According to InstaMed, 77% of healthcare providers say it takes more than one month to collect medical claims. Along with coding and submitting payment to various insurance companies, health practitioners spend time following up or appealing denied claims.
Professionals use medical billing software to save time and easily track claims. Plus, private practices or health systems may use managed billing services, including revenue cycle management (RCM) solutions.
To find the best medical billing providers, we researched more than 30 services to determine which platforms offer intuitive software, comprehensive support, and appeals assistance. When narrowing down our list, we turned to key numbers, like the percentage of claims approved on the first submission, revenue requirements, and plan structure. As a result, we chose seven of the best medical billing companies for 2020.
The 7 Best Medical Billing Companies of 2020
Best Overall: AdvancedMD
AdvancedMD provides a recently updated solution that works for small to large practices, making the service affordable and scalable.
Checks claims for coding errors
95% first-pass success rate
Works with practices of all sizes
Helps with denied claims
Doesn’t code claims
Extra fees for after-hours emergency support
Mobile app isn’t optimized for Android devices
Since 1999, AdvancedMD has been a trusted provider of medical billing services. As a provider who works with small to large healthcare companies, they deliver comprehensive support and custom solutions for your medical business. Its well-rounded options support growing companies making it the best overall medical billing solution in our review.
AdvancedMD is an all-in-one solution that unifies various components of your practice for a seamless experience. The company guarantees a 95% or greater first-pass rate, reducing your denied claims. Top features include:
- Mobile iOS application
- Unlimited users
- Scheduling software
- Automatic updates
- Claims management
- Patient portal
- Automatic data backup
While AdvancedMD doesn't code your claims, roughly 10% to 20% of its staff are certified coders, and the company runs each request through a payor direct clearinghouse where each claim is checked before submission.
As a cloud-based platform, AdvancedMD works on web browsers like Google Chrome, Safari, and Microsoft Edge. Internet Explorer is not supported. You can also use the iOS app on iPads and iPhones, but it's not optimized for Android hardware.
AdvancedMD offers standard packages and custom solutions, including practice management, scheduling and billing, electronic medical record (EMR) or electronic health record (EHR), and RCM services. You can build your package or choose a pre-configured plan:
- Practice management: $429 a month per provider or $1.42 per encounter, with a $150 monthly minimum, and includes scheduling and billing software
- EMR/EHR software: $729 per month per provider, or $2.18 per encounter, with a $150 monthly minimum, and integrates patient management (PM) and EHR software
- Full-service revenue cycle management: 4% to 8% of practice collections, adds 24-hour claims and payment processing, monthly electronic reports, and alerts about patient write-offs
While it costs extra for custom implementation services, you can access free support from 8:00 a.m. to 8:00 p.m. EST, Monday through Friday, via phone, online chat, or trouble ticket. AdvancedMD’s support platform provides a knowledge-base with videos, e-guides, and community-based support.
Best for Independent Physicians: Kareo
Kareo gives physicians more time with patients by offering billing software, managed services, and integrated healthcare IT systems in one unified solution.
Includes practice management software
Managed billing is a separate service
No claims follow-up on basic billing software
Founded in 2000, Kareo aims to free up physicians' time using purposeful technologies designed specifically for independent doctors. As the "only complete technology platform" for independent physicians, this solution puts solo practitioners first, which is why Kareo is the billing software we chose as best for independent physicians.
With practice management and medical billing services combined into one, Kareo provides the basics for your practice. With the billing package, you'll get:
- Scheduling system with physician and patient reminders
- Claims processing and tracking tools
- More than 70 standard reports
- Print and email statements
The company offers a complete lineup of independent physician tools, including clinical, billing, and engagement platforms and services like managed billing. Kareo Billing doesn't come with an EHR unless you purchase their all-in-one Kareo platform that includes billing, engagement, and clinical software for $500 per physician per month. You'll also handle the coding yourself or opt for managed billing where you pay 4% to 7% of net collections each month for end-to-end billing services.
This cloud-based software works on Mac or Windows desktops and in Firefox or Chrome browsers, and the free Kareo app works on iPads, iPhones, and Apple watches.
