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AdvancedMD

Best Medical Billing Service for Large Practices

A Business News Daily Review

Product and service reviews are conducted independently by our editorial team, but we sometimes make money when you click on links. Learn more.

After conducting research and analysis of medical billing services, we recommend AdvancedMD as the best medical billing service for large practices.

We chose AdvancedMD from a pool of dozens of medical billing services. To learn more about our full methodology and for a more comprehensive list of medical billing companies, see Business News Daily's best picks.

AdvancedMD's medical billing service is capable of handling all the revenue cycle management for large and small practices alike. The company excels in managing billing for practices in the 100-provider space, making it our best pick for medical billing service for large practices.

AdvancedMD's outsourced revenue cycle management comes with access to its electronic medical record (EMR) software and practice management platform for a monthly percentage of clients' net collections. Currently, AdvancedMD boasts an organization-wide first-pass claims rate of 98.4%, which is one of the highest of the services we reviewed. The company will also contractually guarantee a minimum first-pass claims rate of 95% for all clients, and it is the only company we reviewed that provides such a guarantee.

Editor's note: Looking for a medical billing service for your practice? If you're looking for information to help you choose the one that's right for you, use the questionnaire below to receive more information from our vendor partners.

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AdvancedMD begins the billing process after the charge entry and coding phase has already been completed. AdvancedMD does not perform charge entry or coding services at all, so that responsibility falls on the practice to complete in-house or outsource to a third party. Once claims are generated, practices can submit them to AdvancedMD for claims scrubbing to capture any errors prior to submission. Currently, the organization-wide first-pass claims rate for AdvancedMD is 98.4%, which is one of the highest rates we found in our review. That means only 2.6% of claims submitted by AdvancedMD are denied by payers.

Once claims are scrubbed, AdvancedMD submits them to the proper payer through its clearinghouse partners. The company primarily works with Change Healthcare clearinghouse. Any clearinghouse fees incurred during this process are built into the company's pricing models and are not charged to the practice on top of the percentage price quoted by AdvancedMD.

If a claim is denied, AdvancedMD's medical billing team will inform the practice as to why the claim was rejected and then work to revise and resubmit the claim until it is paid. The company also follows up with patients and payers with an outstanding balance.

AdvancedMD is our best pick for medical billing service for large practices, but it also works with smaller practices and across all specialties. The average client has roughly 3,000 patient encounters per month, although some of its larger clients submit claims for more than 30,000 encounters per month. AdvancedMD can adapt its medical billing services to your practice's specific needs, though the volume of claims you submit could ultimately influence the price you pay.

The average AdvancedMD client pays between 4% and 6% of the net monthly collections the company secures on its behalf. However, company representatives told Business News Daily there are some outliers that pay as low as 2% or as high as 8% of collections; AdvancedMD's pricing model takes into account a variety of factors, including practice size, the number of claims submitted, the number of patient encounters, the specialty and the complexity of the billing process.

  • Monthly collections: The ultimate price will be the higher of a monthly minimum (set during contract negotiation) or a percentage of your monthly collections, so to offer a precise quote AdvancedMD needs to know how much your practice brings in per month.
  • Patient encounters: Pricing will also depend on the number of total patients seen by physicians.
  • Specialty: Because the billing process and specific rules can vary so much from specialty to specialty, AdvancedMD incorporates the complexity of your specialty into the final percentage.
  • Number of providers: Finally, your total number of providers can also influence the quote.

To obtain a custom quote, contact an AdvancedMD sales representative and provide this information about your practice. They will return a custom quote for you that includes medical billing services, as well as access to the company's full healthcare IT software suite, including EHR and practice management software.

AdvancedMD maintains a full suite of healthcare IT products, including an EHR system and integrated practice management software. It is our best overall pick for electronic medical record software, and you can read a full review of AdvancedMD's EHR software here.

Full access to the EHR and practice management software adds a great deal of value to AdvancedMD's RCM service. At normal cost, the system is more than $700 per month, plus thousands in implementation and training fees; however, with AdvancedMD's medical billing service, the software is included in the negotiated percentage of collections.

These are some highlights of AdvancedMD's EHR and practice management software:

  • Three tiers of implementation and training plans to suit different levels of experience
  • Eight- to 11-week implementation period
  • Extensive integrations with labs, pharmacies and hospitals nationwide
  • 24/7 customer help desk

It is not required for the company's medical billing service clients to use AdvancedMD's EHR software, but they must be on the company's practice management system. This is because AdvancedMD's medical billers use the practice management software to submit and track claims. Practices can monitor the billing team's progress using the software just as they would monitor any in-house staff.

AdvancedMD's practice management software includes extensive reporting functions through the AdvancedInsight module. AdvancedInsight offers a complete view of your practice's financials. It also includes useful planning tools. These are some of the features in AdvancedInsight:

  • Practice benchmarking: Benchmarking is essential to understanding how your practice fits in within the larger industry. AdvancedMD's benchmarking tool allows you to compare your numbers to other practices based on geographic region, specialty, or size to see how you stack up. Benchmarking helps show you where your practice is performing strongly and where it needs improvement. When you outsource your medical billing, these insights could help you see how the RCM team you've partnered with is delivering.
  • Financial dashboard: AdvancedMD's financial dashboard brings your practice's most critical financial information to one central location. The data is displayed in visualizations, like charts and graphs, which can be filtered in a number of ways to help you better understand your cash flow and the income sources.
  • Data analytics: The data analytics tool takes the financial dashboard a step further and allows you to examine historical data and make projections to help guide your business strategy. The tool shows recent trends in accounts receivable, practice productivity and reimbursements. It also allows you to examine your referral network and see which relationships are paying off the most.

The tools in AdvancedInsight are easy to use, and you get on-screen advice that makes navigation easier when you're still learning the program. Overall, it adds a strong element of visibility into the effectiveness of your managed billing.

AdvancedMD offers a strong support system for practices that want to remain engaged with their billing operations even after outsourcing them to a third party. Even though the company doesn't perform charge entry and coding functions, it helps practices manage those tasks by providing thorough resources regarding the ICD-10 coding standards and how to abide by them.

Support staff is available through live and email channels. In addition, AdvancedMD provides a wide range of support material, including how-to guides, tips and tricks articles, and webinars to help staff understand the ins and outs of the platform. Finally, there is a series of regulatory information and updates available through AdvancedMD's website.

AdvancedMD's largest limitation is the fact that it does not manage charge entry or the coding of claims. These are important aspects of the medical billing process that require experienced, certified coders to perform properly. Certified coders could represent a significant in-house cost, so many practices look to  outsource this aspect of the medical billing process. Many of the other medical billing services we reviewed do offer charge entry and coding services, so AdvancedMD is lacking in this regard.

Once claims are generated, AdvancedMD takes over and offers exceptional claims scrubbing services and a medical billing team that works well to get your claims paid. Its high first-pass claims rate, competitive pricing and strong suite of software were enough to earn it our best pick for medical billing services for large practices.

Ready to choose a medical billing service? Here's a breakdown of our complete coverage:

Editor's note: Looking for a medical billing service for your practice? If you're looking for information to help you choose the one that's right for you, use the questionnaire below to receive more information from our vendor partners.

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Adam C. Uzialko

Adam C. Uzialko, a New Jersey native, graduated from Rutgers University in 2014 with a degree in political science and journalism and media studies. He reviews healthcare information technology, call centers, document management software and employee monitoring software. In addition to his full-time position at Business News Daily and Business.com, Adam freelances for several outlets. An indispensable ally of the feline race, Adam is owned by four lovely cats.