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athenaOne

The athenaOne Suite which includes athenaCollector a revenue cycle management solution and athenaClinials an EHR (electronic health records) recently ranked #1 in 2023 Best in KLAS for athenaClinials Ambulatory EMR for 11-75 physi...Read more about athenaOne

3.8 (836 reviews)

393 recommendations

RXNT

RXNT’s cloud-based, ONC-certified medical software—Billing, Practice Management, EHR, and more—improves clinical outcomes & revenue cycle management. Simple, transparent pricing includes free setup and training, free data transfer...Read more about RXNT

4.3 (428 reviews)

367 recommendations

DrChrono

DrChrono’s iPad and iPhone compatible EHR and medical billing platform allows medical practices and healthcare providers to manage patient intake, patient care, clinical charting, billing and revenue cycle management. It includes ...Read more about DrChrono

4.0 (477 reviews)

261 recommendations

AdvancedMD EHR

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 about AdvancedMD EHR

3.6 (451 reviews)

169 recommendations

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Elation Health

Elation Health is the most trusted technology platform for high-value primary care. Since 2010, the company has delivered clinical-first solutions — built on a collaborative EHR platform — that help practices start, grow, communic...Read more about Elation Health

4.4 (51 reviews)

105 recommendations

ChartLogic EHR

ChartLogic offers an ambulatory EHR suite that includes electronic medical record, practice management, revenue cycle management, e-prescribing and patient portal. The solution caters to primary care, surgical care and other compl...Read more about ChartLogic EHR

3.9 (62 reviews)

103 recommendations

PrognoCIS

PrognoCIS EHR and PrognoCIS Telemedicine have earned a reputation for fast, flexible individual provider workflow. The software package offers a full suite of highly desirable features and functions. PrognoCIS provides a cloud-bas...Read more about PrognoCIS

4.1 (287 reviews)

41 recommendations

ModMed

ModMed, also known as Modernizing Medicine®, is an award-winning software company that places doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. Services include electronic health...Read more about ModMed

4.3 (168 reviews)

39 recommendations

WebPT

Established in 2008, WebPT is the nation’s most trusted outpatient rehab therapy software platform in the country, helping more than 150,000 rehab therapy professionals from all practice sizes and specialties run successful and ef...Read more about WebPT

4.3 (462 reviews)

36 recommendations

CharmHealth

CharmHealth is a MU certified, cloud-based EHR, Practice Management and Medical Billing solution that helps healthcare organizations ranging from large multi-specialty groups to small independent medical offices function efficient...Read more about CharmHealth

4.3 (127 reviews)

33 recommendations

Practice EHR

Practice EHR, a medical practice management software, was developed to accommodate the needs of small to mid-size businesses. The platform is customizable to internal medicine practices, chiropractors, physical therapists, family ...Read more about Practice EHR

4.3 (70 reviews)

31 recommendations

NextGen Office

NextGen Office is an award-winning, cloud-based, clinical and billing solution designed for smaller, independent practices (≤ 10 providers). This all-in-one, full-service solution includes specialty-specific EHR content, an easy-t...Read more about NextGen Office

4.0 (1255 reviews)

30 recommendations

Nextech EHR & PM

For more than 20 years, Nextech has provided a full-featured EMR and Practice Management solution within a single database. This system is a fit for dermatologists, plastic surgeons, ophthalmologists, and physicians, and is used b...Read more about Nextech EHR & PM

4.0 (193 reviews)

28 recommendations

Compulink Healthcare Solutions

Compulink Advantage is an all-in-one database EHR solution for specialty practices such as optometry, ophthalmology, orthopaedics, ENT, mental health, podiatry, and more. Available cloud-based or server, Advantage includes smart f...Read more about Compulink Healthcare Solutions

4.1 (283 reviews)

19 recommendations

Valant EHR Suite

Valant’s Behavioral Health EHR and Practice Management Software includes all the tools you need to provide exceptional individual and group care while running a successful private practice. Unlike other non-specialized EMR softwa...Read more about Valant EHR Suite

4.1 (275 reviews)

19 recommendations

CollaborateMD

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 about CollaborateMD

4.0 (73 reviews)

18 recommendations

Nexus EHR

Nexus EHR is an ONC Certified 2015 Edition Cures Update cloud-based ambulatory EHR and PM platform. It is designed for small to midsize practices and various specialties including orthopedics, neurology, podiatry, cardiology, gene...Read more about Nexus EHR