All three Kareo billing plans offer the same features, such as charting, billing, and reporting. You can also add credit card payments to your billing for 2.3% plus $0.30 per in-office transaction and 3.9% plus $0.30 for online or card-on-file payments. The three billing plans include:
- $320 per physician per month
- $110 per therapist per month
- $160 per non-physician per month
Kareo continues its dedication to independent physicians in its support options. All subscribers get a success coach, online training, and email support. Live chat or live phone support is also available from 5:00 a.m. to 5:00 p.m. PST.
Best for Small Medical Groups: ChartLogic
With ChartLogic, certified coders support your small practice billing needs while offering all-in-one services.
No tiered pricing
Billing works best with ChartLogic’s EMR system
ChartLogic got its start in 1994, making it the oldest revenue cycle management software on our list. Its unique approach includes an audit of your past billing and collection efforts, which helps you plan for software implementation going forward. With certified coders, end-to-end billing monitoring, and available EMR and PM software, it's our top choice as an all-in-one solution best for small medical groups.
The company works as a partner with your business by handling your end-to-end billing and features a 95% first-pass rate. ChartLogic:
- Reviews, edits, codes your claims
- Send claims through a claims scrubber
- Monitors claims and follows up
- Provides claim status information
- Offers customizable reports
Plus, you get practice management software with scheduling, patient registration, claims, and collection software rolled into one package. You can use ChartLogic software on any Windows or Mac desktop and on Apple, Android, and Microsoft tablets. It supports Chrome, Firefox, Safari, and Edge browsers.
Once you go through a medical billing analysis, you'll speak with the company to customize your package. Prices typically run 3% to 6% of your monthly collections. If you already use an EMR system, then the company will work with you to integrate it. But, they prefer you use their EMR and PM software.
Along with a dedicated account manager, you'll get help with onboarding and training for no extra charge. You can also use their help center with live chat, webinars, and tutorials. Or call their support hotline from 6:00 a.m. to 6:00 p.m. MST, Monday through Friday.
Best for Hospitals: athenaCollector
A Healthcare IT suite for hospital systems that want to outsource some billing processes to third-party providers.
Coordinates with in-house billing
Includes claim management
Robust reporting features for enterprises
Lower first-pass resolution rate
May charge fees for denied claims
Complicated for solo users
Founded in 1997, athenaCollector is part of AthenaHealth systems, which offers many healthcare IT technologies. As a medical billing company, athenaCollector provides the convenience of an automated billing service while retaining in-house control, which is why we chose it as best for hospitals.
athenaCollector helps your hospital get paid faster and easily view performance results. It provides a 93% first-pass claim resolution rate and offers features like:
- Appointment scheduling
- A patient check-in process for collecting payments upfront
- Integrated health insurance eligibility checking
- Real-time performance reports
- Revenue cycle dashboard with tasks and patient data
- Claims management using an up-to-date rules engine
athenaCollector doesn't code your claims. However, it scrubs your codes for errors using a rules engine, and human coders review and revise claims to reduce denials. Along with billing, your monthly cost includes a healthcare IT suite with EMR and PM software.
Its cloud-based services work best on Chrome browsers and offer limited capabilities when using Edge or Safari. Internet Explorer won't be supported in 2021. While it works on Mac or Windows computers, athenaCollector doesn’t support full web browser capabilities on iPads or iPhones. However, in 2019 the company started rolling out an iOS mobile app for clinical workflows to select healthcare agencies.
This service doesn't offer tiered plans. Instead, you'll pay a percentage of your net collections. Lower rates go to those with high claims value and high claims volume. Rates typically range from 4% to 7%. The company bases your custom rate on:
- Billing complexity
- Practice size
- Claims volume
- Practice specialty
- Claims value
You'll get 24/7 emergency support plus plenty of online resources, including videos, webinars, and knowledge-bases.
Best for Large Practices: Waystar
Waystar unites all types of healthcare payments, from the government to commercial, in one platform.
98.5% first-pass rate
Comprehensive reporting and tracking
Supports Medicare billing
Steep learning curve
May pay extra fees for setup and onboarding
In early 2018, Waystar combined two industry-leading platforms, Navicure and ZirMed, for an enterprise-grade RCM solution. It provides high-level reporting, end-to-end billing solutions, and integrates with all major PM software. Its breadth of high-level features makes Waystar our choice for a billing solution that's best for large practices.
