6 Best Medical Billing Software for Practices 2025
Revenue Cycle Management

6 Best Medical Billing Software for Practices 2025

Janet Scott
Janet Scott
July 19, 2023
Last updated on:

December 19, 2024

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Read time: 7 mins

Medical billing software is a specialized application designed to streamline and automate the billing and revenue cycle management processes in healthcare settings. It provides tools and features for claims submission, coding assistance, payment processing, denial management, and reporting.

Hospitals need medical billing software to manage their financial operations efficiently. These software solutions help hospitals accurately code and submit claims, track payments, reduce claim denials, optimize revenue collection, and generate comprehensive reports for financial analysis. By automating and streamlining billing processes, medical billing software enhances efficiency, improves revenue generation, and ensures compliance with regulatory requirements.

This blog will discuss the top 6 medical billing software in US that help small practices by streamlining operations, reducing errors, and improving revenue cycle management.

What is the importance of accuracy in medical billing?
Accuracy in medical billing is crucial to ensure correct reimbursement for healthcare services, prevent financial losses, maintain compliance with regulations, and foster trust between healthcare providers and payers.

To understand the outcomes of incorrect medical billing, read our blog 'Consequences Of Incorrect Medical Coding And Billing.'

According to a report by Introspective Market Research, the global Medical Billing Software market was valued at USD 87.95 Million in 2021, and it isexpected to reach USD 186.08 Million by 2028, reflecting a CAGR of 11.3% during the analysis period.

Why Need Medical Billing Software
Image 1 - Top Reasons to Invest in Medical Billing Software

List of Medical Billing Software for Small Practices

Numerous medical billing software options are available, each offering specific features and benefits. Here are six best medical billing software for small businesses, along with their benefits, use cases, and market adoption:

1. Kareo:

Kareo is a popular cloud-based medical billing software known for its user-friendly interface and inclusive features. It offers tools for claims management, patient billing, appointment scheduling, and electronic remittance advice (ERA) processing. Kareo streamlines the billing process, improves revenue cycle management, and provides detailed reporting and analytics. It is widely adopted by small to medium-sized healthcare practices due to its affordability, ease of use, and robust functionality.

Features:

  • Kareo's intuitive design ensures easy navigation and quick user onboarding, reducing training time and enhancing efficiency.
  • The software simplifies claim creation, submission, and tracking, reducing billing errors and accelerating reimbursement timelines.
  • Kareo's scheduling tools enable seamless appointment management, reducing no-shows and optimizing provider schedules for enhanced productivity.
  • The software offers comprehensive insights into financial performance, allowing practices to identify trends, optimize revenue cycles, and make informed business decisions.

2. AdvancedMD:

AdvancedMD is the best medical billing software that caters to various specialities and practice sizes. It provides features for claims management, coding assistance, patient scheduling, and electronic health record (EHR) integration. AdvancedMD streamlines the billing workflow, enhances accuracy, and offers robust reporting capabilities. It is favored by both small practices and large healthcare organizations for its scalability, flexibility, and advanced features.

Features:

  • AdvancedMD caters to various medical specialties, offering tailored solutions and workflows to meet specific practice requirements.
  • The software offers integrated telemedicine functionality, enabling healthcare providers to conduct virtual visits with patients, expanding access to care, and facilitating remote billing and reimbursement processes.
  • AdvancedMD's scheduling feature allows practices to manage appointments efficiently, minimizing wait times and improving patient satisfaction.
  • Integrating electronic health records streamlines patient data management, enhancing care coordination and simplifying billing processes for improved efficiency.

3. Epic Systems:

Epic Systems is a leading electronic health record (EHR) vendor and the best medical billing software offering integrated medical billing functionalities. Its medical billing module seamlessly integrates with the EHR system, allowing for efficient charge capture, claims management, and revenue cycle management. Epic Systems provides extensive customization options and advanced reporting capabilities. Large healthcare systems and hospitals widely adopt it due to its comprehensive functionality and interoperability.

Features:

  • Epic Systems offers extensive customization capabilities, allowing healthcare providers to tailor the billing workflows to their specific needs and preferences.
  • The software provides robust reporting and analytics features to gain insights into financial performance, identify trends, and make data-driven decisions.
  • Epic Systems' interoperable platform enables seamless data exchange with other healthcare systems and payers, facilitating smoother billing processes and promoting coordinated patient care.
  • The software includes powerful claims scrubbing capabilities, which check claims for errors and inconsistencies before submission, reducing claim denials and improving first-pass acceptance rates.
  • The system verifies patient insurance eligibility, reducing the risk of claim rejections due to incorrect or outdated insurance information.

According to Fortune Business Insights, the global medical billing outsourcing market was valued at approximately $14.65 billion in 2023. It isanticipated to reach around $16.32 billion in 2024 and is projected to grow to about $39.98 billion by 2032, reflecting a compound annual growth rate (CAGR) of 11.8%.

4. AthenaCollector:

AthenaCollector is a cloud-based medical billing software for large healthcare organizations. It is the best medical billing software for billing companies. It offers robust claims management, denial management, payment posting, and revenue reporting features. AthenaCollector automates billing processes, optimizes collections, and provides real-time insights into financial performance. It is favored by larger practices and billing companies for its scalability, extensive reporting capabilities, and revenue optimization tools.

