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The Best Medical Billing Services of 2022

Max Freedman
Business News Daily Contributing Writer
| Updated
Jun 24, 2022

Find the right medical billing services for your practice based on practice size, claim volume, flexibility and other needs.
Best for New Practices
Flexible services
Customizable reports
Integrated EMR and PMS
Best for Reporting
athenahealth Medical Billing
Thorough reporting suite
Similar-practice analysis
Hands-on consultation
Best for Large Practices
AdvancedMD Medical Billing
Exceptional first-pass acceptance
Highly experienced staff
Hundreds of customizable reports
Best for Medical Billers
RxNT Medical Billing
Software specifically for billers
Integrated clearinghouse
Solutions for all sizes
Best User-Friendly Medical Billing Service
Kareo Medical Billing
Great user experience
Flexible services
High first-pass acceptance rate
Find the right medical billing services for your practice based on practice size, claim volume, flexibility and other needs.

Best Medical Billing Services

  • Medical billing services are third-party companies that handle a medical practice's revenue cycle management.
  • The cost of medical billing services range from 3% to 10% of monthly practice collections.
  • ChartLogic is the best medical billing service for small practices; AdvancedMD is the best medical billing service for large practices; and CareCloud is the most flexible medical billing service we reviewed.
  • This article is for medical practice administrators considering outsourcing their revenue cycle management to a medical billing service.

Medical practices contend with a convoluted billing process unlike other businesses, which can often mean payment for services rendered often comes weeks or months after the fact. Medical billing services expedite the time it takes practices to receive payment from insurance providers and the government, plus it helps practices save on payroll costs. To determine the best medical billing services of 2020, we thoroughly examined nearly 30 vendors, comparing key factors like pricing, fees, contracts, claims processes, and broader healthcare IT products. Read more below about the options we think are best for various types of medical practices


Find the Right Medical Billing Service for Your Business

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Compare Our Best Picks

RCM Editor's score Use case Pricing (% of monthly collections) End-to-end RCM? Contract requirement Practice management software First-pass claims acceptance rate* Credentialing support Operating systems
athenahealth 87/100 Best for reporting 7% to 8% No medical coding 2 years Required 93% Full service, recredentialing Windows 8.1, 10; macOS; iOS
AdvancedMD 87/100 Best for large practices 3% to 8% No medical coding 1 year Required 96% (contractually guaranteed) Full service, recredentialing Windows 10; macOS
RXNT** 88/100 Best for medical billers Starts at $65 a month plus per-claim charge N/A 1 year N/A N/A NPIs, DEA licensure Windows; macOS
DrChrono 86/100 Best for new practices Requires quote Yes 1 year Required 96% Full service, recredentialing Windows 7 and above; macOS 10.12 and above
MedClarity 82/100 Best for dermatologists Requires quote Yes Varies Required >95% Full service, recredentialing Windows 7 or above
Kareo 86/100 Best for ease of use Varies among third-party billers Works with third-party billers 30-day cancellation notice Required >95% Full service, recredentialing Windows 10
CureMD 86/100 Best for tracking KPIs Starts at 4% Yes 1 year Required 98% Applications, follow-up Windows 10
SimplePractice 82/100 Best for paying as you go 3% to 7% Works with third-party billers 1 to 2 years Required Varies among third-party billers Third-party billers Windows 8.1, 10; macOS 10.14 and above; iOS 13; Android 7.0
MedicsPremier 82/100 Best for growing practices 3% to 6% Yes Varies Required ~99% Full service, recredentialing Windows 10
ChartLogic 85/100 Best for free implementation 3% to 6% Yes 2 years Required >95% Full service, recredentialing Windows 8.1 and 10
CareCloud 88/100 Best for flexibility 3% to 7% Yes 3 years Required ~97% Full service, recredentialing Windows 7 and above; macOS 10.6 and above

*Some billing companies rely on a composite first-pass claims rate, which may slightly inflate the percentage of claims truly accepted and paid on the first pass.

**Does not offer medical billing services; instead provides software used by medical billers in practices and at RCM companies.

Our Reviews

DrChrono Medical Billing: Best Medical Billing Software for New Practices

DrChrono is great for new practices in need of medical billing, as it handles the entire RCM cycle.
DrChrono has a high FPAR of 97%.
DrChrono requires you to use not just its practice management software, but its EMR system as well.