With a 98.5% first-pass rate, Waystar offers the highest percentage of first-time resolutions out of all the service options. Its goal is to unify all payments, including Medicare. Waystar’s revenue cycle management services provide:
- Automatic claim editing and scrubbing
- Health insurance eligibility verification
- Real-time claim tracking dashboard
- Enterprise-level reporting and analytics
- Integrated payment processing
- Auto split remits function
- Over 600 payer appeal templates
- An appeals wizard tool
The cloud-based platform integrates with all major PM and health information systems (HIS), so you can keep using your existing EHR software and in-house medical coders. Waystar is operating system agnostic, so it works on Mac, Windows, and web browsers.
Since Waystar works with companies of all sizes, pricing starts at $100 but is based on your custom solution. Fees and subscriptions take into account your organization's type, like home health or urgent care, and the number of providers. Waystar offers four bundled plans, Starter, Core, Performance, and Premium. Plus, it offers standalone services such as:
- Patient finance clearance
- Revenue integrity
- Claim management
- Denial management
- Patient financial experience
- Agency management
- Patient insights
Waystar consultants work with you to determine your training and onboarding needs. You can reach customer support via a customer service phone number or through your online portal.
Best for Flexibility in Services: CareCloud
With CareCloud, you can outsource some or all of your billing needs, making it a versatile choice for group practices and individuals.
Includes consulting services
Customizable billing options
High startup costs
Only offers an iOS app
Since 2009, CareCloud has delivered custom solutions tailored to your private or group practice by letting you choose your level of involvement. You can use any EMR or PM software with CareCloud or buy their services, making it the clear winner of our best for flexibility category.
Customize your package by choosing an all-in-one-solution or pick certain services, like RCM, to reduce costs. For instance, CareCloud’s RCM package delivers a 97% composite resolution rate on claims. Top features of its RCM billing services include:
- Real-time claim analytics
- CareCloud Central practice management software
- Patient statements generation
- Automatic patient eligibility verification
- Free, merit-based incentive payment system (MIPS)
- CollectiveIQ technology to reduce coding errors
With CareCloud, you code your bills and supply your own EHR system (or select their EHR platform). It works on most browsers, including updated versions of Internet Explorer, Firefox, Chrome, and Safari. You can use the software on Windows or Mac computers. The mobile app is built on an iOS platform, so it may not work as well on non-Apple tablets. CareCloud offers four different solutions:
- Central: $349 per provider per month for practice management software that includes a full suite of products like scheduling, billing, collections, reporting, and patient experience management (PXM) Breeze system
- Charts: $279 per provider per month, but you must also have a PM subscription (Central). It's a complete EHR system with customizable charts and includes the Breeze software
- Concierge: Starts at 3% of collections, this RCM software provides everything you need for billing plus gives you access to PM Central software
- Breeze: $199 per provider per month, for comprehensive patient engagement management software (PXM) as a standalone service, or it's included in Central and Charts
With CareCloud services, you get a dedicated client manager, U.S.-based support, and access to an online user community. However, you will pay for onboarding and implementation, with prices starting at $1,000 per provider.
Best for Speciality Practitioners: CureMD
Whether you want billing-only services or an all-in-one solution for your specialty practice, CureMD fits the bill.
EHR software designed for specialties
Billing services include an all-in-one system
Doesn't work on Android phones
Works best in Internet Explorer
Fees for more than five users
In business since 1997, CureMD caters to 34 private practice specialties and provides end-to-end revenue cycle management. Its adaptability to special services and unique workflows makes it our winner in the best for specialty practitioners category.
