Medical Billing Reviews
Everything you need to know about the Top Medical Billing Companies
What is Medical Billing?
Medical billing is the process of submitting and following up on claims with health insurance companies in order to receive payment for healthcare services rendered by a healthcare provider. It involves the use of medical codes to represent medical diagnoses and procedures, as well as the submission of claims to insurance companies and the management of payment collections. The goal of medical billing is to ensure that healthcare providers receive accurate and timely payment for their services while complying with insurance regulations and guidelines. Medical billing is an essential part of the healthcare industry and helps to ensure that patients receive the care they need while providers are compensated for their work.
How Medical Billing Works?
Medical coding and medical billing are two critical functions in the healthcare industry that are interdependent and necessary for ensuring proper patient care and accurate revenue management. Although distinct, medical coding and billing are closely related, as both are involved in reporting medical diagnoses, procedures, and supplies to commercial and federal payers, including insurance companies such as Aetna and government programs like Medicare.
Medical coders and billers work with clinical staff, including physicians, nurses, and other healthcare professionals. They must have a deep understanding of medical terminology, anatomy, and pathophysiology to properly interpret and translate physician notes and operative reports into medical codes that accurately reflect the services provided to the patient. Medical coders also work closely with billing companies and may participate in the billing process.
In some small physician practices, the same person may serve as both the medical coder and medical biller. However, in larger healthcare organizations, these roles are often separated, with medical coders responsible for translating clinical documentation into standardized medical codes and medical billers responsible for submitting claims and managing revenue collection.
Although medical coding and medical billing are separate functions, they are both essential parts of the healthcare revenue cycle. Medical coding companies play a crucial role in ensuring accurate and timely medical coding, which is foundational for healthcare providers to be properly reimbursed for the services they provide. Similarly, medical billing ensures that insurance companies and other payers are billed correctly for the services rendered to patients. Both processes, facilitated by medical coding companies and billing teams, require precision, attention to detail, and a thorough understanding of medical terminology and billing regulations. These companies often employ experts in both fields to streamline the billing cycle, reduce errors, and maintain compliance with the ever-evolving healthcare laws and regulations, ultimately safeguarding the financial health of healthcare providers.
Here is a general outline of medical billing workflow:
- Patient registration: This is the process of collecting patient information such as name, address, date of birth, insurance details, and medical history. This information is used to verify patient eligibility for insurance coverage.
- Charge capture: This is the process of documenting the healthcare services provided to the patient, including diagnosis, treatment, and procedures. The healthcare provider records the details of each service provided and assigns medical codes to each service.
- Claim submission: After the healthcare provider has documented the services provided and assigned the appropriate codes, a claim is created and submitted to the insurance company. The claim includes patient and provider information, details of the services provided, and the associated medical codes.
- Payment posting: Once the insurance company receives the claim, they will review it and determine the amount they will pay the healthcare provider. The payment is then posted to the provider's account, and any remaining balance is the responsibility of the patient.
- Denial management: If a claim is denied by the insurance company, the healthcare provider must investigate the reason for the denial and correct any errors or resubmit the claim with additional documentation if necessary.
Top 5 Medical Billing Companies
We have identified the top medical billing companies that stand out in terms of pricing, usability, and technology. These companies have proven to be reliable, efficient, and effective partners for medical practices seeking to streamline their billing processes.
- Kareo – Best for Reporting
- Cerner – Best for Large Practices
- CureMD Healthcare – Best for Fast Claim Reimbursement
- eClinicalWorks – Best for Tracking KPIs
- athenahealth – Best for Coding & Compliance support
Medical Billing Companies being Assessed
Kareo
Kareo has grown immensely over the past years and one of the main reasons for their growth has been their billing support staff. They invest time to ensure that their clients get paid by regularly conducting sessions with the practice owners regarding ways of improving their billing and by keeping up to date with payer payment changes.
With Kareo, a physician’s work ends at the creation of the super bill. The Kareo team takes it over from there, scrubbing the claims for errors before sending it out to ensure that the denial rate is reduced. If however a rejection is received, the Kareo team works with the practice to ensure that the errors are fixed and the claim can be resubmitted again to expedite payment.
The company also assists a practice in handling patient statements. It posts patient statements via email or regular mail if needed. It also handles any customer support regarding billing; relieving your front desk from answering complicated billing related queries. Thus three thumbs up to Kareo for their billing service.
However, as robust as their billing service is -their EHR is a letdown. It is a small system built with very basic functionality. Honestly, expecting more from a system that is free would be asking too much.
Kareo has ventured recently into the EHR market and will take time to develop a sophisticated system. This is a red signal for those of you who want to outsource billing to a company supported by a good EHR system as well. Kareo EHR does not support specialties; they don’t provide you with customized templates for your practice, you can either create your own by using their “Template Editor Tool” or pay extra to get assistance from Kareo.
