Review and compare the top 8 medical billing systems. Whether you’re a practice, a clinic, or a medical billing company, having the right software helps organize and simplify your workflow to make your office more efficient. In this 2021 software review, you can compare the top medical billing software vendors, learn about advantages, strengths and weaknesses, and take action on the solution that best fits your needs.
Starting with the leading contender in the medical office solution space, it’s plain to see why PracticeSuite has wowed its customers to become the first choice of many practices and healthcare businesses.
This cloud-based medical office platform is comprehensive in its product features, but is also very adaptive, so that you can use a single module such as the billing software, or utilize the entire platform as an enterprise-wide solution. Because it’s cloud-based, you don’t have to confine your use to office workstations. Instead, you can access patient data securely from anywhere, on any connected device.
The complete end-to-end platform supports 150 medical billing and 61 EHR software specialties, which makes it highly integrative and pragmatic. PracticeSuite can adapt to a wide range of practice sizes, from solo practitioners to groups of over 100 doctors. Not only is it one of the most advanced revenue cycle management systems we reviewed, but it’s also one of the most affordable, which is why it deserves its five-star rating.
The real strength of this solution that we’ve found is its revenue cycle management workspace and dashboards. Here are a few more standard features that distinguish this practice management platform and make it unique:
- Complex scheduling scenarios with multi-location/multi-provider/multi-specialty/multi-resource scheduling
- Revenue monitors that alert managers when revenue leakage is about to occur
- Configurable Key Performance Indicator (KPI) reporting dashboards that are customizable by office role
- Granular security settings including days/hours that data is accessible to users
- Patient engagement portal with CRM, online reputation, and social media management
The chief advantage of choosing a billing system that’s part of an all-in-one office platform is it allows you to grow and expand beyond billing to eventually incorporate your entire practice under a single software. No practice stays small forever, and as you grow, not having to change practice systems is an infinite advantage that’s impossible to overstate.
You don’t have to sign a long-term contract to do business with this vendor, and it is the only billing software company we found that will happily sign a non-compete agreement with medical billing service companies who use their software to bill on behalf of physicians. Specific functionality available to billing companies include:
- Medical billing & revenue cycle management platform that is completely web-based
- Single-sign-on to all practices
- HIPAA compliant Inter-office communications with task assignment
- Work rejections, denials, and post payments across all clients on one dashboard
- Electronic health record – Integrated EMR in +61 specialties
PracticeSuite also has the highest customer retention rate of all the software companies that we’re covering today. (Read full review here)
The basic version of the billing system is offered as a 30 Day free trial, and you can upgrade to premium features or EMR whenever you want or need them. Premium editions of the software start at $99 per month and go up to $395 per month for the entire platform, which includes EMR.
“As the owner of a medical billing company, I’ve been using Practice Suite now for about 5 years. I’ve used many billing software systems over the years (Allscripts, Mends II, Versyss, PCN, Sage, Brightree) and have never been as satisfied as I am with PracticeSuite. Their Free Edition is truly free and it includes support. It’s a great way to get started as a biller. I just can’t say enough about the support team – always pleasant, knowledgeable and efficient. You just can’t go wrong with Practice Suite.” Rita Tretter Cheyrige Medical Services, LLC (review via Clearinghouses.org)
“The most flexible and powerful billing program out.” — Roman Kniahynyckyj, Metrohealth (review via Capterra)
“I can bring on new employees and train them quickly since the system is so easy to use. Also when there are claim formats we need specific to our specialty or region they create what we need.” — Debbie Forde, MedSource Physician Services (via Software Advice)
Started back in 2004, Kareo began as a billing software and has since expanded into billing services and electronic health records. Today it reports a growing community of 40,000 providers and it has amassed a substantial online review presence on third-party websites. Overall they have a strong 4 Star rating and customers who review it the highest like the software’s interactivity, usability, and intuitiveness.
Read recent reviews of Kareo on SoftwareAdvice here.
Perhaps the most popular EMR in the out-patient physical therapist space, WebPT’s low entry point pricing combined with feature rich clinical charting makes it the leading out-patient clinical documentation software for speech therapy, physical therapy, and occupational therapy.
For back office claim management WebPT offers the well-known billing solution TheraBill, an integrated partner solution they acquired in 2015. They have working interfaces with a number of other billing software partners as well, offering the flexibility of billing to speech therapist, physical therapist, and occupational therapist who are using other systems to bill but that use WebPT to document therapy notes. To read more about the benefits of an All-in-one practice management system, click here.
