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Medical Billing Software


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drchrono EHR logo
 
drchrono EHR is a patient care platform that offers customization at the point of care and on the go. In addition to EHR, drchrono also includes scheduling, billing and patient reminders. It is available on iPad, iPhone and Apple Watch. Healthcare... Read More
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drchrono EHR is a patient care platform that offers customization at the point of care and on the go. In addition to EHR, drchrono also includes scheduling, billing and patient reminders. It is available on iPad, iPhone and Apple Watch. Healthcare... Read More
 
AdvancedMD logo
 
AdvancedMD is a cloud-based, Meaningful-Use-Certified EHR and practice management system with medical billing capabilities. The platform offers robust functionality and keeps the billing system up-to-date on payer rule changes.
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326
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AdvancedMD is a cloud-based, Meaningful-Use-Certified EHR and practice management system with medical billing capabilities. The platform offers robust functionality and keeps the billing system up-to-date on payer rule changes.
 
NueMD logo
 
NueMD's billing and practice management software operates its own claims clearinghouse which allows their clients the ability to process an unlimited number of claims. The software can be acquired on a monthly contract.
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NueMD's billing and practice management software operates its own claims clearinghouse which allows their clients the ability to process an unlimited number of claims. The software can be acquired on a monthly contract.
 
athenahealth EHR logo
 
athenahealth is connecting care nationwide with cloud-based services for electronic health records (EHR), revenue cycle management & medical billing, patient engagement, care coordination, and population health management, as well... Read More
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athenahealth is connecting care nationwide with cloud-based services for electronic health records (EHR), revenue cycle management & medical billing, patient engagement, care coordination, and population health management, as well... Read More
 
PrognoCIS by Bizmatics logo
 
PrognoCIS is a cloud-based ICD-10 compliant and MU certified EMR solution which helps medical facilities and practitioners to manage patient medical recording. The software comprises of integrated modules for EHR, Practice Management,... Read More
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143
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PrognoCIS is a cloud-based ICD-10 compliant and MU certified EMR solution which helps medical facilities and practitioners to manage patient medical recording. The software comprises of integrated modules for EHR, Practice Management,... Read More

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iSALUS EHR logo
 
iSALUS Healthcare offers a fully-integrated electronic health records (EHR), practice management and billing services solution with a host of features to support small to mid-sized practices. This system is flexible and securely accessible... Read More
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iSALUS Healthcare offers a fully-integrated electronic health records (EHR), practice management and billing services solution with a host of features to support small to mid-sized practices. This system is flexible and securely accessible... Read More
 
Compulink logo
 
Compulink is a provider of highly customizable, ONC Certified EHR and practice management software for specialty practices. Designed to adapt to a practice's specific needs, the integrated solution offers functionality to support patient... Read More
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Compulink is a provider of highly customizable, ONC Certified EHR and practice management software for specialty practices. Designed to adapt to a practice's specific needs, the integrated solution offers functionality to support patient... Read More
 
Greenway Health Prime Suite logo
 
Greenway’s fully-integrated offering makes it well suited for practices of all sizes and for a wide variety of specialties. Billing features include integrated appointment reminders and follow-ups. Greenway is ONC-ATCB certified
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Greenway’s fully-integrated offering makes it well suited for practices of all sizes and for a wide variety of specialties. Billing features include integrated appointment reminders and follow-ups. Greenway is ONC-ATCB certified
 
The Valant Behavioral Health EHR logo
 
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 records,... Read More
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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 records,... Read More
 
ECLIPSE logo
 
ECLIPSE is a CCHIT Certified EHR that suits any size practice, which means that the system supports Meaningful Use attestation. Their electronic billing system is designed to save physicians time with an “all-in-one” platform.
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ECLIPSE is a CCHIT Certified EHR that suits any size practice, which means that the system supports Meaningful Use attestation. Their electronic billing system is designed to save physicians time with an “all-in-one” platform.

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Aprima EHR logo
 
Aprima EHR is part of the complete Aprima system, including Practice Management and Revenue Cycle Management solutions. Aprima EHR’s navigation feature presents clinically relevant findings based on presenting symptoms, diagnosis... Read More
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Aprima EHR is part of the complete Aprima system, including Practice Management and Revenue Cycle Management solutions. Aprima EHR’s navigation feature presents clinically relevant findings based on presenting symptoms, diagnosis... Read More
 
WRS Health logo
 
WRS Health offers unique features to each of the 35 specialties it serves, such as audiology and neurology. This web-based medical billing software automatically captures charges to improve billing efficiency.
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WRS Health offers unique features to each of the 35 specialties it serves, such as audiology and neurology. This web-based medical billing software automatically captures charges to improve billing efficiency.
 