Editor's score: 86/100

In our review, we found DrChrono's revenue cycle management services ideal if you are opening a new medical practice and need a lightweight yet effective system to get started. The company can handle your entire billing cycle, from charge entry and coding to final payment, while achieving an above-average FPAR of 97%.

DrChrono not only thoroughly scrubs your claims before filing them, but also monitors your claims throughout their approval process. These processes largely explain how DrChrono achieves its high FPAR. In the rare event that your claims are denied, DrChrono will entirely oversee the process of rectifying them and getting them approved and paid.

DrChrono's RCM services include access to its EMR and PMS systems. Like most medical billing services, DrChrono requires you to use its PMS. However, unlike most services, DrChrono also mandates that you use its EMR, and you'll have to pay for the data migration if you need to switch EMR platforms to make this happen.

EverCommerce, a medical software-as-a-service company, recently acquired DrChrono. This acquisition has resulted in EverCommerce adding DrChrono to its EverHealth integrated medical software.

That said, EverCommerce already has its own medical billing service, AlertMD. It remains unclear whether EverCommerce will merge AlertMD and DrChrono into one new product or AlertMD will absorb all DrChrono medical billing features and staff. For now, DrChrono remains a distinct entity with no changes to its medical billing operations. We will consider this acquisition and how it impacts service offerings the next time this category is updated.

Read DrChrono Medical Billing Review

athenahealth Medical Billing: Best Medical Billing Service for Reporting

Athenahealth's consulting and reporting services go above and beyond those of most revenue cycle management services.
The athenahealth rules engine scrubs your claims based on common denials from nearly 7,000 other practices.
Athenahealth won't enter and code your charges or manage all your denied claims, so you'll need an in-house medical biller.

Editor's score: 87/100

In our review, we found that athenahealth is an excellent revenue cycle management pick for practices interested in a hands-on consultative approach. It's also an ideal partner for practices that might struggle to keep pace with denied or rejected claims, as its first-pass acceptance rate (FPAR) for electronic claims is 99%.

Athenahealth's medical billing team will use its rules engine to scrub your claims for common errors. The information behind this engine comes from common payer denials among athenahealth's network of nearly 7,000 practices. You can customize it to reflect your payers' common reasons for denial as well.

For urgent situations that merit immediate patient care, athenahealth provides same-day or next-day authorizations. athenahealth will initiate the authorization process within two hours of receipt for same-day cases. You’ll see your urgent authorizations completed within 48 hours 94% of the time.

Although claim rejections and denials are infrequent with athenahealth, the company will manage some of your denials and rejections until you get reimbursed. However, it won't do this for all your denials, nor will it code and enter your charges. These tasks fall to the medical biller you must keep on staff to use athenahealth.

Athenahealth has an integrated clearinghouse, though it sometimes files claims directly with payers. When payments are overdue, athenahealth will follow up until you're reimbursed.

Athenahealth's standout tool is its consulting and reporting suite. Its billing team will reach out to you first if they notice drops in performance or metrics below the standard for practices similar to yours. You'll also receive custom reports and learn how to manage your practice for higher profits. This extent of consultation is rare among revenue cycle management services and, for some practices, may make up for athenahealth's flaws.

Read athenahealth Medical Billing Review

AdvancedMD Medical Billing: Best Medical Billing Service for Large Practices

AdvancedMD has an especially high first-pass acceptance rate of 98.4%.
AdvancedMD is well versed in working with large practices.
AdvancedMD won't code or enter your charges.

Editor's score: 87/100

We've chosen AdvancedMD as the best medical billing service for large practices. Its revenue cycle management team boasts an FPAR of 98.4%, which is especially high among the companies we reviewed.

AdvancedMD's high FPAR stems from the fact that all its billing team members must have at least one year of experience, and many are certified medical coders. These experts are more than qualified to scrub your claims in ways that minimize errors. That said, you'll have to do the work to get your claims into AdvancedMD's system, as its billing services don't include charge entry or coding.

In the rare event that your claims are denied, AdvancedMD will handle all the work involved in pursuing them, keeping the burden off your staff so you can focus on delivering care. We also like how AdvancedMD will follow up with payers or patients who haven't yet paid their bills.

Large practices in need of medical billing services can work with AdvancedMD. Its clients' average number of monthly patient encounters is 3,000, though some clients see as many as 30,000 patients per month. Most AdvancedMD client practices also have at least 100 care providers on staff.

