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Compare Medical Billing Software

This page is managed by
Kathleen Irwin, Market Research Associate
Last updated: October 14, 2014

Top 10 Most Reviewed Medical Billing Software Systems

 
PrognoCIS by Bizmatics PrognoCIS Medical Billing allows healthcare professionals to collect and organize billing data. It integrates fully with PrognoCIS EMR. Users can track underpayments and define rules to customize automated claims processing.
        212 Reviews
 Price
 Demo

90

Recommendations
in the last 30 days
Office Practicum Office Practicum is specifically designed for the needs of pediatricians, with features such as templates for school forms. It can be bundled with billing services and you can still do all of your billing on your own system.
        197 Reviews
 Price
 Demo

14

Recommendations
in the last 30 days
Benchmark Systems Benchmark Medical Billing Services is a web-based EHR solution for payroll, billing and collections, insurance coding and more. Benchmark has experts to handle the numbers, such as CPAs who are available to manage accounting.
        161 Reviews
 Price
 Demo

46

Recommendations
in the last 30 days
Kareo Designed for small to mid-sized practices, Kareo medical billing offers eligibility checks and accounts receivable, among other tools. Kareo can help healthcare professionals save time with electronic claims submissions features.
        152 Reviews
 Price
 Demo

124

Recommendations
in the last 30 days
2014 WRS Health 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.
        102 Reviews
 Price
 Demo

128

Recommendations
in the last 30 days
 

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MediTouch PM Practice Management Software MediTouch from HealthFusion is a web-based EHR solution that eliminates the need for a paper SuperBill, as it is able to instantly convert codes into an electronic claim. MediTouch is customizable and works on the iPad.
        96 Reviews
 Price
 Demo

102

Recommendations
in the last 30 days
NueMD 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.
        88 Reviews
 Price
 Demo

240

Recommendations
in the last 30 days
VelociDoc by Practice Velocity VelociDoc is an EMR solution designed for urgent care clinics. In addition to streamlining the daily operations of a clinic, it enables users to check insurance coverage status in real time and to submit error-free forms.
        77 Reviews
 Price
 Demo

2

Recommendations
in the last 30 days
ChiroTouch ChiroTouch is an electronic medical record (EMR) and practice management system designed specifically for small and medium chiropractic practices. The latest release, Version 5.0, has received ONC-ATCB certification.
        67 Reviews
 Price
 Demo

46

Recommendations
in the last 30 days
Nextech Nextech is a comprehensive practice management suite that handles both medical records and billing. It allows users to drag and drop line item charges and to divide batch payments from insurance companies among multiple patients.
        60 Reviews
 Price
 Demo

8

Recommendations
in the last 30 days
 
 


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U.S. Physiatry

Buyer's Guide

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 and more.

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
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.

Costs and Return on Investment

Medical billing software prices 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

Support for ICD-10. By law, every healthcare provider and payer—or at least those that are subject to requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)—must use ICD-10 billing codes by October 1, 2014. This is a very large undertaking as there are 155,000 classifications of diagnoses, tests and procedures under ICD-10—that’s a big upgrade from the 17,000 ICD-9 codes. Providers and billing staff should make sure their software vendor supports the latest set of codes. For more information, visit the Centers for Medicare and Medicaid Services (CMS) website.

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.



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