WebPT logo
 
WebPT was designed to help physical therapy clinics transition smoothly to cloud-based practice management and billing. Its billing support is designed to maximize reimbursements and ensure a smooth and accurate claims process.
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WebPT was designed to help physical therapy clinics transition smoothly to cloud-based practice management and billing. Its billing support is designed to maximize reimbursements and ensure a smooth and accurate claims process.
 
PracticeSuite logo
 
PracticeSuite’s practice management, electronic health records (EHR) and patient management platform is suitable for medical practices and third-party medical billing companies of all sizes.  Practices can use patient-oriented... Read More
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PracticeSuite’s practice management, electronic health records (EHR) and patient management platform is suitable for medical practices and third-party medical billing companies of all sizes.  Practices can use patient-oriented... Read More
 
CGM Clinical logo
 
CompuGroup Medical (CGM), creators of CGM Clinical, was established 25 years ago by a computer scientist who recognized how beneficial improved technology systems could be fore the healthcare sector. He worked to develop a streamlined... Read More
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CompuGroup Medical (CGM), creators of CGM Clinical, was established 25 years ago by a computer scientist who recognized how beneficial improved technology systems could be fore the healthcare sector. He worked to develop a streamlined... Read More

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ACOM Health RAPID Software logo
 
ACOM Health’s RAPID EHR supports patient scheduling and medical billing capabilities created specifically for chiropractors. It is ONC-ATCB certified, and features ambulance, DME and workers’ compensation billing services.
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ACOM Health’s RAPID EHR supports patient scheduling and medical billing capabilities created specifically for chiropractors. It is ONC-ATCB certified, and features ambulance, DME and workers’ compensation billing services.
 
MedPointe logo
 
MedPointe from Health Systems Technology, Inc. is a standalone EHR solution that offers integrated billing, accounting, picture archiving, and patient scheduling features within suite, along with medical billing services. The program... Read More
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MedPointe from Health Systems Technology, Inc. is a standalone EHR solution that offers integrated billing, accounting, picture archiving, and patient scheduling features within suite, along with medical billing services. The program... Read More
 
ReDoc powered by xfit logo
 
ReDoc powered by xfit is cloud-based rehab therapy documentation, scheduling and practice management software for practices of all sizes. A fully-integrated solution from Net Health, ReDoc drives PT, OT, and SLP workflow that moves... Read More
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ReDoc powered by xfit is cloud-based rehab therapy documentation, scheduling and practice management software for practices of all sizes. A fully-integrated solution from Net Health, ReDoc drives PT, OT, and SLP workflow that moves... Read More
 
UnifiMD logo
 
Designed in collaboration with practicing physicians, UnifiMD is an electronic health records (EHR) solution that was developed to meet the requirements of independent practices of varying size and specialty. UnifiMD provides users... Read More
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Designed in collaboration with practicing physicians, UnifiMD is an electronic health records (EHR) solution that was developed to meet the requirements of independent practices of varying size and specialty. UnifiMD provides users... Read More
 
RxNT logo
 
RxNT offers a suite of cloud-based solutions including RxNT|EHR, RxNT|eRx, and RxNT|PM. The three products are available for purchase in standalone form or within an integrated suite. They are accessible on any connected mobile device... Read More
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RxNT offers a suite of cloud-based solutions including RxNT|EHR, RxNT|eRx, and RxNT|PM. The three products are available for purchase in standalone form or within an integrated suite. They are accessible on any connected mobile device... Read More
 

Buyer's Guide

by Gaby Loria,
Market Research Associate
Last Updated: April 21, 2017


Medical billing software automates repetitive and error-prone billing tasks. It helps medical offices:

  • Increase collections
  • Code claims properly
  • Verify patients’ insurance coverage
  • Post payments and EOBs
  • Provide reports on collections and rejections
Claim Status Dashboard

 

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.

In this guide we discuss the following:

What Type of Buyer Are You?
Benefits of Medical Billing Software
Medical Coding Software
Cost and Return on Investment
Important Considerations

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 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 knowing which claims get rejected most often, which payers pay the slowest, and which visits can be upcoded, 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
Collections Management in Kareo speeds payment

Important Considerations

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.

Free Download:
Medical Billing Software Pricing Guide

Free Download:
Medical Software Buyer's Toolkit

 

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