Read AdvancedMD Medical Billing Review

RxNT Medical Billing: Best Medical Billing Software for Medical Billers

RXNT is one of the few services we found that offers software for medical billing companies instead of the client practices.
RXNT's medical billing software facilitates the entire process, from charge entry and coding through final reimbursement.
RXNT does not offer revenue cycle management to practices, and medical billing companies can only use it for 50 claims per month.

Editor's score: 88/100

Unlike the other medical billing services in our reviews, RXNT offers not revenue cycle management but software that medical billing companies can use. This software enables medical billing firms to complete all their important RCM tasks from start to finish.

RXNT's medical billing platform makes entering and coding charges easy. It also has a rules engine that automatically flags common claim errors to minimize denials and rejections. The result is a high FPAR for your company, though a small number of denials and rejections is inevitable, of course. When you do experience claim denials, RXNT has the tools you'll need to manage, revise and resubmit them on your clients' behalf.

We like how RXNT's clearinghouse is fully integrated with the medical billing software, meaning you won't have to charge your clients extra for its use. Once claims made through the clearinghouse are approved, you'll have everything you need right in front of you to follow up on any claims that patients or payers don't pay on time.

If you want to expand your medical billing company's services into consulting, RXNT has reporting features to facilitate this transition. These and all other features are available to your company from any location, whether you're a one-person operation or a gigantic team. However, RXNT appears to limit providers to 50 claims per month. Outside this limitation, RXNT is our best pick for medical billing companies.

In a recent mobile app update, RXNT introduced several features to align its app more closely with its cloud-based desktop software. While many of these updates pertain more to RXNT’s EMR and PMS, some are relevant to RXNT’s medical billing software. These updates include direct access to your state’s prescription monitoring program and an improved sign-in screen. They also have faster links to a patient’s medication history, chart, forms and encounters.

Read RxNT Medical Billing Review

Kareo Medical Billing: Best User-Friendly Medical Billing Service

Kareo is great for small practices that only want to outsource some of their billing needs.
Kareo offers an especially user-friendly PMS where you can track its billing team's progress on your claims.
Kareo doesn't typically respond to its Better Business Bureau complaints.

Editor's score: 86/100

Kareo is another excellent choice for small practices, especially those that only need to outsource part of their revenue cycle management. These practices will benefit from Kareo's ability to oversee small, modest or large swaths of the process while remaining accountable to you. Because Kareo requires you to use its PMS, you'll see real-time updates of its billing team's progress with your claims.

With Kareo, you'll get the standard features for medical billing services, including charge entry and coding, claim scrubbing, denied-claim management, and follow-up on unpaid claims. You'll also get full access to Kareo's EMR at no additional cost. Also included in your costs are Kareo's clearinghouse fees, for which some other billing services charge extra.

Kareo’s automated billing service sends patients text, email, and printed statements to have up-to-date records of their bills. This helps ensure that patients can receive bills in whatever form is most convenient for them.

Kareo is especially well known for its user-friendliness. Its EMR and PMS dashboards resemble social media feeds, and most features are accessible with just one or two clicks. We were slightly concerned to see Kareo not responding to customer complaints on the Better Business Bureau site, as is common practice. That said, conflating a lack of response with a bad product is ill-advised – overall, Kareo is quite strong.

Kareo has merged with the healthcare marketing agency PatientPop. The merger gives all customers of one service access to the other as well. Since Kareo’s medical billing service includes access to its EMR, it now also includes access to PatientPop. This arrangement means that, when choosing Kareo for medical billing, you’ll also get robust patient acquisition tools. For now, Kareo and PatientPop remain distinct brands but they will eventually become the joint brand Tebra.

Kareo’s automated billing service sends patients text, email, and printed statements so they have up-to-date records of their bills. The convenience and accuracy this service provides have kept more than 1,600 billing companies across the U.S. using Kareo.

Read Kareo Medical Billing Review

MedClarity: Best Medical Billing Service for Dermatologists

MedClarity specializes in dermatology medical billing services, though it can work with any practice in any field.
MedClarity can manage part or all of your revenue cycle.
MedClarity doesn't list the range of monthly collection percentages it charges its clients – you'll need to obtain a custom quote.

