management
Best ophthalmology RCM services
- Zotec Partners
Best for data-driven innovation
- Rivet
Best claim denial management tools
How I Picked The Best Medical Billing Services
In this article, we offer an understanding of medical billing and coding to help you choose the right service.
Selecting medical billing services involves evaluating functionality and meeting specific use cases that matter most when choosing this type of software. I have personally tried and researched these tools; here's how I evaluate them:
Core Medical Billing Services Functionality - 25% of total weighting score:
- Claim submission and tracking
- Patient billing and invoicing
- Insurance verification
- Payment processing
- Reporting and analytics
- Integration with medical billing codes
Additional Standout Features - 25% of total weighting score:
- AI-driven claim scrubbing
- Real-time eligibility checks
- Customizable reporting dashboards
- Integration with EHR/EMR systems
- Mobile access for on-the-go billing
Usability - 10% of total weighting score:
- Intuitive user interface
- Drag-and-drop functionality for claim management
- Customizable workflows
- Easy navigation and search capabilities
- Minimal clicks to complete tasks
Onboarding - 10% of total weighting score:
- Availability of training videos
- Interactive product tours
- Chatbots for instant support
- Webinars for in-depth training
- Pre-built templates for quick setup
Customer Support - 10% of total weighting score:
- 24/7 support availability
- Multiple support channels (phone, email, chat)
- Dedicated account managers
- Comprehensive knowledge base
- Fast response times
Value For Money - 10% of total weighting score:
- Transparent pricing models
- Competitive pricing compared to similar tools
- Flexible subscription plans
- Discounts for long-term commitments
- ROI potential based on feature set
Customer Reviews - 10% of total weighting score:
- Overall satisfaction ratings
- Specific feedback on ease of use
- Comments on customer support quality
- User testimonials on feature effectiveness
- Frequency of updates and improvements
Key Features Of Medical Billing Services
Specialty-Specific Billing: Specialty-specific billing refers to tailoring billing practices to meet the unique needs of various medical specialties, such as cardiology, dermatology, or orthopedics. It involves using precise codes and industry knowledge to accurately capture services and procedures, reducing claim rejections.
Medical Coding Services: Medical coding services involve translating healthcare diagnoses, treatments, and procedures into standardized codes like ICD-10, CPT, and HCPCS. Accurate coding is essential for correct billing, ensuring that providers are reimbursed appropriately by insurance companies.
Credentialing Services: Credentialing services validate the qualifications, licenses, and certifications of healthcare providers to ensure compliance with medical standards. This process is vital for providers to participate in insurance networks and receive reimbursements.
KPI Dashboard and Reporting: KPI dashboards and reporting in medical billing services provide real-time visibility into key performance indicators like claim approval rates, denial rates, and revenue cycle efficiency. These tools allow healthcare organizations to track billing performance and identify areas needing improvement.
Transition Management: Transition management refers to the organized and strategic process of switching from one medical billing system to another. It involves data migration, staff training, and system testing to ensure a seamless transition without disrupting billing operations.
Claims Management: Claims management is a key feature in medical billing services as it helps healthcare providers streamline the insurance claims process. It enables users to submit claims, medical billers, medical claims, track their status, follow-up on denied or rejected claims, and ensure quick reimbursements.
Electronic Health Records (EHR) Integration: EHR integration allows the medical billing service to communicate with the health records system, sharing necessary patient data for billing purposes. This helps reduce manual data entry, minimizes errors, and improves data consistency across different platforms.
Patient Portals: Patient portals empower patients by giving them access to their personal health records, appointment scheduling, billing, and payment capabilities. This helps increase patient satisfaction and engagement while reducing the administrative burden on the healthcare provider’s end.
Automated Billing: Automated billing features allow for automatic generation and sending of patient invoices. This cuts down on manual administrative work, ensures timely billing, reduces the chances of errors, and ultimately, expedites the payment collection process.
Reporting and Analytics: This feature provides valuable insights into your practice’s financial health and the effectiveness of your billing processes. With reports and analytics, you can identify bottlenecks in your revenue cycle, monitor key performance indicators, and make data-driven decisions to improve profitability.
Compliance Management: Medical billing services should have robust compliance management features. Given the sensitive nature of patient data and the strict regulatory standards in healthcare, this feature helps ensure your practice stays compliant with HIPAA, ICD-10, and other necessary guidelines. This helps you avoid legal complications and maintain patient trust.