A juxtaposition of WebPT, CollaborateMD is a stand-alone billing system that interfaces with over 20 EHR’s such as Praxis, HelloHealth, and AmazingCharts. To understand more about the Pros and Cons of fragmented stand-alone systems verses All-in-one systems, read our complete review of all in one medical office systems. If you are considering a locally-installed program, you will also want to read our comparison of cloud-based systems versus local server-based systems to understand the strengths and weaknesses of each option. There’s a fundamental and important difference between stand-alone billing systems versus all-in-one practice management systems. Read our full review of cloud-based practice management software systems here.
#5 Practice Management Systems
One of the more expensive options in this 2021 billing software review, Practice Management provides both medical billing and EHR software and has a very loyal following of users. Some EHR providers require a binding contract to subscribe to their software; this means that you’ll want to see the system in operation at a practice of similar size, setting, and specialty before entering into a legally enforceable obligation. Checking references only can be tricky, as who’s going to offer a dissatisfied reference? But seeing is believing. So when a binding contract enters the picture, observing the system at work in an office of similar size and specialty is the safest place to start.
Read over 120 Reviews of Practice Management
Before signing any contract, always remember that any promises made by a salesperson that are material to your operations should be stated to your satisfaction in the final SLA, or Service Level Agreement. To learn more about the benefits of a no contract, risk-free medical billing platform that offers the most advanced revenue cycle management features available today, click here.
View 31 real-time billing and practice management reports that just may change your life.
A leader in the EHR space, DrChrono offers an integrated practice platform with high-end multi-location features like being able to customize EHR, practice management, medical billing, or revenue cycle management at the practice level. It is the highest priced system in our 2021 comparison, and their medical billing software is offered in conjunction with their EHR. If you do not need an EHR system, you may want to take a look a more modular system that can be adopted a single module at a time.
If you are a medical billing company looking for an advanced revenue cycle management platform to manage multiple clients, PracticeSuite offers features like single sign-on across all your clients, consolidated reporting, single screen denial management, and payment posting across all clients from a single dashboard.
If you are a practice that has complex scheduling needs such as multi-location/multi-provider/multi-specialty, and the need to schedule rooms and resources, take time to look at our patient calendar that is designed to handle complex scheduling scenarios, and that offers advanced features such as next-available, wait-listing, text reminders, and flexible appointment times, double booking, and custom time blocks ( patient appointment scheduler ).
Another combo EHR / Practice Management system designed to manage your entire medical practice end-to-end, CareCloud offers a PM module that can be subscribed to independently from its EHR starting at $349 a month per provider. Although this cost includes a Community Patient Portal and Practice Scheduler, if you’re a medical billing company looking only for a comprehensive billing program, it is not necessarily a disadvantage as these premium features can be offered downstream to your physician clients and help streamline your billing efforts. For instance, if the practice adopts the scheduler, they’ll be entering patient demographics and insurance info in order to check front office eligibility. Similarly, if they adopt the patient portal, it helps streamline collections by making patient balances and payment options available.
#8 eClinicalWorks (Bonus Review)
Although ECW is recently ensnarled in a MU controversy ( read more ), they still have the largest user base of any ambulatory EHR system – and starting at $599 per month per provider, they offer a combined EHR practice management system. And although they don’t offer an exclusive medical billing module, since so many physicians have adopted it due to hospital affiliation, many medical billers and medical billing services are familiar with and trained on the ECW system. So, controversy aside, the sheer ubiquity of this system lands it on our list – last of the top 8 ambulatory physician billing solutions.
* Graph is a summary of data available online as of 10/01/2017. Contact individual vendors for current pricing or price quotes.
Brief History Of Medical Billing Software
Roots Originating From 3 Insurance Claim Forms
Today, almost all medical claims to health benefit payers are submitted to insurances for reimbursement on the CMS-1500 Professional electronic claim form for ambulatory visits and procedures (walk in, walk out). However, non-ambulatory visits and procedures, such as when a patient is admitted to a hospital, are sent for reimbursement on the UB-04 claim form (institution/facility claims). State Workman’s Compensation uses the Professional claim form as well, but a few states like New York have their own Workmen’s Comp claim form.
For years, medical billers typed these insurance forms up by hand on a typewriter and then mailed them to the payer, but as recently as 25 years ago software companies began to develop coding programs to speed up claim processing and to improve claim accuracy for faster adjudication. Today, almost all states require medical insurance claims to be filed electronically, and most are, but low-volume claims and secondary and tertiary payments are still typically sent in as paper claims. Amazingly, insurance payers still receive millions of these types of paper claims each month.
The thing that software does best is to organize and streamline processes. Billing software evolved to not only serve as the vehicle for healthcare organizations to transmit electronic claims to insurance companies, but to communicate critical information between the insurance company and the medical practice, and to improve work-flows and tasks at the practice level.