Editor's score: 82/100

MedClarity's medical billing services are strongly tailored to one specialty: dermatology. That's because, like pretty much every specialty, dermatology has its own ICD-10 codes and payer standards not seen in other fields. MedClarity's experience with these dermatology billing considerations makes it our top pick for dermatologists, who can also use MedClarity's specialty medical software.

With MedClarity's revenue cycle management services, dermatologists get a third-party partner skilled at avoiding claim rejections and denials. MedClarity's dermatology billing experience is behind not just its high FPAR but also its consulting power. Given the company's extensive knowledge of the dermatology revenue cycle, it's better equipped than more general RCM providers to advise your dermatology practice.

MedClarity will take on practices in any specialty – dermatology just happens to be its forte. Whether you run a dermatology practice or boast solely primary care physicians, you can count on MedClarity to oversee part or all of your revenue cycle. You don't need to have billers or coders on staff to use MedClarity, and you don't have to go entirely outsourced either.

Unlike most other medical billing services we've reviewed, MedClarity won't transparently provide its pricing until you get a quote from the company. Therefore, we can't state the range of monthly collection percentages that MedClarity will charge you for its services. However, we can say that your percentage will vary based on the usual factors: your claim volume, average claim value, specialty and more. For dermatologists, the spend is probably worth it.


CureMD: Best Medical Billing Service for Tracking KPIs

CureMD offers medical billing services to 32 specialties at competitive prices.
CureMD's services include medical billing and coding, credentialing, and schedule review.
CureMD's setup and implementation are known to be tough, and since you must also use the company's PMS, you can't avoid these steps.

Editor's score: 86/100

CureMD is among the most versatile medical billing services we reviewed. It can manage the revenue cycle of 32 medical specialties with its vast knowledge of ICD-10 codes and payer rules. It also charges as little as 4% of your monthly collections. Most of the companies we reviewed charge 6% to 8% of monthly collections (and some go as high as 9%), making CureMD's pricing highly competitive.

Although medical coding and billing are its bread and butter, you can also hire CureMD for denial management, credentialing, schedule review, patient payment collection and insurance eligibility verification. CureMD says its FPAR is 96%, which is highly competitive with the industry standard. 

Unlike many other RCM services we reviewed, CureMD handles the majority of your implementation needs and takes a substantial burden off your plate. It will also train your team on how to use its platform. Nevertheless, some CureMD customers say that the implementation process is challenging and lengthy. And it's not like you can avoid implementing CureMD's software – like most medical billing services, CureMD requires you to use its PMS. 

CureMD recently launched a new COVID-19 rapid testing platform to help practices manage demands for testing. The software can remind patients about their upcoming appointments, send test results and automatically scrub and submit electronic claims. It also gives each patient a “digital health card” through which they can view their testing and results history.

The good news is that, after the challenges of setup, CureMD's medical software platform is easily navigable. For user-friendly, low-cost, versatile medical billing, CureMD is an excellent choice.


SimplePractice: Best Pay-as-You-Go Medical Billing Service

SimplePractice offers low-cost medical software and, through third parties, medical billing.
SimplePractice won't lock you into long-term contracts, so you can cancel whenever you want.
SimplePractice's medical billing services don't happen in-house, though your third-party biller will likely appear fully integrated with the SimplePractice medical software platform.

Editor's score: 82/100

Unlike other medical billing services we reviewed, SimplePractice is not a direct billing services provider. However, it can get you RCM services through third-party partners at a low cost. For its medical software – through which SimplePractice can find you a third-party billing partner – you might pay as little as $39 per provider per month. SimplePractice is an excellent choice for any practice looking into mental health billing.

Of course, SimplePractice's third-party billing partner will charge a percentage of your monthly collections, as is standard practice for medical billing services. SimplePractice says that its average third-party collection percentage is 2.5% to 7%. The low end of this range is the most affordable we've seen in our reviews. 

We found that SimplePractice's setup process is budget-friendly too, as you won't pay any extra fees for implementation help. Plus, unlike most of its competitors, SimplePractice doesn't lock you into long-term contracts. Instead, you just need to give 30 days' notice if you intend to cancel.

Perhaps the only drawback of SimplePractice is its lack of in-house medical billing services. However, interfacing with your third-party outsourced biller is such a seamless process through the SimplePractice medical software platform that the biller might as well belong to SimplePractice.


MedicsPremier: Best Medical Billing Service for Growing Practices

MedicsPremier's medical billing services cost 3% to 6% of your collections, which is highly competitive even at the high end.
MedicsPremier says that its rules-based claim-scrubbing engine results
MedicsPremier has one of the least user-friendly software interfaces we reviewed, likely requiring extensive training during implementation.

