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AdvancedMD Medical Billing Review

Max Freedman
Max Freedman
  • AdvancedMD's medical billing service is our best pick for large practices.
  • AdvancedMD offers claim scrubbing, denied-claim management, outstanding-balance follow-up and more.
  • AdvancedMD does not manage charge entry or coding, so you will need to keep a biller on staff.
  • This review is for medical practice owners who are thinking of outsourcing their medical billing to AdvancedMD.

AdvancedMD Editor's Score: 87/100

Overall value 80/100
Medical software 80/100
Billing 80/100
First-pass acceptance rate (FPAR) 96/100
Customer service 85/100

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 98% first-pass acceptance rate (FPAR) means you'll get your claims paid quickly. And when any claims are denied, AdvancedMD's certified medical billers follow up within days. AdvancedMD can help large practices with high volumes of claims improve their medical billing.

AdvancedMD Medical Billing

AdvancedMD Medical Billing

The Verdict

AdvancedMD's medical billing services are comprehensive and competitively priced. The company's 98.4% first-pass claim acceptance rate and advanced medical software make it our best pick for large practices.

Large practices also need a top medical software platform. AdvancedMD's medical billing services include access to its electronic medical record (EMR) system and medical practice management software (PMS). We also named AdvancedMD our pick for the best medical software for large practices. Read our review of AdvancedMD's medical software to find out why.

Pros

  • AdvancedMD has a high first-pass acceptance rate.
  • The company follows up on any unpaid claims.
  • It has an experienced billing staff.

Cons

  • AdvancedMD doesn't offer charge entry or medical coding services.
  • The setup customization is difficult.

Usability

AdvancedMD's PMS interface, which you'll need to use for updates on how your billing team is managing your revenue, is quite user-friendly. However, the large number of shortcuts may prove overwhelming for some users. To address this concern, AdvancedMD offers one-on-one training if needed. The extensive library of online setup resources should also prove helpful.

One feature that simplifies AdvancedMD's usability is its dashboard. We particularly liked the inclusion of "task donuts," which provides a quick view of information relevant to each user. Providers, for instance, can set up task donuts to include their patients' notes, prescriptions, and lab orders or results, and a front-office staff member might customize the screen to show patient appointments, unread messages and provider availability. [Read Related: The Benefits of EFT and ERA in Medical Billing]

AdvancedMD
AdvancedMD task donuts provide an at-a-glance overview of key practice operations.

Features

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

Claim scrubbing AdvancedMD will scrub all your claims for errors, resulting in a first-pass claim acceptance rate of 98.4%.
Denied-claim services Although denied claims are rare with AdvancedMD, the company will handle the entire process of getting denials approved.
Flexible solutions AdvancedMD works with health systems with as many as 30,000 monthly patient encounters, but it also works with small practices.
Highly experienced staff All AdvancedMD billers have at least one year of experience, and many are certified medical coders.
Outstanding-balance follow-up If either patients or payers are overdue on payments, AdvancedMD will follow up with them regularly until you're reimbursed.

Claim Scrubbing

Your AdvancedMD medical billers will scrub all your claims for errors and file your scrubbed claims to payers. However – and this is especially important to note – your AdvancedMD billing team will pick up the slack only after your team has entered and coded your charges. 

Did you know?Did you know? AdvancedMD will not manage your charge entry and coding, but the company will pick up the billing process after you've coded your medical claims.

As such, you'll still need front-office staff who are capable of entering and coding your charges. This distinction separates AdvancedMD from most other medical billing services that always enter and code your charges.

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.

However, denied claims are unlikely with AdvancedMD. The company's billing team boasts an outstanding 98.4% FPAR. That means that if your practice is large enough to see 10,000 patients per month, only 160 or so claims will be denied on the first pass. AdvancedMD saves you immense headaches on delayed-claim payments that hamper your practice's cash flow.

Flexible Solutions

Although we've recommended AdvancedMD as our top revenue cycle management (RCM) pick for large practices, you can use it no matter your practice size. AdvancedMD handles billing for practices with as few as 100 or as many as 30,000 encounters per month. The company says its average number of monthly encounters among medical billing clients is 3,000. 

Did you know?Did you know? The average AdvancedMD client has roughly 3,000 patient encounters per month. The company has expertise with diverse specialties from dermatology billing to mental health billing.