Features:

  • AthenaCollector efficiently handles denied claims, providing detailed insights into reasons for denials and automating the appeal process for improved revenue recovery.
  • It offers comprehensive and customizable revenue reports, enabling healthcare organizations to analyze financial performance, identify trends, and optimize revenue streams.
  • The software provides real-time access to key financial metrics and performance indicators, empowering decision-makers with up-to-date information for effective financial planning.
  • AthenaCollector caters to the needs of large healthcare organizations and billing companies, accommodating a high volume of claims and supporting expansion as the organization grows.
  • The software employs intelligent collection strategies, prioritizing high-value accounts and automating follow-up actions to maximize revenue collections and reduce aging AR (Accounts Receivable).

5. eClinicalWorks:

eClinicalWorks is an integrated EHR and best medical billing software that caters to both small practices and large healthcare organizations. Its billing module offers claims submission, payment processing, denial management, and reporting features. eClinicalWorks streamlines billing workflows, enhances accuracy, and provides tools for revenue cycle management. It is widely adopted due to its interoperability with the eClinicalWorks EHR system, making it a popular choice for practices seeking an all-in-one solution.

Features:

  • eClinicalWorks provides instant insurance eligibility checks, reducing claim denials due to inaccurate or outdated patient insurance information.
  • The software supports Electronic Data Interchange for electronic claims submission and remittance, improving efficiency and reducing paper-based billing processes.
  • It automatically generates and sends patient billing statements, promoting transparency in patient billing and reducing billing-related inquiries.
  • The software allows billing based on appointments and services rendered, simplifying charge capture and ensuring accurate billing for provided services.
  • The system accommodates multiple providers within a practice, streamlining billing processes and ensuring accurate attribution of services to each provider.

6. NextGen Healthcare:

NextGen Healthcare is a comprehensive and one of the best medical billing software offering various features, including claims management, coding assistance, payment posting, and revenue reporting. It provides tools for automation, optimization, and streamlining of billing processes. NextGen Healthcare is widely adopted by practices of various sizes and specialties, including independent practices, multi-specialty clinics, and larger healthcare organizations. It is recognized for its robust functionality, scalability, and flexibility.

Features:

  • NextGen Healthcare is suitable for practices of various sizes, from independent practices to multi-specialty clinics and larger healthcare organizations, accommodating growth and expansion.
  • It can efficiently manage denied claims, offering insights into denial trends and automating the appeals process for improved revenue recovery.
  • The software provides real-time claim status tracking, enhancing transparency and enabling prompt follow-up on delayed or pending claims.
  • NextGen Healthcare stays up-to-date with billing regulations, ensuring practices comply with industry standards and regulations.
  • The software supports practices with multiple locations, centralizing billing processes for improved efficiency and consistency.

Market Adoption of the Best Medical Billing Program

Kareo and AdvancedMD are the most common medical billing software adopted by small to medium-sized practices. These two software are widely adopted because of their user-friendly interfaces, affordability, and comprehensive features. Epic Systems is prevalent among large healthcare systems and hospitals for its integrated EHR and billing capabilities. AthenaCollector is favored by larger practices and billing companies for its scalability and revenue optimization tools. eClinicalWorks and NextGen Healthcare have a significant market presence across practices of various sizes, offering integrated EHR and billing functionalities.

Key Considerations for Choosing Medical Billing Software
Image 2 - What to Look for in a Medical Billing Software

How to Choose Among the Best Medical Billing Software for Your Practice

When selecting the best medical billing software for your practice, it's essential to consider several factors to ensure it aligns with your needs. It includes

  • Practice Requirements: Evaluate patient volume, services provided, and specialties to identify needed features and functionalities.
  • Practice Size: Choose software that suits the scale of your practice, whether small or large, considering features and customization options.
  • Ease of Use and Compatibility: Assess user interface, implementation process, training, support, and integration capabilities with existing systems.
  • Budget and Pricing: Consider software costs, pricing models (per user, per claim, or subscription-based), and ROI potential.
  • Reviews and Recommendations: Read feedback from healthcare professionals to gauge reliability, customer support, and user satisfaction.

Conclusion

While software makes billing a breeze, investing in and maintaining medical billing software for hospitals presents challenges. These include high costs, complex implementation processes, ongoing software updates, interoperability issues with existing systems, staff training needs, data security concerns, regulatory compliance requirements, and continuous technical support to ensure optimal functionality and performance.

Therefore an easy way out is to delegate medical billing tasks to a partner with knowledge of medical billing software. A third-party billing services provider will have access to various medical billing software options, allowing them to choose the most suitable solution for your specific needs. Invensis has over 24 years of experience in medical billing services and, over the years, we have acquired expertise in handling various medical billing software, to streamline the billing process. Contact us now to know more about our services

Frequently Asked Questions

1. What are the three types of medical billing systems?

The three types of medical billing systems are:

  1. Closed System: Used within a single healthcare organization, allowing secure internal data exchange.
  2. Open System: Facilitates information sharing across multiple organizations, promoting interoperability.
  3. Isolated System: Operates independently without electronic exchange, often relying on paper records and manual processes.

2. How do I choose a billing system?

To choose a billing system, assess your organization's size, budget, and needs. Consider system interoperability, ease of use, and integration with existing software. Evaluate customer support, security features, and compliance with regulations. Compare user reviews and request demonstrations to ensure the system aligns with your workflow and enhances efficiency.

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