Editor's score: 82/100

MedicsPremier is a low-cost medical billing service with features that offer value greater than what you'll actually pay. MedicsPremier costs 3% to 6% of your monthly collections, a very competitive range compared to other medical billing services we reviewed.

In our review, we found that MedicsPremier will scrub your claims using a proprietary rules engine, through which it claims it can achieve an FPAR of over 99%. For any claims that slip through and get denied or rejected, MedicsPremier will manage the entire revision and resubmission process. MedicsPremier will also verify your patients' insurance so you can know whether your payers will actually cover your services.

We like that MedicsPremier billing services include credentialing with both clearinghouses and insurance companies. The company will post any explanations of benefits and electronic remittance advice that you and your patients should see. MedicsPremier can also help uninsured patients find insurance (though the patient is ultimately responsible for signup). This service is unique to MedicsPremier.

Although MedicsPremier is a cost-effective medical billing choice, the software interface isn't very user-friendly. Without thorough training, your team may find the software difficult to navigate effectively. However, between MedicsPremier's low price and high FPAR, growing practices may still find it to be the right choice to build on their momentum.


CareCloud: Best Flexible Medical Billing Service

CareCloud is a medical billing service provider that can manage part or all of your revenue cycle.
Unlike every other medical billing service we reviewed, CareCloud doesn't require you to use its PMS.
CareCloud's setup process is expensive, and the company typically requires three-year contracts.

Editor's score: 88/100

CareCloud is a medical billing service that can manage part or all of your revenue cycle. You can also opt in to CareCloud's medical software and consulting services when you hire the company for revenue cycle management. Even better, CareCloud is unlike most medical billing services in that, as of its 2020 acquisition by MTBC, it doesn't require its RCM clients to use its PMS. This PMS-agnostic structure is exceedingly rare among medical billing services.

Like every medical billing service we reviewed, CareCloud takes a percentage of your monthly collections as its commission. The percentage you can expect to pay spans 3% to 7%. Rates on the high end are common among medical billing providers, but rates on the low end are somewhat rare finds. Your exact rate will depend on standard factors such as your average claim volume and value, billing complexity, specialty, and practice size.

CareCloud is a flexible and often low-cost medical billing solution, minus its setup. CareCloud often charges high setup fees, typically no less than $1,000. This price could immediately place CareCloud out of budget for smaller practices, as could its three-year contracts, though some clients can secure one-year contracts. For higher-revenue practices in need of flexible solutions, however, CareCloud is an excellent choice.


ChartLogic: Best Medical Billing Service for Free Implementation

ChartLogic's medical billing services are among the most competitively priced we saw in our reviews.
ChartLogic pairs you with a dedicated account manager who's well versed in your specialty and local payer rules.
ChartLogic requires RCM clients to use not just its PMS but its EMR, an uncommon provision among medical billing services.

Editor's score: 85/100

ChartLogic is among the most hands-on medical billing services we reviewed. All ChartLogic RCM clients are paired with a dedicated account manager during setup. This contact will check in with you before and after implementation to solve any problems. 

Alongside this extensive support comes a team of only certified medical coders and billers. Each biller or coder on ChartLogic's staff is highly experienced in a certain medical specialty and will be assigned to you accordingly. Among billers and coders well versed in a given specialty, you'll be paired with contacts who know your local payers' unique rules.

ChartLogic provides all of this at a low cost. You'll pay 3% to 6% of your monthly collections to use ChartLogic, which is competitively priced even on the high end. However, unlike most of the medical billing services we reviewed, ChartLogic requires you to use not just its PMS but its EMR. Both these types of medical software are included in your billing services, though, so ChartLogic is great for small practices that need to minimize their healthcare IT costs.


Medical Billing Costs

Medical practices can expect to pay 3% to 9% of their monthly collections for revenue cycle management. Your exact rate will depend on several factors, including your claim volume, average claim value, billing cycle complexity and practice size.

Depending on your rate, outsourcing your medical billing may prove more expensive than hiring an in-house team. However, outsourced medical billing often includes detailed financial reporting and specialty expertise that an in-house team might not offer.