Moreover, their trainings are in the form of recorded tutorials or weekly webinars rather than a one-on –one training program with the practice. To me this is a big no. All practices have their own learning curve and should have their training programs designed in a way that suits them. My advice to the company would be to address this issue so that they can offer their clients a complete deal rather than a good service not supported by an equally good product.
Cerner
Cerner is another popular billing company in the market though they seem to be slightly over priced. Before we analyze their billing services a few words about their product.
Cerner probably has the most forward-looking functionality in the industry. One would appreciate the innovativeness they have shown, if only the team at Cerner had found a way to tone down the complexity that these features have added to the system. The system has a very steep learning curve. Some of their clients complained that their implementation period stretched to 40 weeks rather than the standard 8 weeks, just because the system was too hard.
In my assessment, here again we have a large practice system being sold to small and medium sized practices. It clearly is not the best fit and is costing the company in the form of bad reviews both for the product and the services, despite the effort they have put in creating their solutions.
On the billing side, they provide you a comprehensive revenue cycle management service just like Kareo. They post your charges, scrub your claims, submit them through a clearing house (Cerner integrates with McKesson Clearing House) and follow up on your denials. They also cover patient collections.
Their support however, has not received a lot of positive reviews. There have been complaints that a practice’s account is continuously transferred from one billing manager to another rather than having a dedicated person who is aware of the practice’s workflow.
In summary, Cerner has a good product that is let down by their support. They need to work on improving their user experience so that the product screens look less cluttered. Until then, this vendor is good for very large practices that need advanced functionality and can compromise on usability. (Epic users alert)
CureMD
Sharing my most honest review, CureMD remains one of my favorite on the list of medical billing companies. I have already reviewed CureMD’s software in one of my previous analysis. With respect to their product, I found their EHR and vaccine administration management system relatively user-friendly and easy to navigate through, their solution is specialty-specific and offers ample customization for a practice to personalize it as per its size and workflow. However, since they do not cater to inpatient facilities, I personally do not think that their system is a good fit for hospitals.
On a similar note, CureMD has done equally well in terms of support. They offer a variety of support options such as chat, ticket and telephone, with the primary objective to cater to their clientele. CureMD medical billing and coding services also handle patient statements at their end, relieving your staff to perform other meaningful activities. If you sign up with CureMD for your revenue cycle management, you will not only receive a dedicated billing manager but also a devoted implementation manager who will be your go-to-person for all sorts of queries.
They also offer a comprehensive medical billing software, which allows you to print useful financial reports. Moreover, it allows you to print meaningful financial reports. It also has a key performance dashboard with real time figures on A/R periods, revenue collection, common rejection reasons associated with payers, etc. These features facilitate a physician in monitoring the performance of his practice without getting into complicated accounting details.
Advanced claim scrubbing, de-coding difficult rejection responses and helping clients resolve rejections, even if they don’t outsource their billing to CureMD are value-added services that are getting the company positive reviews in the industry.
The integrated EHR and PM is a way better solution than most of their competitors in the market. Their focus on usability and ease of use are the two important features of their solutions that physicians tend to enjoy over other EHR vendors.
eClinicalWorks
2.9% for your billing. That tag line there is a best seller. Who would not want to outsource billing to eClinical when other medical billing companies charge so much more?
My response: Why do you pay so much for an IPhone when there are so many Sony’s and Samsung’s doing the round?
I honestly tried looking at a few positives and except for their price there is nothing that I could find. Even in terms of the price, everything is not as hunky dory as it seems. To get the 2.9% rate a provider must be earning $ 57,000 or more per month. Frankly, hardly any provider earns that much in environment.
If you are content with such minimal functionality and support, Practice Fusion will give you the same thing for free!
eClinical does not offer you the best value for your buck. Their product is pedestrian, their support is horrible.
This should give you a general idea of their billing service as well. You might think that you are saving money with a 2.9% contract. However, eClinical customers have reported incidences where their claims were sent to the wrong payers or denials were not resolved as the billing staff was not up to date on payer payment rules.
In short, don’t fall for the 2.9% flat rate for billing. The pain of being stuck in a contract with suboptimal service is not worth the so called cost savings.
athenahealth
Athena remains one of the oldest billing companies out of the lot. I have already reviewed their product in one of my vendor pricing analysis but will present it here for people who have not read it.
Athena is a large practice product. The system is complicated, requires a lot of clicks and change of screens to get tasks done. This functionality works well for hospitals and large practices where each step of a patient’s clinical encounter is recorded by a different person, such as a nurse practitioner or a medical assistant. However, in small to medium sized practices, many times a physician is handling most of the clinical encounter and would like to record things on one screen rather than having to jump from one screen to another.
