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Greenway Health’s ambulatory platform provides healthcare organizations with clinical, financial, and administrative tools and services. Prime Suite is Greenway’s electronic health record (EHR) and practice management (PM) system....Read more
AdvancedMD is a unified suite of software solutions designed for mental health, physical therapy and medical healthcare organizations and independent physician practices. Features include practice management, electronic health rec...Read more
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
Valant’s EHR for behavioral health offers tools for providers to streamline documentation, increase efficiency, and enhance the productivity of their practice or agency.
The fully integrated suite includes secure patient reco...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
ACOM Health’s cloud-based RAPID software is your one-stop-shop in chiropractic management solutions. It combines electronic health records, practice management, billing, and patient scheduling into a powerfully robust, yet easy-to...Read more
PhoenixEHS/EHR (formerly MedServices EHR) is a cloud-based solution, which helps physicians, CFC/CHC clinics, health care providers, hospitals and FQHC clinics manage patient records, eRX and eLabs, patient assistance programs (PA...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
A+ DELPHI32 is an on-premise billing, scheduling, and patient records management system designed specifically for small mental and behavioral health practices. The comprehensive program meets the needs of all types of mental healt...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
MDConnection is a web-based solution for medical practice management. The system serves the needs of small practices consisting of just one physician or a small group of physicians. The core functions include scheduling, medical b...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
SequelMed is an integrated hybrid electronic health record, practice management, billing and scheduling solution from Sequel Systems that supports a wide range of specialties such as gastroenterology, podiatry, urology and more. B...Read more
HIPAA-Compliant & ONC-Certified Cloud-Based Electronic Health Records & Practice Management. Solo-practitioners or groups of all sizes can grow and manage their practice for an affordable price.
Get telehealth, claims, and eligib...Read more
ChiroTouch is the cloud standard in chiropractic software and the only completely integrated EHR software that can be accessed any way, anytime, and on any device.
Easy in Every Way - ChiroTouch is easy to get started, access, le...Read more
MedWorks is a cloud-based ONC-ATCB certified, integrated electronic medical record (EMR) and practice management solution designed for midsized practices. It is suited for a variety of medical specialties such as family medicine, ...Read more
Online medical billing programs use a Web-based interface to provide many of the essential functions medical practices need in order to maximize their invoicing efficiency and/or revenues. Depending on the needs of the practice, this provides several advantages over traditional on-site system installations. This guide will provide an overview of the market and to help buyers in their decision-making process search for the right solutions.
Online medical billing solutions increase collections in medical offices in numerous ways—from ensuring proper claims coding and verifying insurance coverage to posting payments and generating reports. In addition to increasing revenues by identifying previously unbilled claims, invoicing applications automate a traditionally repetitive and error-prone task and frees up staff to focus on other activities.
Most cloud-based medical billing software is designed for the user to submit claims electronically. More advanced systems will provide coding support, and the top-of-the-line systems will scrub claims, post payments, offer alerts and provide for advanced reporting.
Billing analytics in Kareo Billing
What distinguishes Web medical billing software from other deployment strategies is that the system is available entirely online through a Web browser. This means that the information can be accessed from anywhere with an Internet connection, the user doesn’t have to worry about upgrades or coding updates, and there’s no need for a server or any other kind of IT infrastructure. And in this software-as-a-service (SaaS) model, the user pays a monthly or annual fee rather than upfront purchase cost.
What Type of Buyer Are You?
Most buyers of healthcare invoicing systems fall into one of the following categories:
Integrated suite buyers. This is for buyers who are looking for one integrated suite to manage their entire practice. As well as the invoicing modules, selection will be made based on scheduling, EMR and PACS capabilities, usually with a very targeted focus to the medical specialty.
Inpatient care providers. This includes hospitals and long-term care facilities that submit claims on UB-04 forms. Since this type of form typically requires a system designed for inpatient billing, make sure the product you select has this capability.
Outpatient care providers. Most private practices that submit claims on the CMS-1500 forms fall into this category. Since these buyers are submitting electronic claims to Medicare, Medicaid and private insurance companies, they’ll need something with that level of flexibility in its invoicing and payment structure.
Cash-based providers. You fall into this category if most of your revenues come from customers paying directly with cash, check or a credit card. Since these buyers don’t submit many (if any) claims to insurance companies or to the government, their needs are much more lightweight. Chiropractors, alternative medicine providers and certain kinds of mental health providers are the most common buyers in this category.
Outsourced services. These buyers are third-party companies that submit claims on behalf of providers and receive a percentage of the collections. Typically, their functional requirements will mirror those of their clients, but they may require a very broad-based, flexible system if they bill for clients with varying specialties.
Benefits and Potential Issues
Patient billing software is a project management application that's imperative for mid- to large-size projects. Firms that implement and make use of these systems should realize the following benefits:
Better efficiency: Billing is a notoriously tedious task. Implementing an online medical billing system makes them more efficient at coding, submitting and following up on claims, vastly reducing the time required.
Improved collections and accuracy: As well as being tedious, billing is highly error-prone. Internet-based medical billing software helps users code claims correctly and check them for errors, increasing collection rates and making them better equipped to manage rejections.
Cost amortization: Compared to an on-site solution, a Web-based program will be far less expensive in terms of up-front costs. SaaS also eliminates the need for an IT infrastructure to manage upgrades and to get the product up and running when problems arise.
An important consideration when purchasing a cloud-based patient billing system is the implementation plan. Every user needs to be trained on the product, and often adoption of new technology is met with resistance from people who are comfortable doing things the old way. Therefore, it’s important to get buy-in among all users to get them excited about using it.
Since SaaS programs charge a monthly or annual fee, there is the potential that the user will pay more in the long run than they will for an on-site solution. However, this tends to be the case only for larger companies with bigger budgets and dedicated IT personnel. A more significant drawback would be limited integration to external devices (e.g., ultrasounds and MRIs). If this is a concern, many of the leading client/server systems are available in an application service provider (ASP) model, which means that the system’s server is hosted at a professional data center, which effectively hybridizes the Web-based model with the locally hosted one.
Market Trends to Understand
Consider the following trends as they develop and impact the market:
Mobile computing.Since healthcare providers are increasingly using tablet devices (such as the iPad) or smartphones on a regular basis, more systems are offering mobile compatibility. If your practice could benefit from this kind of mobility, ensure the system you select has strong mobile capabilities.
ONC-ATCB Certification. Government legislation requiring the use of EMRs is impacting the EMR market, but it also affects the practice management market. Since an integrated practice management system has so many benefits, it may be wise to select a program that incorporates all these features—or at the very least supports upgrades and/or integration with EMR systems to be adopted later.
The Online Medical Billing Vendor Landscape
While the market can appear confusing and highly fragmented, the available solutions are differentiated by their appeal to the different buyer types.
This type of buyer...
Should evaluate these systems
Integrated suite buyers
Allscripts, MedLedger, CareTracker, SuiteMed
Inpatient care providers
Inpatient care providers Sage Intergy, athenaCollector, NextGen
Outpatient care providers
AllegianceMD, LeonardoMD, AdvancedMD
Practice Admin, AdvancedMD, NueMD
Costs and Return on Investment
Since the purpose of a medical billing system is to increase collections and decrease the time and effort required to receive them, the traditional measures of effectiveness for SaaS-based medical billing software are average collection timeframe and the ratio of claims accepted to rejected. The biggest benefit to SaaS applications is that they require a much lower upfront cost, since the fees that covers the licensing, technical support and upgrades are all monthly. Therefore, most buyers using this deployment model find the financial return on investment to be almost immediate.