AdvancedMD Medical Billing Review

Why AdvancedMD Is the Best for Large Practices

AdvancedMD offers a medical billing service that picks up medical claims after they’ve been coded by your practice. For large practices, this is no obstacle, and AdvancedMD’s medical billing service is exceptional from there. Its 95 percent first-pass acceptance rate (FPAR) means you’ll get your claims paid quickly. And when any claims are denied, AdvancedMD’s certified medical billers reportedly follow up within 14 days. AdvancedMD can help large practices with high volumes of claims improve their medical billing.

Large practices also need to choose a medical software platform. AdvancedMD’s medical billing services include access to the company’s electronic medical record (EMR) system and medical practice management software (PMS).

Usability

AdvancedMD’s PMS interface is user-friendly, allowing you to make updates on how your billing team manages your revenue. However, the large number of shortcuts may prove overwhelming for some users. 

To address this concern, AdvancedMD offers one-on-one training if needed. However, this training is expensive, especially considering other RCM providers offer free training. The extensive Learning Center of online setup resources should also prove helpful, though.

One feature that simplifies AdvancedMD’s usability is its dashboard. We particularly liked the inclusion of “task donuts,” which provide a quick view of information that’s relevant to each user. For instance, a provider could set up task donuts to include their patients’ notes, prescriptions, lab orders and results. Front-office staff members can even customize the screen to show patient appointments, unread messages and provider information. [Related article: The Benefits of EFT and ERA in Medical Billing]

AdvancedMD Features

Here are some of AdvancedMD’s most important medical billing features:

Claim Scrubbing

Your AdvancedMD medical billers will scrub all your claims for errors and file your scrubbed claims to payers. However it’s especially important to note your AdvancedMD billing team will take over only after your team has entered and coded your charges.

As such, you’ll still need staff who are capable of entering and coding your charges. This distinction separates AdvancedMD from most other medical billing services we reviewed, which offer charge entry and coding services.

Denied-Claim Services

If any claims that AdvancedMD’s billing team files for you wind up denied, you won’t be left to pick up the slack. Instead, AdvancedMD will put its full effort behind revising the claim and resubmitting it as many times as needed until the payer approves it.

Most claims should be accepted by payers on the first attempt, though. The company’s billing team boasts an outstanding 95 percent FPAR. That means that if your practice is large enough to submit 100,000 claims per month, only about 5,000 claims will be denied on the first pass. AdvancedMD is a great choice to reduce the overall days in A/R for your claims, which would otherwise hamper your practice’s cash flow.

Focus on Large Practices

AdvancedMD handles billing for 65,000 practitioners throughout 14,000 practices who typically have 305,000 to 350,000 patient encounters per month. The company has said its average number of monthly encounters among medical billing clients is 317,000. These metrics make it clear that AdvancedMD focuses on large practices. You can rest assured knowing that this provider has the capacity and knowledge to meet the needs of large and complex health systems.

While AdvancedMD does serve 900 independent medical billing companies, it’s likely an imperfect fit for small practices. A single-doctor practice with a small front-office staff might prefer a medical billing service such as DrChrono, which sees the process through from charge entry and coding all the way to payer approval and payment. You can learn more in our review of DrChrono’s medical billing service.

Highly Experienced Staff

Many practices seek medical billing services because even the most robust PMS isn’t saving their front-office staff quite enough time to handle patient-facing work. If that’s the case for your practice, you’ll want to make sure the medical billers you choose won’t find practice management systems tough to use. AdvancedMD has been supporting medical billing companies for 20 years to drive exceptional billing and collections results.

Follow-Up on Outstanding Balances

AdvancedMD won’t let the money you’re owed go unpaid. If a client is utilizing AdvancedMD’s RCM services and a payer approves a claim and doesn’t pay within a reasonable time frame, AdvancedMD will follow up until you get paid. It will do the same with patients who owe you money. If a claim gets rejected, AdvancedMD billing services will send follow-ups. The service will also perform accounts receivable follow-up, payment posting and remittance auditing.

The result is that your front-office employees don’t have to pester patients and payers and can instead focus on the patient experience. It also means you’ll be less likely to have to send patients or payers to collections.

AdvancedMD Cost

For RCM services, AdvancedMD typically charges 4 percent to 8 percent of your monthly collections. These rates are competitive in the medical billing space. Your exact rate will depend on your practice’s size, claim volume, medical specialty, billing complexity and other factors.

You have to contact an AdvancedMD sales representative to get the exact price your plan will be. AdvancedMD offers billing service, RCM and software packages along with a bundle where you’ll save up to 40 percent. This way, if you need more than medical billing services, AdvancedMD has options. 

You can request a demo of the platform if you need help selecting the right plan for the ideal bundle. The AdvancedMD team will discuss your best options based on your budget and growth plans.

AdvancedMD Setup

As you get started with AdvancedMD’s RCM platform, you’ll be offered all kinds of webinars, self-guided training materials and ICD-10 coding resources. You’ll also notice that the software for connecting with your AdvancedMD billers includes support for current procedural terminology (CPT) and healthcare common procedure coding system (HCPCS). This inclusion makes AdvancedMD compatible with a wide variety of medical specialties and clinical settings.

AdvancedMD’s RCM setup also lets you customize several billing-related reports. You can configure these reports in a way that best serves your practice’s specialty, but doing so isn’t exactly easy. AdvancedMD’s reporting suite setup is known to be lengthy and full of unpleasant obstacles.

The challenges with AdvancedMD’s medical billing setup stem mostly from the company’s vast number of features. Though the abundance of features makes AdvancedMD exceptionally flexible, it presents a learning curve you might not experience with other RCM interfaces.

AdvancedMD Drawbacks

One downside of outsourcing medical billing to AdvancedMD is that the company doesn’t offer charge entry or coding management. If outsourced charge entry and coding management are crucial to your billing services, you’ll need to handle them in-house. This setup may make AdvancedMD the wrong choice for tiny practices.

Another challenge relates to the setup: If you want to customize your managed billing and reporting portal, you might be in for a tough time. We found AdvancedMD’s setup for these features to be more difficult than with other medical billing services. However, once you do set up your custom system, you’ll be using one of the most powerful RCM platforms available.

Methodology

We spent hours researching medical billing services, which included software demonstrations, phone interviews, customer service calls and analysis of customer reviews, including those on the Better Business Bureau website. We spent several months browsing company websites, reading customer reviews and speaking with company representatives. To find the best for large practices, we compared the services’ experience with large practices and health systems, as well as its associated medical software’s ability to handle multiple providers and locations. Based on these factors, we chose AdvancedMD as the best medical biller for large practices.

Overall Value

We recommend AdvancedMD Medical Billing for …

• Large practices with multiple locations and high volumes of claims.
• Practices with in-house medical coding capabilities.
• Practices that need extensive coding resources.

We don’t recommend AdvancedMD Medical Billing for …

• Newly opened medical practices that need simple software.
• Practices looking to avoid steep learning curves with reporting interfaces.
• Practices that want to outsource all of their RCM, including medical coding.