Revenue Cycle Management
The best medical software solution gives physicians and office staff instant communication to see if a patient has insurance coverage – this is where electronic eligibility comes into play. It also gives electronic pathways for insurance companies to send electronic reconciliation files containing information about what claims were paid, how much was paid, and what claims they are not going to pay – this is where electronic remittance advice (ERA) comes into play.
The best practice management systems also provide tremendous value by helping practices manage A/R, and the portion of their revenue that comes directly from patients paying out of pocket or from health shared savings (HSA) or flexible spending accounts (FSA) for their co-pays, co-insurance, and outstanding balances.
Revenue improvements made at this level are often referred to as bottom line improvements as they not only directly affect cash flow but directly affect the overall financial picture and potential profitability of the practice.
The Types of Medical Billing Software
Four Distinctive Characteristics
There are different classifications of systems, ranging from how the systems are made, what type of computer infrastructure they run on, what types of computer devices can be used to interact with them, what specialty the system’s features cater to, and even what certifications the system must meet for regulatory requirements.
Best-of-class billing management systems for today’s modern medical practices involves the following:
Web-based – Available from Any Device
To be available from any device, the software needs to be cloud-based. Users can quickly and easily open an internet connect browser on a desktop, tablet, laptop, or smartphone and gain access to the software.
Features for Your Specialty
Many medical specialties have billing process and coding needs that need to be considered. Today’s best billing management software accommodate specialty-specific billing workflows and regulations.
Privacy & Security
With pressures to maintain strict confidentiality policies and meet HIPAA compliance guidelines, the best billing management solutions have advanced features to guard against improper access, track who accesses what and when, and gives security officers in the medical organization tools they need to manage vulnerabilities and HIPAA compliance.
Alignment with Your Care Setting
Like specialty uniqueness, the type of care setting or facility type plays a critical role in selecting the best billing software. Software requirements for ambulatory settings will differ from those in the in-patient, hospital environments. Likewise, compatibility of the software for surgery centers will differ from a mental health or community health center.
Billing Service vs. Practice Settings
While “medical billing” itself might not change that much from the practice setting to that of a billing service, the scale, the complexity, and the need changes tremendously. Those companies who perform medical coding and billing processes on behalf of physicians need different functionality than a medical office. Features needed specifically by a medical billing service include:
Denial and Appeal Management Tools
Billing companies typically apply more rigor chasing down denied claims and filing claim appeals in situations where insurance companies have neglected to pay. Sophisticated denial and appeal management tools help quickly identify the cause of the claim rejection, streamline the path to correcting the claim information, and resubmitting the revised claim for payment.
Multiple Practice Single Sign-on and Workflow Tools
Staff at billing services perform billing duties for multiple medical offices. Each practice has a secure account within the medical software. Billing systems designed for services take the hassles out of navigating in and out of different practices. They consolidate work queues so that specific tasks across practices can be done quickly. And they also allow sectioning off labor so that the billing for several Dr. Johnson’s doesn’t get confused.
Enterprise Code Scrubbing Features
Due to the volume of data and medical claims a billing service manages, they need more automation in the revenue cycle process than a traditional medical office setting. For instance, if 10% of a billing service claims are denied that could be 50 – 100 times the number of claims that will ever be denied for a single practice. Therefore, a service needs tools that scrub their coding and claims before they are submitted to avoid denials before they happen.
As a business, the medical billing company needs productivity reporting across all of their clients (physician offices). They also need performance reporting capabilities for their staff.
Client Performance Reporting & Dashboards
To keep their clients informed about their revenue, cash flow, and overall business efficiencies, billing services need to provide frequent updates on financial position to their clients. Real-time performance dashboards and reporting capabilities help them quickly showcase the value of their services to their individual clients.
Billing Software Pricing Models
Software Pricing Options
Different from electronic medical records, when researching electronic medical billing solutions, there are countless combinations of pricing strategies to explore. The best software pricing strategy for you may differ from that of others, but here are several options that you will have available to you.
A small handful of software options will make a free version of the software available at no charge. This is a great way for medical practices to try the system, use the solution for daily workflow. Depending on the practice’s needs, a free software solution may be all they need to handle their insurance billing.
Many billing software options will include a free version giving a user the opportunity to set up a trial account, use the system for a set number of days or months, and then convert the free version into a paid account.
Paid Monthly Subscriptions
Almost all web-based software options give practices the opportunity to pay monthly for the software license. A set monthly fee will be paid by the provider or sometimes by the number of actual users.
Depending on the medical billing volume, you may want to investigate the cost difference between a paid monthly subscription plan and a transactional pricing plan. In the transactional plan, you pay for the actual number or tier of electronic claim transactions. These plans make good financial sense for organizations with a lot of medical providers or practices and it also is a good choice for high volume organizations to seek bulk pricing.