Coding Tools: Accurate medical coding is crucial for the correct processing of insurance claims. Advanced coding tools in medical billing services ensure your diagnoses and treatment procedures are properly coded, leading to fewer denials or rejections of insurance claims.
Payment Processing: A medical billing service should offer secure and convenient options for payment processing. This feature allows patients to pay their bills online using various payment methods, making the process easier for them and accelerating the collection process for you.
Insurance Eligibility Verification: This feature automatically checks a patient's insurance coverage before their visit. It reduces the chances of claim denials due to coverage issues and helps practices collect patient payments more efficiently.
Revenue Cycle Management: The Revenue Cycle Management (RCM) feature is essential as it manages the entire patient payment cycle - from appointment scheduling to payment collection. This feature ensures a smooth billing process, reduces delays, and improves cash flow in your practice.
Denial Management: Denial management is the process healthcare organizations use to identify, address, and prevent claim denials from insurance companies. It involves analyzing rejected claims, determining the reasons for denials, and taking corrective actions to resubmit claims accurately.
Benefits Of Medical Billing Services
Medical billing services offer a range of advantages for healthcare providers, from improving financial performance to enhancing patient care. Below are five primary benefits of medical billing services for users and organizations.
- Increased Revenue Outsourcing medical billing services can lead to increased revenue by optimizing claims processing and reducing the number of denied claims. This ensures that healthcare providers receive timely and accurate reimbursements, improving their overall financial health.
- Cost Savings By outsourcing medical billing, healthcare providers can save on the costs associated with maintaining an in-house billing team, such as salaries, benefits, and office supplies. This allows organizations to allocate resources more efficiently and reduce overhead expenses.
- Improved Accuracy Professional medical billing companies employ trained experts who are well-versed in the latest billing codes and regulations. This reduces the likelihood of billing errors, ensuring that claims are processed correctly and promptly, which in turn minimizes delays in payment.
- Enhanced Compliance Medical billing services ensure compliance with healthcare regulations such as HIPAA. By staying up-to-date with the latest legal requirements, these services help healthcare providers avoid costly penalties and maintain the integrity of their billing processes.
- Focus on Patient Care Outsourcing billing tasks allows healthcare providers to focus more on patient care rather than administrative duties. This leads to improved patient satisfaction as providers can dedicate more time and resources to delivering high-quality care.
By leveraging these services, providers can ensure accurate billing, reduce costs, and focus more on their primary goal of patient care. Understanding the types of billing solutions for healthcare will help you pick the right service for your practice.
Costs And Pricing Of Medical Billing Services
This section provides an estimate of average medical billing services plans and costs.
| Plan Type | Average Price | Common Features |
|---|---|---|
| Free Plan | $0 | Basic claim processing, limited customer support, up to 25 claims per month |
| Personal Plan | $200 - $300 per month | Claim processing, basic reporting, limited customer support, up to 100 claims |
| Business Plan | $800 - $3000 per month | Advanced reporting, dedicated account manager, unlimited claims, EHR integration |
| Enterprise Plan | $2500 - $6000+ per month | Comprehensive reporting, priority support, custom integrations, unlimited claims |
Frequently Asked Questions
Here are some FAQs about medical billing services.
In the context of medical field, what are credentialing services?
In the medical field, credentialing services involve verifying and validating healthcare providers’ qualifications, licenses, certifications, education, and professional background. These services ensure that doctors, nurses, and other medical professionals meet the required standards to provide care within a healthcare facility or participate in insurance networks.
Key aspects of credentialing services include:
- License Verification: Ensuring the provider has valid and up-to-date state medical licenses.
- Education and Training Validation: Confirming the provider’s educational background, residency, and fellowships.
- Work History: Reviewing employment history to verify past positions and professional experience.
- Malpractice and Disciplinary Record Checks: Checking for any malpractice claims or disciplinary actions.
- Insurance Network Participation: Credentialing is often required for providers to bill insurance companies and receive reimbursements.
These services are crucial for maintaining healthcare quality and compliance with regulatory standards.
How can an medical billing service or expert team help with denial management?
A medical billing service or expert team can significantly improve denial management by offering specialized skills and strategies, including:
- Identifying Denial Patterns: They analyze claim denial data to detect recurring issues and correct them proactively.
- Accurate Claim Submission: Experts ensure claims are submitted with the correct codes, documentation, and details, reducing the likelihood of errors.
- Efficient Appeals Process: The team handles the resubmission and appeal of denied claims promptly and effectively, increasing the chances of approval.