Athena takes HIPAA laws quiet seriously. However, they might have gone a little too overboard with it. Practices have complained that they have to sign in every single time that they see a new patient. This wastes time, especially when the navigation in the solution is not simple.
Implementation is another area where Athena does not work well. They promise to get you implemented in less than six weeks however, for most practices the implementation time period can stretch to 11 weeks. Again, a big practice or a hospital can spare staff and compromise on the revenue loss generated by such long periods of implementation but not small to medium practices.
In terms of their billing service, Athena either charges a flat rate per provider or a percentage of annual collections, whichever is greater. They offer you their EHR and PM for free in this case. Their support is professional and generally competent which is hard to come by nowadays.
On average as a billing company and a provider of medical billing software Athena is a good choice. However, the complete package which includes the EHR is not the best fit for small to medium sized practices.
Disclaimer
The content presented on CureMD is intended solely for educational purposes. It should be noted that your financial circumstances are distinctive, and therefore, the products and services reviewed by us may not be appropriate for your particular situation. We do not provide financial advice, nor do we offer any advisory or brokerage services. Furthermore, we do not suggest or recommend that individuals purchase or sell specific stocks or securities. It is important to bear in mind that the performance information provided may have undergone changes subsequent to its publication, and past results do not guarantee future outcomes.
Why CureMD is the Top Choice for Healthcare Providers
Meaningful Use stage 3
Certified
Fast track
Implementation
Cloud
Technology
Enterprise-grade
Functionality
Award Winning
Usability
Integrated, Interoperable,
and Customizable
MIPS / MACRA
Compliant
Hassle-Free Maintenance
Free Upgrades
HIPAA
Compliant
PQRS / P4P / MIPS
Ready
Top Rated
Support
Uptime
Guarantee
Features and Services
As a physician, you can now experience a more streamlined payment process with reduced workload and lower expenses by utilizing CureMD's revenue cycle management solution. Our optimized system is specifically designed for hospitals, billing services, health systems, and large practices, and it guarantees to minimize redundancies, increase automation, and enforce best practices, all leading to reduced A/R days and lower collection costs.
Boost Your Revenue
Free your staff from routine A/R follow-up tasks with our powerful automation tools. Our low-touch solution ensures maximum efficiency, improves cash flow, and allows your team to focus on new challenges.
Seamless Integration
Our interoperability approach ensures seamless integration with your EMR while updating your RCM. We invest in collaboration with leading standards bodies, ensuring your practice stays current with the latest industry changes.
Accelerate Reimbursement
With over 25 years of success in the market, our solution has a proven track record of accelerating revenue reimbursement and improving profitability for healthcare practices.
Scale Your RCM with Ease
As your practice grows and adopts new reimbursement models, our solution scales with you, allowing you to manage growth and changes at your own pace without needing additional resources.
Optimize Efficiency
Our consolidated view of all hospital and professional financial data across your entire enterprise reduces redundancies and improves efficiencies. You can maximize profitability by making data-driven decisions.
Improve Profitability
Reduce errors and improve staff efficiency with our fully integrated workflows, revenue cycle monitoring, and proven FTE efficiencies. You can achieve better profitability and focus on providing quality care to your patients.
Unlock the Full Potential of Your Practice with Our Medical Billing Solution
Use clinical info to drive financial outcomes within a clinically driven revenue cycle. Streamline medical billing and help enhance patient access to care. Learn how.
Schedule an Online Demo
Highly flexible & affordable billing experience with unprecedented financial transparency.
Key Factors to Assess Before Selecting a Medical Billing Company
Effective medical billing is crucial for the financial health of healthcare providers. It ensures that healthcare services are accurately coded, claims are submitted promptly, and reimbursements are received in a timely manner. However, not all medical billing companies are created equal, and healthcare organizations sometimes find themselves considering a switch to a new billing partner. We will explore the key factors and considerations to keep in mind when evaluating medical billing company reviews before making the decision to switch.
-
Billing Accuracy and Compliance
One of the primary factors to consider when evaluating a medical billing company is its track record for billing accuracy and compliance. Accurate billing not only ensures that healthcare providers receive rightful reimbursements but also helps in maintaining compliance with coding and billing regulations.
What to Look for:
- Low Claim Denial Rate: A reputable medical billing company should have a low claim denial rate, indicating a high level of accuracy in claim submissions.
- Coding Expertise: The company should demonstrate expertise in medical coding, ensuring that services are billed appropriately.
- Compliance Commitment: Ensure that the company has a strong commitment to compliance with healthcare regulations, reducing the risk of audits and legal repercussions.