Software Prices Vary Drastically – Why?
Monthly Software Pricing Ranges
Billing software prices range from absolutely free $0 to over $800 per provider per month, not including an electronic health record application. There are three factors that typically drive pricing for medical practice management software.
The first factor is the feature set. But, the tricky thing with today’s software choices is that low cost doesn’t always mean reduced features. Different practice management software vendors have different ways of addressing critical workflows. Some vendors use tools that they embed in their products from other companies. This might drive the price for that specific capability up compared to a vendor who engineered their product without having to pay someone else.
Secondly, price is often a derivative of what type of technology platform is being used. Older medical practice management technology architectures have historically cost more. Companies with these infrastructures often find themselves covering these costs as well as covering the costs of developing new products on new practice management platforms. The combination could keep the price of their software higher than other competitors. In sharp contrast, web-based medical billing can be more affordable for the average doctor office.
The final point on pricing variance involves the type of healthcare provider license that is being purchased. Full-time providers and/or physician based pricing is often higher than part-time providers and/or other clinical staff licenses such as therapists, nurses, and other clinicians. Billers help manage cash flow by coding patient encounters for their providers.
Software Check List
#6 Review the Top Specifications for Billing Software
There are countless features that today’s best software programs offer. Let’s review the top 18 billing requirements you should expect to see in each software program you are considering.
- Offer multiple ways to identify or look-up patients
- Secure and encrypted credit cards on file (with consent)
- Create flexible payment plans that track date, and amount, of the last payment
- Report and track any unapplied monies
- Create customized letters to payers, work-comp, attorneys, and patients
- Monitor and control write-downs
- Create charges and easily associate procedures and diagnoses
- Review charges and perform initial claims validation
- Manage claim rejections and claims status at the clearinghouse level
- Work denial & perform claim appeals on unpaid items
- Post Payments and adjustments
- Receive and post ERA’s – Electronic Remittance Advice (electronic E.O.B.)
- Claims Performance Dashboard
- Perform necessary facility-based UB04 billing
- Managing patient payments and collections
- Patient statement processing
- Electronic patient payments
- Benchmark reporting of key performance indicators
We gave 18 requirements to look for in a top-notch healthcare billing system, but these are all back-office (billing) functions. Here are some front-office items that are also part of the best billing management solutions––such as appointment scheduling.
- Check eligibility manually or in batch from the patient appointment calendar
- Easily enter patient demographics and insurance info from scheduling
- Easily view open patient balances from appointment scheduling
And EHR, But In The Context Of Medical Billing
In a typical medical office, you have a front office staff, clinical staff, and back-office (billing) staff, each having their own separate software modules.
Front office staff answer the phones, set patient appointments, verify insurance benefits and collect payments such as co-pays. After checked in, a medical assistant takes the patient’s vitals in preparation for the doctor visit. During this time, vitals and the reason for the visit are entered into the clinical EHR awaiting the attending physician’s review. Upon exam, the doctor will arrive at a diagnosis and enter it into the EHR, which the billing department will then code and submit to insurance for reimbursement.
EMRs are separate applications from billing software but they work hand in hand, and in the best EHR systems the coder can easily view the medical notes to make sure the procedure is coded correctly. Each EMR application has its own pros and cons, but to make health records electronic, they are a medical necessity.
#7 Review Popular Medical Software Companies
We are glad you have visited PracticeSuite and hope you stay on our website to learn about the great value we can bring to you. However, we know that you have lots of choices and that not every medical billing software option is right for everyone.
Also, testimonials directly from a customer who uses the medical billing software options are great ways to get a feel for how the software works. Just like online reviews of any sort, you know that some reviewers will have great things to say about the software and the company. Others will have terrible things to say. You will have to balance out the reviews against your experience with the company and product to make a decision you feel good about.
Below is a list of companies who make medical billing software that we respect (listed in Alphabetical order) along with a link to publically available customer reviews.
Athenahealth (User Reviews)
PracticeFusion(Medical Billing Solution Review)
Software Purchasing Resources
#8 Review Helpful Resources As You Weigh the Pros and Cons
Below are three resources that have proven extremely helpful to those evaluating medical practice software over the years.
3 Things to Consider When Choosing Billing Software
Does Your Billing Software Include These Features?
Will the Right Medical Billing Software Make Your Practice Profitable?
Now that you have the straight information about each of these medical billing software companies, you can make a more informed choice with your own practice’s cash. If you’re looking for a reliable billing solution, sign up for our full-featured free trial edition and give us a whirl without spending a dime.
Last Updated on February 10, 2021