Recommendations: Sorts listings by the number of recommendations our advisors have made over the past 30 days. Our advisors assess buyers’ needs for free and only recommend products that meet buyers’ needs. Vendors pay Software Advice for these referrals. Reviews: Sorts listings by the number of user reviews we have published, greatest to least. Sponsored: Sorts listings by software vendors running active bidding campaigns, from the highest to lowest bid. Vendors who have paid for placement have a ‘Visit Website’ button, whereas unpaid vendors have a ‘Learn More’ button. Avg Rating: Sorts listings by overall star rating based on user reviews, highest to lowest. A to Z: Sorts listings by product name from A to Z.
CGM APRIMA, previously known as APRIMA EHR, is a market leading, award-winning EHR loved by physicians and office staff. Designed to take advantage of multiple hardware forms including the APRIMA Mobile app which is perfect for t...Read more
CollaborateMD is a medical billing and practice management solution that helps practices and billing services of all sizes automate and streamline billing and coding processes. The system was designed to be both comprehensive and ...Read more
PracticeAdmin is a cloud-based practice management and medical billing software solution, providing Software-as-a-Service (SaaS) to billing companies, specialty medical practices and other providers.
PracticeAdmin is designed...Read more
MedEZ is an electronic health record (EHR) and billing suite suitable for most medical facilities, particularly behavioral health centers and substance abuse rehabilitation programs. On-premise and cloud-based deployments are avai...Read more
athenahealth, recently ranked #1 by 2022 Best in KLAS for athenaClinials Ambulatory EMR for 11-75 physicians and athenaIDX practice management, provides cloud-based services for electronic health records (EHR), revenue cycle manag...Read more
ClinicalWorks, an electronic health record (EHR) and practice management solution, provides technology for every step of the patient care delivery process. Clinicians access features including patient engagement, Telehealth, custo...Read more
Harmony e/Notes is a hybrid integrated solution that offers functionalities for electronic medical records, practice management, billing and revenue cycle management. Specialities that the solution caters to include cardiology, ge...Read more
AllegianceMD is a cloud-based medical software system that is designed to serve the needs of small and midsize practices, as well as ambulatory surgery centers. The solution includes practice management functionality for billing a...Read more
Voted #1 by PCMag in 2019, WRS Health is a cloud-based integrated electronic health records (EHR) solution that offers practice management, revenue cycle management and billing services.
The solution includes modules for charting...Read more
Modernizing Medicine Gastroenterology offers gGastro EHR, a fully integrated platform designed for gastroenterologists. It combines the attributes of an electronic health records (EHR) system and endoscopy report writer (ERW) in o...Read more
NueMD offers a suite of cloud-based software and medical billing services for practices of all sizes. NueMD is an integrated practice management, medical billing, electronic health recording and appointment scheduling solution.
EZNotes is an on-premise documentation and billing solution designed for the chiropractic profession, which uses customizable prompting screens to generate SOAP notes, new patient consultations (case histories) treatment plans, or...Read more
MedicsPremier supports comprehensive financial/operational/workflow management and a nearly 100% success rate on first attempt HCFA/UB clearinghouse claims with a utility for workers compensation/no-fault claims/documentation.
Quest is a cloud-based claim filing and medical billing solution designed for physicians in specialties including cardiology, nephrology, neurology, and more. It helps users outsource billing and claim filing, process claims and e...Read more
Kareo is a web-based medical billing and practice management solution used by medical practitioners and physicians across the United States. The system suits small practices and billing companies. With Kareo, practices can schedul...Read more
MD Online's InSyncÂ® is a practice management and EMR system that assists healthcare professionals in providing superior care while maintaining regulatory compliance; it is one of the first solutions to be ONC-ATCB certified....Read more
PatientClick is a cloud-based medical suite that offers users solutions that help them manage both patient care and administrative workflows. The solutions include electronic health record (EHR), ePrescription, practice management...Read more
CareCloud Inc. offers an integrated electronic health recording (EHR) solution–Charts–that provides collective benefits of EMR, practice management and medical billing services. Charts helps physicians to streamline clinical opera...Read more
Electronic medical software has never been this easy. From billing and invoicing, to patient charting, AMS Ultra can help increase cash flow, quality of care, and patient satisfaction.
AMS Ultra Customizable Practice Software is...Read more
CureMD is a certified cloud-based EHR, practice management, patient portal and revenue cycle management. CureMD helps physicians and office staff manage their practice operations. It also helps practices adopt Meaningful Use - dri...Read more
Medical billing software is used by healthcare providers to automate their manual billing tasks, such as verifying patients’ insurance, processing and submitting claims, processing payments, and following up on denied claims. The software helps providers increase their collections by avoiding repetitive and cumbersome administrative tasks.
The software can be purchased either as a standalone system; as an integrated part of an electronic health records (EHR) solution; or as an integrated part of a practice management suite.
Medical billing software automates repetitive and error-prone billing tasks. It helps medical offices:
Code claims properly
Verify patients’ insurance coverage
Post payments and EOBs
Provide reports on collections and rejections
Claim Status Dashboard in MediTouch by HealthFusion
There are hundreds of computerized medical billing systems on the market and they range from functionally simple to very sophisticated. The most basic systems help providers generate paper statements based on demographics and billing codes input by the user. Additionally, medical office billing software allows providers to submit claims electronically, scrub claims, post payments, pull advanced reports and more.
When comparing different medical billing software, it’s helpful to have an understanding of the common features offered with this software. Here are some of the features you can typically expect in a medical billing system:
Automates the process of creating, submitting, tracking, and processing medical insurance claims in order to collect payment from providers.