- Staying Updated on Regulations: Billing professionals stay current with changing insurance policies and compliance rules, helping to avoid denials due to outdated practices.
- Training and Support: They provide training to internal staff on best practices for reducing claim errors and managing denials in-house.
This ultimately boosts revenue cycle performance and reduces administrative burdens
What are the cheapest and most expensive Medical Billing Services?
The most affordable Medical Billing Services usually start around $100 per provider per month, while the most expensive ones can exceed $500 per provider per month. However, keep in mind that the quality of the service is more important than the cost.
How long does it take to transition to a new medical billing system?
Transitioning to a new medical billing system typically takes anywhere from 3 to 12 months, depending on several factors:
- System Complexity: More complex systems with extensive features or customization options take longer to implement.
- Data Migration: Transferring and validating large amounts of historical billing data can add time.
- Training Requirements: The time needed to train staff on the new system influences the transition period.
- Testing and Troubleshooting: Running test phases to ensure everything works properly can extend the timeline.
- Organizational Size: Larger organizations with multiple departments or facilities may require more time for full integration.
Planning and allowing for flexibility in the timeline is key to a smooth transition.
Is it better to have an in-house medical billing team or use a Medical Billing Service?
This decision depends on the size of your practice, your budget, and your administrative capacity. Small to medium-sized practices often benefit from using a Medical Billing Service as it reduces the need for in-house expertise, minimizes errors, and improves efficiency. However, larger practices with the budget and capacity may choose to keep it in-house for more control over the billing process.
How to change your medical billing system?
Efficient management of transitions between hospital billing systems involves several key strategies:
- Thorough Planning: Develop a detailed project plan, including timelines, task owners, and risk assessments.
- Cross-Department Collaboration: Involve all stakeholders, including IT, billing staff, and clinical teams, to ensure smooth integration.
- Staff Training: Provide comprehensive training on the new system to avoid disruptions.
- Data Migration Best Practices: Ensure accurate and secure migration of historical billing data.
- Test and Pilot: Run pilot programs and testing phases to identify issues before full implementation.
- Ongoing Support: Set up help desks and continuous support to assist staff post-transition.
- Monitor and Adapt: Track performance metrics and adjust processes as necessary to optimize workflow.
Do I need a dedicated account manager for my hospital billing systems?
Yes, having a dedicated account manager for your hospital billing systems can be highly beneficial. Here are a few reasons why:
- Focused Oversight: A dedicated account manager ensures continuous attention to billing operations, minimizing errors and delays.
- Quick Issue Resolution: They provide a direct point of contact for resolving system issues or addressing urgent needs.
- Customization and Optimization: An account manager can tailor system functionality to your hospital’s specific needs, improving efficiency.
- Vendor Communication: They act as a liaison between your hospital and the software provider, facilitating updates, support, and enhancements.
- Ongoing Training: The account manager can ensure staff are trained on system upgrades or changes, keeping processes smooth and consistent.
While not essential for every hospital, a dedicated account manager can significantly enhance system efficiency and billing accuracy. I also suggest medical billing and coding courses to enhance your practice’s financial management and streamline billing operations.
What is medical billing and coding?
Medical billing and coding is the process of translating healthcare services into codes and submitting claims for payment. Medical coders assign specific codes to every procedure, diagnosis, and treatment a patient receives. Medical billers then use these codes to create bills and send them to insurance companies to get reimbursed.
What are medical billing and coding deadlines by state?
Medical billing and coding deadlines vary by state, with most requiring claims to be submitted within 30-90 days of service. Specific deadlines depend on state regulations and payer contracts, so it’s important to check local rules for accuracy.
How much to charge as a medical billing specialist?
As a medical billing specialist, how much to charge depends on various factors like experience, location, and the complexity of services offered. Entry-level specialists may start at around $15-$20 per hour, while those with more experience or specialized skills can charge upwards of $25-$35 per hour. It’s essential to research local rates and industry standards to set competitive pricing. For more insights on compensation, check out this comprehensive guide on medical billing specialist salary.
Other Medical Software Solutions for You
If you are in the market for medical billing services, you might also appreciate these additional tools and services:
- Updated, new, or more advanced medical billing software might be what you need before you consider (and pay for) a switch to outsourcing services
- Medical collection services can be an option if you are struggling to get payment for services rendered
- If you are struggling with billing organization, you might also consider investing in new or better healthcare claims management tools
- You might consider outsourcing your revenue cycle management system, which can help if you run a small practice and aren't very "financials-minded"
The Takeaway
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