To make the proper choice between in-house and outsourced, you should ask your revenue cycle management candidates for full details of the services you get with your plan. You should also clarify whether clearinghouse fees, if applicable, are part of your monthly fees or added on later. Lastly, you should check whether copays count as part of your collections. The answer will affect how much you pay monthly.

Key Medical Billing Features

These are some of the most important features of a medical billing service:

1. Charge entry and coding

Though this is not universal, most medical billing service providers will handle charge entry and coding, kicking off the billing process at its very first step. This step even precedes claim scrubbing and submission – without it, the process hasn't truly begun. If your medical billing company of choice doesn't offer this service, an in-house staff member will need to handle it.

2. Claims scrubbing

Thoroughly scrubbed claims are far less likely to result in denials or rejections, especially when your medical billing service of choice includes a rules engine. Companies with these engines automatically check their claims for errors that payers commonly use to deny or reject claims. Once these errors are flagged, you or your medical billing company can revise them and refile your claims with these mistakes excluded. The result will be a higher FPAR and faster payment.

3. Denied-claims management

No medical billing service can entirely avoid denied claims, but most medical billing companies will manage the revision and resubmission processes when this does happen. Some companies will go the extra mile and prioritize denied claims to get them paid as soon as possible. In either case, your back-office staff won't be left poring over rejected or denied claims, trying to find and fix errors before resubmission.

4. Medical software access

While not necessarily reflective of the quality of the billing service itself, most revenue cycle management companies include access to their practice management software (PMS) and electronic medical records (EMR) in their offerings. This can be a cost-effective way to gain access to some of the top medical software on the market. Most medical billing providers will also require you to use their PMS, though you can typically use whichever EMR you please. If not, you may have to pay extra to migrate your data from your old EMR to your new one.

5. Flexible services

Some medical billing companies can manage as much or as little of the revenue cycle as you need. If you're only looking for someone to pick up the slack after you file your claims, you can arrange an appropriate deal. If you're instead looking to entirely outsource your revenue cycle management, that too is possible. However, some medical billing companies don't offer certain services, such as charge entry and coding, whatsoever. In this case, you may need in-house billers and coders as well.

6. Integrated clearinghouse

As part of your medical billing service, you want either a fully integrated clearinghouse or a partnership with one that results in no extra fees for your practice. Most of the companies we reviewed have one of these two arrangements, and a small number even bypass clearinghouses entirely and submit medical claims directly to payers. Make sure to ask about clearinghouses and fees anytime you speak with a potential billing services provider.

7. Follow-up on unpaid claims

Virtually every medical billing company we reviewed will follow up all unpaid claims on your behalf. This service applies to payments from both your patients and their payers. An effective medical billing service will follow up on unpaid claims promptly and repeatedly until the account is settled. When handling patient statements and follow-ups, the best medical billers consider customer service and how their collection efforts could reflect on your practice.

Advantages of Medical Billing Services

As with any service, a firm knowledge of the advantages your practice will receive is key to your RCM choice. That's because an in-house medical billing staff is often less expensive, but the benefits of outsourcing may be well worth the extra spend.

  • Greater efficiency: Especially if you're a small practice, outsourced medical billing can be key to ensure your team isn't overworked. Small practices' front-office teams are often jacks of many trades for whom the revenue cycle is tedious, lengthy, and complex. Outsourcing the process (partially or entirely) alleviates this challenge.

  • Higher accuracy: Careless claim errors are a huge revenue drain. When you outsource your billing to experts, especially those with rules-based engines, you mitigate this risk. These experts and their technology are a powerful combination for identifying potential claim errors and solving them before they become huge issues.

  • More collections: Outsourced medical billing teams focus entirely on billing. The result is more collections more quickly. Even the best in-house teams, given their many responsibilities, can rarely achieve the revenue peaks possible with outsourcing.

  • In-depth data and analytics: Many medical billing services will analyze your accounts receivable and use the trends they observe to suggest modifications to your processes. You should also be able to create reports at will in the included PMS.
    Through these reports, you can get a clear view into your finances and see how to adjust your operations for more revenue.

  • Practice management consultation: Especially for smaller practices, the consulting services that accompany revenue cycle management can precede growth. The operational advice you receive can result in more revenue, which you can invest in hiring more staff or expanding your services. And if you follow your consultant's recommendations, you'll be on a fast path to even more revenue soon enough.

Did you know?FYI Using your billing service's EMR and PMS is a great way to find medical software for less than it costs to hire in-house medical staff and obtain separate EMR and PMS solutions.