4.6 (9 reviews)

18 recommendations

HARMONY Medical

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 about HARMONY Medical

4.5 (25 reviews)

12 recommendations

NextGen Enterprise

NextGen Healthcare provides scalable, integrated solutions and professional services to help your practice administer excellent care and operate your business more efficiently. We serve medium to large enterprise-level ambulatory ...Read more about NextGen Enterprise

4.2 (5 reviews)

12 recommendations

Azalea Health

Azalea provides cloud-based electronic health records (EHR), practice management (PM), revenue cycle management (RCM) and telehealth solutions for ambulatory and hospital care settings. Azalea is suitable for community and rural h...Read more about Azalea Health

4.3 (89 reviews)

10 recommendations

Buyers Guide

Last Updated: March 16, 2023

While patient care remains a top priority for all medical practices, they are still businesses that need to create profit in order to survive and compete. Being such, high efficiency of billing processes is imperative for medical practices.

Medical billing comprises complex processes involving multiple variables at various levels. These variables could be in the form of manual errors during coding, claims denials from insurers, delays in claims processing at insurer’s end etc. Consequently, this crucial operation can end up consuming resources to the extent that it impacts the top priority of any medical practice.

Fortunately, there are business organizations that take up the responsibility of handling all billing-related processes so medical practices can dedicate solely to patient care.

This Buyers Guide discusses such organizations, known as medical billing service providers, and elaborates on the basic things to know before hiring one.

Here’s what we’ll cover:

What are medical billing services?

Common offerings of medical billing services

What type of client are you?

Benefits of medical billing services

Key considerations

What are medical billing services?

Medical billing services (or medical billing service providers) are organizations that take care of billing-related processes on behalf of medical practices. These HIPAA-approved services also take over a practice’s claims management, including submission of claims to clearing houses and following up on denied or rejected claims.

Common offerings of medical billing services

The first step toward selecting the right medical billing service provider is to understand their typical offerings. According to our research, the following are the common aspects you should be aware of:

Claims management

Capture, organize, bill, and file medical claims related to patients’ diagnosis, treatment, and medication.

ICD-10 compliance

Manage the intricacies of ICD-10 cataloging and maintain proper coding compliance.

Payment processing

Securely and reliably accept payments via different modes, including online and cards.

Patient visit documentation

Capture patient details during visits and document subsequent procedures such as diagnoses and prescribed treatment.

Insurance verification

Gather patient insurance information and verify eligibility.

What type of client are you?

The next step is to understand the types of medical practices that seek out billing services. This knowledge will help you select billing services based on your practice requirements.

Here are the key benefits of medical billing services:

  • Integrated EHR software users: Several EHR vendors bundle billing services with their software tools. Using services from your EHR software vendor allows you to consolidate EHR functions (such as patient charting, scheduling, e-prescribing, and patient portals) with billing processes at a central point.

  • Standalone medical billing clients: Some medical practices have complex billing and compliance needs, such as multi-jurisdictional claims management, and they are typically fine with keeping their EHR and billing processes separate. Such buyers can go for standalone billing services from specialized providers.

Benefits of medical billing services

Here are some important points to consider before you finalize a medical billing service provider:

  • Specialized billing expertise: Medical billing service providers maintain specialized staff to handle billing processes specifically. Their staff undergo regular training and assessment to remain updated on new billing rules and compliances. This helps ensure billing processes with minimal errors and high claims approval rate.

  • Enhanced patient care: The service provider will free up resources by absorbing your workload, thus allowing you to focus on delivering better patient care.

Key considerations

Even though you might be hurrying to meet GDPR requirements, it is important to consider some of the below parameters when buying GDPR software.

  • Data ownership: Patient data is highly sensitive and protected by strict regulatory policies. Transferring billing responsibilities also means sharing the responsibility of patient data ownership. Inquire with vendors about data security measures at their end to ensure maximum possible protection of your patient data. Additionally, learn about their data storage and transfer conditions to ensure hasslefree operations in the event you decide to change the service provider at a later stage.

  • Service level agreements: Despite a provider promising high-quality services, there could be unexpected challenges that hamper your billing operations. Reviewing and negotiating service level agreements will help ensure that your practice is protected against the impact of such challenges.