While at its core, healthcare involves human-human intervention, technology has always played a pivotal role in medicine throughout history. And in the 21st century, one of the most significant tech revolutions that has occurred in healthcare has been medical software.
Whether through instantly available real-time electronic health records, intelligent patient scheduling tools, or online drug databases, countless software innovations have improved the quality of care delivered by clinicians and reduced administrative burdens.
For most practitioners, it’s now virtually impossible to imagine practicing without these tools. And patients have increasingly come to expect, and appreciate, the digital care management tools that have become a central part of their healthcare journey.
However, with all the promise of improved efficiency and simplified processes, there’s one area that’s only become more complicated—medical billing.
There is much debate over the causes of the increasing complexity of the healthcare insurance system. And perhaps at some stage in the future, the billing process will become more user-friendly. But for now, we’re all stuck with a system that can be incredibly difficult to practice in.
Fortunately, some forward-thinking companies have created comprehensive, yet easy-to-use medical billing software solutions. These products can make the healthcare insurance system much easier to navigate for clinicians and consumers alike.
In this article, we’ll provide an overview of medical billing software, then look at the 5 best solutions available to practitioners in 2023.
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What is Medical Billing Software?
Put simply, medical billing software is a computer application designed to automate the healthcare billing process.
It helps healthcare providers—from hospitals to community clinics and individual practitioners—to manage and track patient care episodes from the point of scheduling an appointment, all the way to the final payment of a balance.
Medical billing software handles tasks such as:
- Patient registration
- Verification of insurance eligibility
- Creating and submitting insurance claims
- Reimbursement tracking and reconciliation
- Claims management and reporting
The primary aim of medical billing software is to streamline the healthcare revenue cycle, enabling providers to receive payments faster, more accurately, and more efficiently.
On a broad level, the main benefits of medical billing software are minimizing claims errors and maximizing reimbursement.
Because the healthcare insurance system is so complex, human error is common with manual claims.
When a billing error is made, it can result in:
- Lost or delayed revenue
- Potential compliance issues
- Inefficient use of staff time (clinical and administrative)
- Dissatisfied patients
This concept often makes providers cautious, who are understandably wary about anything resembling insurance fraud. But let’s be clear, maximizing reimbursement has nothing to do with insurance fraud.
Maximizing reimbursement is about ensuring both provider and client obtain the highest payment they are entitled to from an insurer for services that have legally been provided.
The benefits of maximizing reimbursement include:
- Providers can maintain healthy cash flow and a viable business model
- Copays for patients can be kept to a minimum
- The value and integrity of the insurance system as a whole is maintained
Medical billing software helps to minimize errors and maximize reimbursement by:
- Automating routine tasks. Things such as patient intake, collecting demographic details, insurance verification, and pre-authorization can be done automatically.
- Ensuring timely and accurate billing. Because medical billing software automatically collects insurance and coding details, accurate claims for reimbursement can be submitted promptly after each service.
- Providing an organized billing system. All details required for tracking patient information, payments, and claims are stored in one place, meaning they can be monitored closely and any problems responded to quickly and easily.
- Improving collections and patient satisfaction. When healthcare consumers are presented with an easy-to-understand bill, which clearly identifies reimbursements and provider fees, they are more likely to pay their account on time and feel satisfied with the service provided.
One of the first questions providers often ask is, “How much does medical billing software cost?”
It’s an understandable query. After all, while the right tools can bring many benefits to clinicians and consumers, the cost of software and apps can quickly add up.
The cost of implementing medical billing software can vary widely. Factors affecting the price include:
- The number of users
- Software features
- Whether the software is hosted in the cloud or on-premise
- The degree of customization required.
Some vendors offer subscription-based pricing models, where healthcare providers pay a monthly or annual fee. Whereas others may charge a one-time licensing fee.
Prices for medical billing software can range from a few hundred dollars to several thousand dollars per year. However, despite the initial investment, the right product can provide a significant return on investment (ROI) by improving efficiency, reducing errors, and enhancing revenue collection.
Medical billing software can be broadly classified into two types: on-premise and cloud-based.
On-premise software is installed and runs on computers within the healthcare facility. This type of software often requires an upfront investment in hardware and IT infrastructure. On-premise software can be more secure as all data is stored locally. However, it can also be more expensive in the long run due to maintenance and upgrade costs.
Cloud-based software is hosted on the vendor’s servers and accessed through the internet. It requires less upfront investment, as it doesn’t require any hardware purchases. Updates and maintenance are typically handled by the vendor. However, the recurring subscription fees can add up over time, and there may be potential concerns about data security.
If you’re considering purchasing medical billing software, it’s best to look at several different options before committing to a purchase.
Most clinicians find that because of the wide range of choices in the market today, they can find a solution that’s a close, if not perfect match for their business and practice style.
To give you a head start on your search, we’ve detailed our picks for the 5 best medical billing solutions.
The platforms below have been acknowledged for their comprehensive features, user-friendly interface, reliable customer support, and competitive pricing. They offer a suite of billing and practice management tools designed to help healthcare providers manage their revenue cycle effectively.
A web-based medical billing and practice management solution. Kareo is suitable for both small practices and billing companies. It covers all types of health practitioners, from physicians to therapists to allied health clinicians.