-
Transparent Pricing and Fees
Medical billing companies typically charge fees based on a percentage of the revenue collected or a fixed monthly fee. It's essential to understand the pricing structure and ensure that it aligns with your organization's financial goals.
What to Look for:
- Clear Pricing Model: The billing company should have a clear and transparent pricing model that outlines all fees and charges.
- Competitive Rates: Compare the company's rates with industry standards to ensure that you're getting a competitive deal.
- No Hidden Costs: Verify that there are no hidden costs or unexpected charges in the billing company's contract.
-
Experience and Specialization
Medical billing can be a complex field, and experience matters when it comes to navigating the intricacies of healthcare reimbursement. Consider the experience and specialization of the billing company to ensure they have the expertise required for your specific healthcare niche.
What to Look for:
- Industry Experience: Look for a billing company with experience in your specific healthcare sector, whether it's primary care, specialty clinics, or hospitals.
- Track Record: Review the company's track record of successful billing for healthcare providers similar to your organization.
- Knowledge of Regulations: Ensure that the billing company is well-versed in the regulatory requirements specific to your area of practice.
-
Technology and Software
The technology and software used by a billing company can significantly impact the efficiency and accuracy of billing processes. Evaluate the technology stack employed by the billing company and its compatibility with your existing systems.
What to Look for:
- EHR Integration: Check if the billing company's software can seamlessly integrate with your Electronic Health Record (EHR) system, facilitating the flow of data between clinical and billing processes.
- Automation and AI: Determine whether the company utilizes automation and Artificial Intelligence (AI) tools to streamline billing and reduce errors.
- Data Security: Ensure that the company's technology and software adhere to strict data security standards to protect patient information.
-
Communication and Responsiveness
Effective communication and responsiveness are essential for a smooth billing process. Consider the billing company's communication channels and their ability to address your concerns promptly.
What to Look for:
- Accessibility: The billing company should have accessible customer support and responsive communication channels.
- Timely Responses: Evaluate their responsiveness to inquiries, issues, and concerns.
- Regular Updates: Determine if the company provides regular updates on the status of claims and financial reports.
-
References and Testimonials
References and testimonials from other healthcare providers who have used the billing company's services can offer valuable insights into their performance and reliability.
What to Look for:
- Client References: Ask the billing company for references from existing clients, and contact them to gather feedback on their experiences.
- Online Reviews: Check online platforms and review sites for testimonials and ratings from healthcare providers who have worked with the company.
-
Scalability and Customization
Consider whether the billing company can accommodate the scalability of your healthcare practice. It should have the flexibility to adapt to your changing needs and provide customized solutions when necessary.
What to Look for:
- Scalability: Ensure that the billing company can handle the growth of your practice without compromising on service quality.
- Customization: Verify that the company can tailor its services to meet your specific requirements and preferences.
-
Data Analytics and Reporting
Comprehensive data analytics and reporting capabilities are valuable for tracking the financial performance of your healthcare practice. Evaluate the reporting tools and analytics offered by the billing company.
What to Look for:
- Real-time Analytics: Determine if the billing company provides real-time access to key performance indicators (KPIs) related to revenue and claim status.
- Custom Reports: Check if they offer customizable reports that align with your reporting needs.
- Insights for Improvement: Assess whether the company provides actionable insights based on data analysis to optimize revenue collection.
-
Transition and Onboarding Process
Switching to a new billing company can be a complex process. Evaluate the onboarding and transition support offered by the billing company to ensure a smooth transition without disruptions to your revenue cycle.
What to Look for:
- Onboarding Assistance: Determine if the billing company provides comprehensive onboarding support, including data migration and training.
- Transition Plan: Ensure that there is a well-defined transition plan in place to minimize any potential disruption to your revenue cycle.
- Timelines: Clarify the expected timelines for the transition process.
-
Track Record of Success
Review the billing company's track record of success and its ability to consistently deliver on its promises. A proven history of successful billing for healthcare providers is a strong indicator of reliability.
What to Look for:
- Case Studies: Ask for case studies or success stories that showcase the billing company's achievements with other healthcare providers.
- Longevity: Consider the company's longevity in the industry as a testament to its reliability and sustainability.
- References: Revisit references and testimonials to confirm their satisfaction with the company's services.
CureMD Orthopedics Medical Billing stands out as the premier choice for healthcare providers for several compelling reasons. Firstly, our comprehensive solution is designed with a deep understanding of the intricacies of healthcare billing. It seamlessly integrates with healthcare workflows, streamlining the entire revenue cycle process. From precise coding to claims submission and reimbursement tracking, CureMD's solution ensures accuracy and efficiency at every step. Healthcare providers can trust our system to optimize revenue, reduce errors, and enhance overall financial performance.
To Top