Choosing a Medical Billing Service

As you compare potential medical billing services, take the following steps to determine the best candidate:

1. Get a full picture of the company's features.

Claim scrubbing and follow-up are par for the course. You'll also commonly find that revenue cycle management companies include reporting, consultation, and EMR and PMS access with your services. Check for these features as you speak with company representatives.

You should also determine whether the features that accompany your medical billing leave the company or your own team responsible for entering and coding charges. It's worth asking if your billing service candidates are following the most recent ICD-10 coding system updates. You should also get a sense of the billing company's experience with other practices in your specialty. Lastly, ask about the depth and extent of reporting and analytics solutions.

2. Compare prices.

Revenue cycle management companies will generally take a monthly percentage of your collections instead of charging flat fees. The percentage will vary based on the factors described above, and different billing services may quote you different percentages. Think about whether a company that charges you more would provide better or lower-quality services than your other candidates before making a decision.

As you compare prices, you should also check whether the RCM company includes EMR and PMS access with its billing services. These inclusions may justify the company charging higher prices. That said, most medical billing services require you to use their PMS (and a few have the same rule about their EMRs). In some cases, migrating your data from your old platforms to your new one may incur additional charges.

3. Determine how long setup and implementation will take.

Since you'll be installing software (unless you are opting to work through your existing software provider for your billing), you'll need to account for the implementation process in the timeline. Fully setting up the software side of your billing services often takes several weeks to three months. Sometimes, the setup process results in additional fees, though we found that many companies include implementation and training for free.

Did you know?FYI Medical billing setup and implementation can take several weeks or months, usually three months at maximum.<

Check whether your medical billing provider includes free training with your implementation. If it does, chances are you'll be paired with a dedicated account manager who will help you set it up. You may also get access to setup resources you can browse on your own time. 

4. Figure out your support options.

With medical billing services, support isn't just about phone calls and emails; it's about having a full, transparent window into your billers' work at all times. Look for providers whose PMS platforms include a portal where you can see your claims' real-time status and look over your third-party billers' work.

On the traditional support side, you should check whether you can reach your provider by phone, email, or live chat just during weekday business hours or at all times. The company's representatives should be happy to assist you and easy to reach. 

Your billing service should also provide you with your payers' electronic remittance advice and explanations of benefits. These documents are important for obtaining a transparent view into your payers' operations.

TipTip: When dealing with something as sensitive as your practice's finances, you should thoroughly vet any potential service partner to guarantee trust and transparency.

5. Consider patient engagement tools.

Medical billing is primarily a payer-facing need, but not entirely. Since most medical billing services require you to use their PMS, they may also manage the patient portal that most PMS platforms include. This means that your billing service can directly send patients their statements and follow up on unpaid charges. Should statements go unpaid long enough, your billing service could even oversee the process of sending patients to collections.

It's important to find out whether the patient portal will cost your company extra or is included with your billing services. You should also find out how exactly your company of choice pursues unpaid bills and how long it waits to send these bills to collections.

Medical Billing Service FAQs

How can a medical billing service improve a medical practice?

Medical billing services take the burden of managing billing off of medical practices' staff, offering charge entry, coding, claim scrubbing, denial management and more. They can also follow up on unpaid claims, contacting payers and patients who are late on their payments. In addition, they will stay on top of all electronic remittance advice (ERA) from payers to ensure claims are usually accepted on the first pass.

Most medical billing services provide access to their medical software as well. Medical software automates and streamlines many key functions in the front office, clinical environment, and back office. The front-office tasks include registering patients, scheduling appointments, verifying insurance, and checking patients in and out. Clinical providers use medical software to fill out patient charts, order tests, prescribe medications, and share patient histories with other providers. Finally, the back-office tasks include charge entry, medical coding and medical billing. Medical software works in tandem with RCM services to support all of these needs. [Read Related: How to Fill Out and File an HCFA Form]

What is a good first-pass claims acceptance rate?

A good first-pass acceptance rate (or FPAR) exceeds 95%. Some of the best medical billing services we reviewed have FPARs of 96% to 99%.

How much do medical billing services cost?

Medical billing services typically cost 3% to 8% of a medical practice's monthly collections. This percentage is usually determined by a combination of factors, mainly the practice's size and specialty, the volume and value of its claims, and the complexity of the coding and billing required. 

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.
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