Kareo helps to manage all aspects of insurance billing and revenue cycle management (RCM). It also includes several stand-out features to make the lives of clinicians and administrative staff easier, including:
|Price||Starting at USD $125 per month|
|Best For||Small group practices or solo practitioners|
More than just billing software, AdvanceMD is a full suite of software solutions for healthcare practitioners of all types. Features available include full EHR and practice management products, telehealth tools, financial analytics, patient charts, and even reputation management.
Automated medical billing features include intake forms, appointment reminders (to reduce no-shows), insurance eligibility verification, consent forms, and charting. Charge capture is included in the charting process, meaning clinicians and billing staff don’t need to double-handle data.
|Price on application. Depending on features required|
Those needing comprehensive practice management software
AthenaHealth offers several cloud-based software products that cover every stage of the healthcare patient journey. The unique thing about AthenaHealth, is that almost all their products can be used as a stand-alone service or as part of a full practice management package.
AthenaHealth’s award-winning medical billing solutions promise to relieve the burden of revenue cycle work by:
Depending on the number of clinicians and patients
Specialized stand-alone medical billing softwar
Mental health billing is complicated. And the fact is, many medical billing solutions simply don’t have the features required by behavioral health clinics and solo providers. That’s where TheraNest comes in.
Designed by therapists for therapists, TheraNest is an easy, affordable, and complete practice management software solution that contains simple billing and RCM services in all of their 3 product tiers (can be expanded if needed). Features include a secure patient portal, 1-click invoicing, the ability to take credit card payments, and audit and management reporting.
Lite $29 per therapist, Professional $39 per month, Enterprise price application
Mental and behavioral health providers
Built specifically for coaches and therapists, Quenza is a HIPAA-compliant therapy app and electronic health record. Because Quenza is fully-customizable, it’s easy to create practice-branded intake forms, invoices, and insurance claims forms, all using our drag-and-drop form builders.
Quenza has several other features that make it stand out compared to other software solutions, such as:
Lite $49 month, Standard $89 month, Unlimited $149 month
Coaches or therapists in group or private practice
Future Developments: Will Medical Billing Be Automated?
With rapid advancements in artificial intelligence (AI) and machine learning technologies, the healthcare industry is on the cusp of a significant transformation.
These technologies have the potential to automate many aspects of medical billing by streamlining processes, reducing the need for human intervention, minimizing errors, and increasing efficiency. Several AI software products are also close to viability for implementation in clinical tasks, such as interpreting radiology images and robotic surgery.
In medical billing, AI could potentially be used for tasks such as predicting and addressing potential claim denials, automating medical coding, and providing real-time analytics to optimize revenue cycle management. However, for medical billing to be fully automated, there remain some significant challenges around data safety and protecting health information that must be overcome.
We’ve covered a lot of information in this article. So before wrapping up, let’s summarize the most common medical billing software benefits.
Medical billing software offers a multitude of benefits, such as:
- Increasing efficiency by automating routine tasks. This frees up staff to focus on more critical aspects of patient care. After all, you became a clinician to treat patients, not deal with insurers.
- Reducing the chance of errors by minimizing manual data entry. Most problems with insurance claims are due to human error, so medical billing software can lead to more accurate billing and fewer claim denials.
- Improves cash flow and revenue cycle management. By speeding up the billing process and enabling faster payment collection, medical billing software can bring significant financial benefits to practice owners.
- Enhancing patient satisfaction. Complicated bills for healthcare are one of the biggest complaints from consumers. By providing detailed billing statements and online payment options, billing software helps patients better understand their charges.
As a general rule, it would be fair to say that dealing with insurance is not something most healthcare providers enjoy. However, the financial realities of medical care in the 21st century mean that for most, navigating the insurance system is a necessity for those who want to run a successful healthcare business.
While medical insurance is inherently complex and challenging, the rewards for providers who learn to efficiently navigate this system are huge.
By leveraging the latest advancements in medical billing software, savvy clinicians can simultaneously improve their revenue and increase patient satisfaction. But the catch is, to do so, you must choose a software partner who understands your business.
If you are a coach or therapist, Quenza has been purpose-built just for you.
Not only does Quenza have a suite of tools that can help with intake, record keeping, and invoicing. We also provide a comprehensive ecosystem for practitioners of all levels and backgrounds to undertake 1:1 work, run groups, create online courses, and manage a group practice.
To see how Quenza could help streamline your practice today, sign up now for a full-access 1-month trial for only $1.
- ^ Amatayakul, M.K. (2012). Electronic Health Records: A practical guide for professionals and organizations. Chicago, IL: American Health Information Management Association.
- ^ PriceItHere.com. (n.d.). How much does medical billing software cost in 2023? Retrieved July 1, 2023, from https://priceithere.com/medical-billing-software-prices/.
- ^ Vasconcellos, E. (2023). How cloud storage differs from data center storage. Business News Daily. Retrieved July 1, 2023, from https://www.businessnewsdaily.com/4982-cloud-vs-data-center.html/.
- ^ Murdoch, B. (2021). Privacy and artificial intelligence: Challenges for protecting health information in a new era. BMC Medical Ethics, 22(1). doi:10.1186/s12910-021-00687-3.