Run claims through an auditing procedure before submitting them to find and correct any errors in coding. This feature helps reduce denied or rejected claims and increase approval rates.
Checks patient insurance eligibility ahead of appointments to ensure procedures and services will be covered by patient insurance.
What Type of Buyer Are You?
Most practices we speak with match one of these common buyer types:
Inpatient care providers. This category of buyer includes hospitals and long-term care facilities that need to submit claims using UB-04 forms. This type of form typically requires a system designed for inpatient billing, although some outpatient healthcare billing software systems do have a module for UB-04 billing.
Outpatient care providers. This category is made up of the private practices that submit claims on the CMS-1500 forms. These buyers need to submit electronic claims to Medicare, Medicaid and private insurance companies using Medicare billing software/Medicaid billing software. Software needs do not vary much by size of organization, although larger organizations will need a more robust, scalable medical insurance billing software program.
Specialists. Specialists such as chiropractors, naturopathic doctors and mental health providers of varying designations typically see patients that pay directly via cash or credit card. Moreover, their patients typically do not submit many (if any) claims to insurance companies or government payers. As a result, these providers have more lightweight needs.
Outsourced billing services. These buyers are third-party companies that submit claims on behalf of providers. They are typically paid a percentage of collections by providers. They have similar functional requirements to their respective provider clients, but may require a very broad, flexible system if they bill for clients of varying specialties or types of care.
Integrated suite buyers. These buyers require billing functionality, but would rather implement one integrated suite for scheduling and EMR. Their vendor selections are often driven by the EMR functionality, since most integrated systems are differentiated by their EMR offering, not their billing modules.
Benefits and Potential Issues
Billing software is an integral part of the overall revenue cycle management process. Billing and other administrative tasks are notoriously paper-laden and cumbersome. A modern medical billing software system allows billers to be as efficient as possible at coding, submitting and following up on claims.
Moreover, staff will find that medical billing and coding software helps them code claims accurately to avoid errors. As a result, most providers find their collection rates increase when going from manually submitting claims to using medical claim software.
Finally, advanced reporting tools typically provide insights that are tough to gain without a medical billing solution. By collecting important data around claims and payers, such as which claims get rejected most often and which payers pay the slowest, providers can make data-driven decisions to improve collections.
Most practices and billing services we speak with face a common set of billing challenges, and consequently, they’re considering purchasing (or replacing) software to address those challenges. Here are common scenarios we often hear about during our phone consultations:
Transitioning from paper claims. Typically, solo or small practices are making the move from paper claims to an electronic system (though that is not always the case). They have a difficult time keeping track of patients and who owes what. They will implement medical billing software for the first time to reduce paperwork, track all data in a central place and improve efficiency overall.
Bringing billing in-house. Another common scenario, most practices choose to bring billing in house—as opposed to outsourcing to a third-party service—to cut costs, have more control of their billing and accounts receivable and get everything centrally located.
Replacing antiquated software. Finally, offices replacing their existing system do so because it’s outdated and expensive to maintain, it doesn’t meet their technical requirements (e.g., integration with electronic medical record software) or they have a difficult time using it. In this scenario, Web-based medical billing software is an attractive option because it’s modern and easy to use, costs less up front and updates automatically as vendors release new versions and enhancements.
Medical Coding Software
Many medical billing software solutions include functionality that enables HIPAA-compliant medical coding. Users can enter procedure and diagnosis codes and even look up codes online to find the correct ones. This capability allows users to file and track claims more easily and helps in the tracking of data over time. Many medical billing software solutions will also update codes automatically to ensure the accurate ones are always being used.
Costs and Return on Investment
The prices of medical billing software programs often depend on the application’s deployment model. On-premise systems will require upfront costs for licenses, servers and other necessary hardware, setup and training. Buyers of on-premise systems will also need to pay ongoing maintenance and support fees, which are typically 15-20 percent of the upfront licensing costs.
Software-as-a-Service (SaaS) applications typically require lower upfront costs and ongoing monthly fees that cover licensing, support and upgrades. Finally, there are free medical billing software options that are supported by alternative revenue streams, such as advertising.
Most buyers who have successfully implemented systems will be able to generate returns on their investments through improved accuracy of filings, improved billing efficiency, and subsequently, increased collections.
Collections Management in Kareo speeds payment
Integrated suites vs. stand-alone billing solutions. Buyers will need to decide if they want to implement a standalone system, a system integrated with patient scheduling (typically called “practice management”) or a fully integrated billing, scheduling and electronic medical records (EMR) system. Many vendors such as AdvancedMD and NueMD offer all three options. Medical billing solutions have long been the only or primary applications used in many doctors’ offices, and they are usually the first systems new practices will implement. Despite government legislation requiring the adoption of EMRs, we still hear from many practices looking for standalone billing or practice management systems.
On-premise vs. Web-based. SaaS or Web-based medical billing systems have become very popular and comprise well over 50 percent of new solution sales. Low upfront costs, greater accessibility and little to no IT requirements are contributing factors to so many buyers preferring Web-based systems. Assuming buyers have reliable Internet access, we typically recommend they consider these programs.
Security. A primary concern we hear from buyers regards data security. Since medical billing involves the storage and transmission of so much sensitive patient data, buyers will want to make sure they implement a secure system. Vendors are well aware of this need and offer HIPAA-compliant systems.
User adoption. Usability tends to be more a function of the end user and how the system is configured than the medical claims software itself. Users with medical experience can typically adopt most systems quickly. Many complaints regarding usability tend to be related to setup and maintenance of servers and other hardware, not the applications themselves.