Medical billing companies help healthcare providers by coding, scrubbing, and submitting claims as well as following up with patients and insurance providers. With the cost to rework denied claims rising annually, medical billing software is often a worthwhile investment for saving time and reducing expenses.
To determine the top medical billing companies, we evaluated over 25 companies on factors including pricing, features, first-pass success rates, user-friendliness, reputation, and customer profiles. Read on to find out which one is best for your needs.
The 6 Best Medical Billing Companies of 2021
Best Overall: AdvancedMD
95% first-pass acceptance rate
Works for small, mid-sized, or large practices
Customizable packages and pricing
Doesn’t code claims
Mobile version available on iOS only
Since its founding in 1999, AdvancedMD has been a leader in healthcare technology solutions. Today, AdvancedMD helps over 13,000 practices of all sizes process 6.5 million insurance claims annually. We chose AdvancedMD as the best overall option due to its high first-pass acceptance rate, great customer service, and versatile features.
AdvancedMD offers cloud-based software that makes it easy to manage your claims process from beginning to end, both in the office and on-the-go with their mobile iOS app. Although the interface can be cumbersome, you can customize your workflow to your practice’s unique needs. The medical billing management tools will look for coding errors, then track, review, and submit claims quickly and accurately for you.
AdvancedMD has a 95% first-pass rate, which is one of the highest in the industry. User reviews commend the customer service and sales representatives for being especially helpful and going above and beyond.
In addition to medical billing services, AdvancedMD also offers add-on features, such as telemedicine, invoicing, and patient marketing. For pricing, AdvancedMD offers two standard bundles:
- Practice Management, which includes scheduling and medical billing software for $429/month unlimited or $1.42 per encounter
- EMR/EHR Software bundled with Practice Management for $729/month unlimited or $2.18 per encounter
You can get a custom package and quote by adding additional or subtracting features à la carte by contacting a sales representative. The more features you decide to bundle, the more cost-effective your pricing will be.
Best for Solo Practitioners: Kareo
Specifically designed for practices with one to 10 people
Dedicated success coach for 90 days
Managed billing is a separate service from practice management
Clean claims rate not found on their website
Lack of transparent pricing on their website
Kareo was founded in 2004 with the goal of revolutionizing the way private practices manage their business. Kareo currently has 150,000 active users and processed over $25 billion in claims in 2019. We chose Kareo as the best for solo practitioners because it’s the only major SaaS platform designed specifically for small practices.
Kareo offers EHR, billing, and marketing software as well as managed billing services. Small practices can manage, validate, and submit claims; run reports; schedule appointments; and collect payments. Those who aren’t interested in managing billing themselves can outsource tasks to Kareo’s medical billing experts through managed billing. Billing software and managed billing are sold separately.
Kareo’s cloud-based billing software is easy to use and there are no additional costs for training or support if you sign a one-year contract. Pricing is difficult to find on their site, but they offer three main packages:
- Practice Management, low claim volume: $150/month (up to 50 claims per month)
- Practice Management, unlimited claims: $300/month
- Billing Services: 4% to 9% of collections, based on volume and specialty
All three plans come with a 90-day success coach who will assist you with setup and training. You can also contact a sales representative to get a custom quote. For added convenience, you can add credit card processing and direct deposit through Stripe for a processing fee of 2.75% plus $0.30 per transaction.
Best for Multiple Providers or Large Practices: Waystar
98.5% first-pass acceptance rate
Comprehensive reporting and tracking
Supports Medicare billing
Can be pricey
Slow customer service
May pay extra fees for credit card processing
Navicure and ZirMed joined forces in 2018 to launch Waystar, an enterprise-friendly billing solution. Waystar is our choice for best for large practices thanks to its convenient integrations, extremely high first-pass acceptance rate, and powerful predictive analytics.
Waystar has a first-pass rate of 98.5%, the highest of all the billing companies listed here and one of the highest in the industry. Its goal is to unify all payments, including Medicare. Waystar’s AI-powered software automatically detects prior authorizations, scrubs claims before they’re submitted, creates tailored communications to patients, provides detailed analytics on outsourced collection agencies, and more. No matter the size of your practice, Waystar can generate data-driven insights to improve your operations in a matter of seconds.