CureMD guarantees a 5% to 10% increase in your collections when using its medical billing services. Plus, 96% of claims are accepted and paid the first time they're submitted. The services handle all of your billing operations, including:
- Claim creation and submission
- Denial management
- Appeals process
- Real-time check-in verification
The plan prices cover five users per provider, and extra users cost $100 per user per month. The company offers several packages, including:
- Medical billing services: Starting at 4% of collections for RCM, PM, EHR, patient portal, iPad app, maintenance, support, and backup services
- All-in-one: $395 per provider per month for CureMD's full suite of healthcare IT software, including EHR, PM, and billing
- EHR: $295 per provider per month for electronic prescribing, interoperability between medical providers, and customizable reports
- PM: $195 per provider per month for e-learning, integrated inventory management, and personalized dashboards
- Speciality EHR: $295 per provider per month for workflows tailored to your specialty to include custom lists, assessment plans, flow sheets, and medications
The cloud system requires no new hardware, as it'll work on Windows or Mac computers, and the app works on iOS devices.
You won't pay a dime for setup or training with CureMD. And if you need customer support, you can call or instant message from 8:00 a.m. to 8:30 p.m. EST, email, or submit a support ticket online.
What Is a Medical Billing Company?
A medical billing company is a third-party service that handles part or all of healthcare providers' billing activities. These businesses offer billing software for providers to make it easier to bill insurance companies and patients. The companies may also offer managed billing services or software-as-a-service (SaaS), including built-in denial management and follow-up processes.
Some providers combine other software, such as patient management, electronic health records, and patient experience, into a bundled package with billing software. Healthcare IT plans may be called revenue cycle management (RCM) systems, software that follows the revenue from the beginning to end. So, RCM technology starts with scheduling the patient appointment and ends when your practice gets paid.
All medical billing services must submit claims electronically using a format determined by the Health Insurance Portability and Accountability Act (HIPAA). According to Title II of HIPAA, healthcare providers and billers must be HIPAA-compliant.
How Does a Medical Billing Company Work?
When you sign up with a billing provider, you can access billing software via proprietary or cloud-based systems. However, the majority of services are online systems that work in your web browser. If your solution is an RCM or PM system, you may get a patient portal where insurance data is entered, and your billing company verifies eligibility. Then you code your bills and submit to your billing services.
Once the company receives your information, they use an automated system to scrub billing data, a process where a system runs bills through thousands of rules to catch any errors. Some full-service billing companies may edit your codes or manually catch mistakes before it goes to the insurer.
With managed billing, your provider oversees claim denials and follow-ups on your behalf. Or you may use software that kicks back the denials to you to handle. Almost all providers give you a dashboard to see your claim status and run various reports to provide deeper insights into your revenue cycle and performance.
Why Are Medical Billing Companies Important?
Practitioners want to spend more time with patients and less time handling administrative work. Whether you're an independent physician or part of a large practice, outsourcing some or all of your medical billing process is a timesaver. It reduces your time spent verifying eligibility, overseeing claims and denials, and following up. Plus, the automated process used to scrub claims means fewer coding errors and time spent fixing data entry mistakes.
Since time is money, you can reduce expenses and increase revenue when using medical billing services. For example, CureMD states that with its services, you'll get paid "6% more and 35% faster." Other companies, like ChartLogic, handle the coding for you so you may be able to reduce your staffing and rely solely on your managed billing service.
Before selecting healthcare IT services, it's essential to assess your current billing costs, including time spent submitting and following up. Determine which parts of your process you want to outsource, and if you want other services, like EHR, included.
What Are the Expected Costs of Medical Billing?
Medical billing providers offer several types of plans, from monthly subscriptions to payments per healthcare encounter. The costs of medical billing may include one or more of the following:
- Subscription plans range from $100 to $729 per month per provider.
- Pay-per-encounter packages charge $1.42 to $2.18 per billing claim.
- Many services charge a custom rate between 3% to 10% of your monthly claims collections.
- Some provide credit card processing services ranging from 2% to 4% plus $0.15 to $0.35 per transaction.
Medical billing services may charge fees for denied claims, onboarding or setup, or extra charges to use required software, such as a patient management system.
How We Chose the Best Medical Billing Companies
We looked at over 30 medical billing companies to determine category winners. In making our top choices, we first looked for an intuitive user experience, so that most users would be able to immediately work with the software. We then considered the percentage of claims approved on the first pass since this affects revenues. We also looked at platform features and services as well as the hardware and software requirements to compare providers. Plus, we explored various factors, including revenue or contract requirements, reporting options, and customer support.