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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 an integrated medical software suite for independent practices. Features include practice management, electronic health records, patient engagement, telemedicine, rooming, reputation management, financial analytics and... Read More
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AdvancedMD is an integrated medical software suite for independent practices. Features include practice management, electronic health records, patient engagement, telemedicine, rooming, reputation management, financial analytics and... Read More
 
NueMD logo
 
NueMD offers a suite of cloud-based software and medical billing services for practices of all sizes. NueMD is an integrated practice management, medical billing, electronic health recording and appointment scheduling solution. Medical... Read More
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NueMD offers a suite of cloud-based software and medical billing services for practices of all sizes. NueMD is an integrated practice management, medical billing, electronic health recording and appointment scheduling solution. Medical... Read More
 
athenahealth EHR logo
 
athenahealth is providing cloud-based services for electronic health records (EHR), revenue cycle management & medical billing, patient engagement, care coordination, and population health management, as well as Epocrates and other... Read More
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athenahealth is providing cloud-based services for electronic health records (EHR), revenue cycle management & medical billing, patient engagement, care coordination, and population health management, as well as Epocrates and other... Read More
 
Kareo Clinical EHR logo
 
Kareo is a Web-based EHR, medical billing, and practice management used by thousands of physicians across the United States. This system suits small practices and billing companies. With Kareo, practices can schedule patients, confirm... Read More
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Kareo is a Web-based EHR, medical billing, and practice management used by thousands of physicians across the United States. This system suits small practices and billing companies. With Kareo, practices can schedule patients, confirm... Read More

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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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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
 
Compulink logo
 
Compulink Advantage is an integrated hybrid medical solution that provides medical service providers functionalities such as electronic health records (EHR), practice management, revenue cycle management, inventory management, optical... Read More
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Compulink Advantage is an integrated hybrid medical solution that provides medical service providers functionalities such as electronic health records (EHR), practice management, revenue cycle management, inventory management, optical... Read More
 
ECLIPSE Practice Management logo
 
In 1985, a chiropractor and software developer teamed up to create ECLIPSE, an ONC certified Complete EHR now used by thousands of providers nationwide. Designed for single practitioners, ECLIPSE is routinely used by multi-disciplinary... Read More
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In 1985, a chiropractor and software developer teamed up to create ECLIPSE, an ONC certified Complete EHR now used by thousands of providers nationwide. Designed for single practitioners, ECLIPSE is routinely used by multi-disciplinary... Read More
 
A+ DELPHI Psychotherapy Billing Software logo
 
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 health... Read More
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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 health... Read More
 
Practice EHR logo
 
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 medicine,... Read More
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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 medicine,... Read More

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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
 
Aprima EHR logo
 
Aprima EHR is designed to take advantage of mobile hardware including the Aprima Mobile smartphone app for tablets, touchscreens and smartphone devices. Aprima is suitable for physicians in primary care and more than 70 specialties... Read More
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Aprima EHR is designed to take advantage of mobile hardware including the Aprima Mobile smartphone app for tablets, touchscreens and smartphone devices. Aprima is suitable for physicians in primary care and more than 70 specialties... Read More
 
Azalea Health logo
 
Azalea Health offers a collection of medical solutions for a variety of specialties. Providing a cloud-based EHR, practice management software, revenue cycle management, and more, Azalea products bring together a practice's medical... Read More
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Azalea Health offers a collection of medical solutions for a variety of specialties. Providing a cloud-based EHR, practice management software, revenue cycle management, and more, Azalea products bring together a practice's medical... Read More
 
Intergy by Greenway Health logo
 
Greenway Health’s ambulatory platform provides healthcare organizations with clinical, financial, and administrative tools and services. Intergy, part of the Greenway Health suite, is available as both a web-based and on-premise... Read More
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Greenway Health’s ambulatory platform provides healthcare organizations with clinical, financial, and administrative tools and services. Intergy, part of the Greenway Health suite, is available as both a web-based and on-premise... Read More
 
eClinicalWorks logo
 
eClinicalWorks is an integrated suite of electronic health records (EHR), practice management, patient engagement, tele-visits, population health, care coordination and analytics. On-premise and cloud based deployments are both available. eClinicalWorks... Read More
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eClinicalWorks is an integrated suite of electronic health records (EHR), practice management, patient engagement, tele-visits, population health, care coordination and analytics. On-premise and cloud based deployments are both available. eClinicalWorks... Read More

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ChiroTouch logo
 
ChiroTouch is an electronic health records (EHR) and practice management system designed specifically for small to midsize chiropractic practices. It combines electronic health records, billing, patient scheduling, outcomes assessments... Read More
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ChiroTouch is an electronic health records (EHR) and practice management system designed specifically for small to midsize chiropractic practices. It combines electronic health records, billing, patient scheduling, outcomes assessments... Read More
 
WebPT logo
 
WebPT is a cloud-based, multi-product platform for outpatient physical, occupational and speech therapy clinics. At its core, WebPT is an electronic medical records (EMR) system that enables therapists to produce and store patient... Read More
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WebPT is a cloud-based, multi-product platform for outpatient physical, occupational and speech therapy clinics. At its core, WebPT is an electronic medical records (EMR) system that enables therapists to produce and store patient... Read More
 
EHR YOUR WAY logo
 
EHR YOUR WAY is a behavioral health EHR that can be deployed on desktop and mobile cloud-based devices. The solution covers various aspects of behavioral health including inpatient and outpatient Mental Health and Substance Abuse,... Read More
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EHR YOUR WAY is a behavioral health EHR that can be deployed on desktop and mobile cloud-based devices. The solution covers various aspects of behavioral health including inpatient and outpatient Mental Health and Substance Abuse,... Read More
 
NextGen Healthcare logo
 
Automate medical billing tasks like insurance eligibility, patient communication, and patient payments. Support a patient-centric revenue cycle with scheduling, billing, and claims processing.
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Automate medical billing tasks like insurance eligibility, patient communication, and patient payments. Support a patient-centric revenue cycle with scheduling, billing, and claims processing.
 
AllegianceMD logo
 
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 and... Read More
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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 and... Read More
 

Buyer's Guide

by Lisa Hedges,
Content Analyst
Last Updated: May 3, 2018


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 software is an integral part of the overall revenue cycle management process. 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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