That said, AdvancedMD is perhaps 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 through payer approval and payment. You can read more in our review of DrChrono’s medical billing service. However, if the other benefits of AdvancedMD prove thoroughly convincing, it's possible for a small practice to have success with AdvancedMD.

AdvancedMD
An overview of financial performance offers you a transparent window into the success of your outsourced billing team.

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. With AdvancedMD, that's not an issue.

AdvancedMD only hires billers with at least one year of medical billing experience, and 10% to 20% of AdvancedMD's billers are also certified medical coders. This certification means that you can trust the AdvancedMD team to adequately scrub your claims; after all, the company does have a 98.4% FPAR. 

Outstanding-Balance Follow-Up

AdvancedMD won't let the money you're owed go unpaid. If a payer approves a claim and doesn't pay within a reasonable time frame, AdvancedMD will follow up until you get paid. The company will do the same with patients who owe you money. 

The result is that your front-office staff 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
Encouraging patients to update information in the patient portal ensures billers can contact patients when they owe a balance to your practice.

Pricing

For RCM services, AdvancedMD typically charges 4% to 6% 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. 

Setup

As you get started with AdvancedMD's RCM platform, you'll be offered all kinds of webinars, training videos and ICD-10 coding resources. You'll also notice that the software for connecting with your AdvancedMD billers includes support for clinical modification codes and hospital procedure codes. 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 the 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. 

Key TakeawayKey takeaway: Although AdvancedMD offers a wide range of customized reports, setting up your customized suite is often quite challenging.

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.

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 get your customized system set up, you'll be using one of the most powerful RCM platforms available.

Methodology

We spent hours researching medical billing services. That research included software demonstrations, phone interviews and customer service calls, as well as analysis of customer service reviews available online, including those listed on the Better Business Bureau website. We spent several months browsing company websites, reading customer reviews and speaking with company representatives. When choosing our pick 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 our best pick for large practices. 

What Is a Medical Billing Service?

A medical billing service is a company that maintains a staff of medical billers (and sometimes coders) to prepare and track claims on behalf of client healthcare organizations. Medical billing services often hire certified medical billers with credentials such as AAPC or AHIMA certification. These organizations tend to offer specialty experience and consultation to a healthcare organization, removing the burden of managing billing while maintaining transparency into financial performance. The best medical billing services excel at not only managing a healthcare organization's billing but also improving collections and boosting revenue. 

AdvancedMD Medical Billing FAQs

How much does AdvancedMD's medical billing service cost?

AdvancedMD's medical billing service ranges from 4% to 6% of your monthly collections. The pricing varies based on factors such as practice size, specialty, claim volume and billing complexity. These rates are competitive with those of the other medical billing services we reviewed.

Do I have to use AdvancedMD's medical software to use the billing service?

Yes, to outsource medical billing to AdvancedMD, clients also must use the company's medical practice management software. Because AdvancedMD's medical billers use the same software, you can monitor their activity in real-time. Use of AdvancedMD's EMR system is not required, but it is recommended for practices that adopt the PMS.

Does AdvancedMD's medical billing service include medical coding?

No, AdvancedMD does not handle charge entry or medical coding as part of its revenue cycle management services. You will need to have a medical coder on staff or outsource to another company that will perform medical coding. 

Bottom Line

We recommend AdvancedMD Medical Billing for ...

  • Large practices with multiple locations and high volumes of claims.
  • Practices that have 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 that are looking to avoid steep learning curves with reporting interfaces.
  • Practices that are looking to outsource all of their revenue cycle management, including medical coding.

Image Credit: Getty Images
AdvancedMD Medical Billing

AdvancedMD Medical Billing

The Verdict

AdvancedMD's medical billing services are comprehensive and competitively priced. The company's 98.4% first-pass claim acceptance rate and advanced medical software make it our best pick for large practices.

Max Freedman
Max Freedman
Business News Daily Contributing Writer
Max Freedman is a content writer who has written hundreds of articles about small business strategy and operations, with a focus on finance and HR topics. He's also published articles on payroll, small business funding, and content marketing. In addition to covering these business fundamentals, Max also writes about improving company culture, optimizing business social media pages, and choosing appropriate organizational structures for small businesses.