Waystar also offers the following standalone services:
- Claims and denial management
- Patient financial clearance
- Patient insights
If you prefer to keep your existing EHR software, Waystar integrates with all major PM software. Customers praise Waystar’s comprehensiveness and easy-to-use interface, the ability to correct rejected claims, and competitive pricing.
Although we chose Waystar as the best option for larger practices, it works with practices of all sizes. Monthly pricing starts at $100, but your actual price will be completely customized based on your practice’s needs. However, some customers have noted that prices can get costly.
Best for Hospitals: athenaCollector
Modern and easy to use
Shorter contract lengths
93% first-pass resolution rate
Doesn’t code claims
No pricing on website
Lower first-pass rate than other companies
AthenaCollector is part of the athenahealth umbrella. Founded in 1997, athenaCollector now collects over $29 billion in collections annually. We chose athenaCollector as the best choice for hospitals because it allows you to keep your billing in-house while adding powerful, enterprise-friendly features for management.
Once you set up athenaCollector, you’re ready to go—the software is very user-friendly and easy to learn quickly. You can fully customize your dashboard to your practice’s preferences. Similar to AdvancedMD, athenaCollector won’t code your claims, so you’ll need to have a coder on staff. This is one of the main reasons athenaCollector is better suited for a hospital or larger practice.
AthenaCollector scrubs your codes for errors using intuitive rule engine software, designed to reduce denials and increase your first-pass claim rate. In addition to billing software, you’ll also get EMR, PM, and patient engagement tools. You can schedule appointments, verify patient insurance, run customized reports, and view real-time data on how your practice is performing all from one centralized place.
Unlike other medical billing companies, athenaCollector does not offer packaged plans. You’ll need to reach out to sales to receive a custom quote. They charge a percentage of your net collections, but this percentage varies based on:
- The size of your practice
- Your practice’s specialty
- Claims volume
- Billing complexity
Best for Specialty Providers: CureMD
Designed for specialties
96% first-pass claims rate
Low starting price
Doesn’t integrate as well with outside EHRs
Not great for more than five users
CureMD has been the go-to billing company for specialty practices since 1997. Serving over 32 specialties, CureMD provides flexible solutions for billing, EHR, and PM. We chose CureMD as the best for specialties because its workflows are specifically designed with specialties in mind, it has a high first-pass claims rate, and has relatively low monthly pricing.
CureMD handles coding and oversees claims by submitting them, following-up on them, and managing appeals and denials. CureMD’s proprietary scrubbing algorithm guarantees a 96% first-pass rate for your submitted claims, which is one of the highest rates in the industry. The company also guarantees you’ll see a 5% to 10% increase in collections within the first few months of signup.
CureMD offers billing, PM, and EHR as separate services, but if you’re looking for all three, you can easily purchase CureMD’s all-in-one plan. CureMD does not charge any setup or training fees and works on your desktop or iPad. Customers have noted that it’s not the easiest to integrate with any other EHRs you may be using but is an easy-to-use, all-inclusive platform if you use their EHR.
CureMD offers the following plans:
- Medical billing services: Starting at 4% of collections, but may be more depending on the size of the practice, exact specialty, and value of claims
- PM: $195 per provider per month
- EHR Cloud: $295 per provider per month
- Speciality EHR: $295 per provider per month
- All-in-one: $395 per provider per month for EHR, PM, and billing
Unlike most providers, CureMD charges clearinghouse fees (most providers include such fees in their pricing packages). Each plan includes up to five users per provider. It costs $100 per user per month to add any additional users, so it’s not as ideal for larger practices.
Best for Flexible Solutions: CareCloud
User community included in all plans
High setup and onboarding fees
No Android app
Long contract lengths
CareCloud has been tailoring solutions to practices of all sizes since 2009. Whether you’re looking to connect outside EMR or PM software or outsource only some of your billing needs, CareCloud’s versatility made it the obvious winner for most flexible solution.
CareCloud has customers of all sizes and types, from small practices to specialists to enterprise organizations. To get started with CareCloud, you can bring your own EHR system or use their built-in one. CareCloud’s RCM boasts a 97% composite resolution rate on claims, and its billing software comes with CollectiveIQ, a proprietary set of advanced billing rules designed to catch claim errors before they happen. The cloud-based software works and syncs across all major browsers and desktops, but the mobile app version is currently only available on iOS.
CareCloud offers four different solution packages. To get the prices listed below, you will need to enter a longer contract (one to three years), which can be a drawback:
- Central Practice Management: $349 per provider per month for a full suite of applications such as scheduling, claims, billing, collections, reporting, and patient experience management (PXM) Breeze system
- Charts Electronic Health Records: $279 per provider per month, but a subscription to Central is required. Charts is a customizable EHR system that includes the Breeze PXM software.
- Concierge Revenue Cycle Management: Starting rate is 3% of collections. This RCM software comes with an expert revenue cycle team and includes the Central and Breeze software.
- Breeze Patient Experience Management: $199 per provider per month if you only want patient engagement management software (PXM) without any of the other packages. Also included in all three of the other packages.
Unlike most providers, CareCloud will change how they bill you based on your claim frequency and complexity. All plans come with access to an online user community, and the Central and Concierge packages come with dedicated teams of account managers. The company does charge fees for onboarding and setup, which start at $1,000 per provider.
What Is a Medical Billing Company?
A medical billing company is a service that doctors and hospitals use to outsource billing to patients and insurance companies. Medical billing companies will process, submit, and audit billing claims as well as manage patient data entry and verify their insurance benefits. All medical billing companies are required to be HIPAA-compliant by law.
In addition to managing billing and insurance claims, some medical billing companies bundle other features and services, such as patient management, electronic health records (EHR), and revenue cycle management (RCM), into the same software-as-a-service platform. Not all of them will, however, so if you’re looking for features beyond billing, make sure you pick a provider that can do all of the functions you’re interested in.
What Are the Benefits of Using a Medical Billing Company?
There are a few major upsides to outsourcing tasks to a medical billing company. Medical practices of all sizes can save a ton of time by outsourcing administrative work thanks to automated processes. Medical billing companies will automate and oversee data entry, claims, denials, and follow-ups. By saving time, you’ll also save money, as some medical billing companies also code for you. This means you can use the money normally needed to hire coders to hire additional doctors and nurses instead.
However, there are a few drawbacks as well. If you choose to outsource your billing, you’ll have less oversight into the process. Also, you might not be able to access patient billing records as quickly as you would with billing in-house. Lastly, some billing companies have hidden fees and variable costs.
How Much Do Medical Billing Companies Cost?
Monthly pricing ranges from as low as $100 per month to as high as over $700 per month, depending on the number of providers. Some billing companies require you to contact sales to receive a custom quote or take a percentage of collections rather than charge a set monthly amount.
Pricing can also vary based on practice size, billing complexity, and claims value. Some companies charge additional fees for setup.
What Is the Difference Between a Medical Billing Company and Medical Billing Software?
While the terms “medical billing company” and “medical billing software” are used interchangeably, they have slightly different meanings. Medical billing software refers to any program used to manage and oversee billing. This could refer to software that your medical staff uses to manage billing all on their own or could refer to software that your team uses in conjunction with a third-party medical billing company. A medical billing company is a third-party entity that handles billing for you, which also may encompass software that your team uses to communicate with your chosen provider.
Purchasing medical billing software for your team to keep things in-house is less expensive than outsourcing everything to a medical billing company, but doing so may require an expert biller on staff. If you don’t have a solid biller to manage your software, outsourcing to a medical billing company is a smart choice.
How We Chose the Best Medical Billing Companies
We looked at over 25 medical billing companies to find the best in each category. To narrow down our list, we looked at costs, platform features, hardware and software requirements, first-pass success rates, ease-of-use, customer feedback, industry reputation, and types of clients served.
All of our top choices were picked based on their affordability for a range of services and features, their reputations for accurate billing, their reputations within the industry and their niche, and how well they integrate with other platforms and software.
WebPT. "The True Cost of a Denied Claim in Your PT Practice." Accessed Dec. 8, 2020.