Comparison of Medical Billing Rates

Comparison of Medical Billing Rates

Medical billing services charge their clients by three methods:

The percentage basis is generally used by medical insurance billers (MIBs) who do full-practice management or a combination of patient billing and claims billing, and just as it sounds, the MIB charges the provider a percentage of the money they collect per month as opposed to the amount of money they bill.

Follow is the review of some of the top medical billing services to help about how the prices differ from one company to the next.

Drchrono

  • Softwarefinder rating: 4/5
  • Best Medical Billing Service for Small Practices
  • Focused on smaller practices of 1 – 15 providers. Typically charges 4% to 8% of net collections.

CareCloud

  • Softwarefinder rating: 4/5
  • Best Low-Cost Medical Billing Service
  • Offers three tiers of services. Typically charges 3% to 7% of net collections.

AdvancedMD

  • Softwarefinder rating: 4/5
  • Best Medical Billing Service for Large Practices
  • Offers three tiers of services. Typically charges 3% to 7% of net collections.

DrChrono

DrChrono’s medical billing service is geared toward small and midsize practices, primarily in the range of one to 15 providers or 16 to 25 providers.

The company works with practices across all specialties, charging a percentage of their clients’ net collections.

DrChrono boasts a competitive first-pass claims rate of 97%, meaning only 3% of the claims its billers submit are denied by payers and require additional work and resubmission.

Besides, DrChrono’s percentage of collections includes access to its electronic medical records (EMR) software and practice management software.

DrChrono’s billing team starts the revenue cycle management process from the very beginning, generating claims by entering charges and coding them properly based on clinical documentation from the practice.

Once the claims are generated, DrChrono scrubs each one for common errors that would lead to rejection by the payers. If any errors are flagged, the company’s medical billers and coders revise the claim accordingly before submission.

The only drawback is that clients are required to use both the EMR and practice management software, whereas most medical billing services only require clients to use their practice management system.

CareCloud

CareCloud’s medical billing service has three different tiers, each of which offers a different scope of service for practices with different billing needs.

Concierge:

With Concierge, CareCloud will take over the claims submission and denial management process, getting claims to the appropriate payers promptly and then monitoring for any rejections. If a claim is rejected, CareCloud’s billing team will work to revise and resubmit the claim as needed.

Concierge Plus:

The second tier is similar to the first, except CareCloud adds a claims scrubbing step to the process. Using its rules engine, CollectiveIQ, CareCloud checks each claim against a database of more than 120 million common errors. If a potential mistake is flagged, its billing team will more closely review that claim before submission.

Concierge Pro:

Concierge Pro is CareCloud’s full revenue cycle management tier of service. CareCloud will access clinical documentation from the practice to generate claims by performing charge entry and coding services. Once created, those claims are put through the CollectiveIQ claims scrubbing system and adjusted if needed. Once scrubbed, the claims are submitted through the appropriate clearinghouse or directly to the proper payer. CareCloud billers will follow up on unpaid claims and work any denials to the point of payment.

CareCloud offers both a proprietary electronic health records (EHR) system and practice management software. Revenue cycle management clients must use CareCloud’s practice management platform because all billing is performed through that system. Use of the company’s EHR software is optional, although it is included in the price of the billing service.

The main limitation we discovered with CareCloud is its significant setup fees, which are steep compared to other medical billing services we reviewed. Even among companies that do charge setup fees, CareCloud is the most expensive. While these fees are one-time costs incurred during onboarding, they can become a significant upfront expense, especially for a practice on a tight budget.

AdvancedMD

AdvancedMD’s medical billing service is capable of handling all the revenue cycle management for large and small practices alike.

The company excels in managing billing for practices in the 100-provider space, making it best for medical billing service for large practices.

AdvancedMD’s outsourced revenue cycle management comes with access to its electronic medical record (EMR) software and practice management platform for a monthly percentage of clients’ net collections.

Currently, AdvancedMD boasts an organization-wide first-pass claims rate of 98.4%, which is one of the highest of the services we reviewed.

The company will also contractually guarantee a minimum first-pass claims rate of 95% for all clients, and it is the only company we reviewed that provides such a guarantee.

AdvancedMD begins the billing process after the charge entry and coding phase has already been completed. AdvancedMD does not perform charge entry or coding services at all so that responsibility falls on the practice to complete in-house or outsource to a third party.

Currently, the organization-wide first-pass claims rate for AdvancedMD is 98.4%, which is one of the highest rates. That means only 2.6% of claims submitted by AdvancedMD are denied by payers.

AdvancedMD’s pricing model takes into account a variety of factors, including practice size, the number of claims submitted, the number of patient encounters, the specialty and the complexity of the billing process.

Monthly collections:

The ultimate price will be the higher of a monthly minimum (set during contract negotiation) or a percentage of your monthly collections, so to offer a precise quote AdvancedMD needs to know how much your practice brings in per month.

Patient encounters:

Pricing will also depend on the number of total patients seen by physicians.

Specialty:

Because the billing process and specific rules can vary so much from specialty to specialty, AdvancedMD incorporates the complexity of your specialty into the final percentage.

The number of providers:

Finally, your total number of providers can also influence the quote.

AdvancedMD’s largest limitation is the fact that it does not manage charge entry or the coding of claims. These are important aspects of the medical billing process that require experienced, certified coders to perform properly.

EHR Benefits – All You Need To Know About EHRs

EHR Benefits

EHR Benefits

Are you searching for an EHR? Do you want to make a shift from all that tiring paperwork and upgrade to a digital setup? All good medical healthcare facilities in the modern age, feature a strong digital record-keeping system. Today, we have a ton of solutions to address the needs of a clinician, each more specific than the previous. The patient record keeping is among the foremost priorities in the healthcare industry, and for that, you have the EHR/EMR software to consider. Both provide you with a secure and reliable solution to store and manage your patient’s records data. However, a significant population in the healthcare professionals remain unaware of the countless benefits EHR systems boast and how they can improve their work experience and practice success. This article intends to touch some of the major benefits of having EHR software.

What is EHR software?

When we look for the electronic record-keeping platform for healthcare providers, an endless list of EHR/EMR solutions pop up in front of us. All doctors require a solution that allows them to create and manage patient’s records data, update it after every encounter, and easily retrieve it whenever needed. EMR and EHR solutions offer you the ease to do all this at the convenience of your computers, under one comprehensive system.

While EMR systems accomplish all that, EHR software takes the process to a whole new level with the many advanced features and tools they offer. There are instances when healthcare professionals need the opinion of multiple experts for a patient, the EHR allows them to coordinate and share patient data and make referrals conveniently. EHR allows you to keep all the data at one place and authorize other clinicians to access the record and view the details of a patient. Not only that, EHRs support integration with lab tests, imaging, and pharmacies for prescriptions refills, all without the hassle of any manual workarounds and time-consuming interactions.

What are the benefits of EHR for patients?

With paperwork, the chances of error are significantly high. Human errors in paper records in the past have accounted for a significant amount of mishaps in a healthcare setting. EHRs do not eliminate the human factor. They do, however, feature a set of precautionary checks and error-proof mechanisms that potentially minimize, if not eradicate any errors from occurring by alerting the user if it deems wrong information is being entered.

Moreover, the patient doesn’t have to move back and forth, from one physician to another, to get a second opinion. EHRs make it easy for a hospital to centralize the patient’s data. As soon as you give access to a doctor, they can view the history and data of the patient without any trouble. This way different medical teams can communicate easily and save patients much time and hassle, in the process. The receptionist does not have to loop through tons of records, which in itself is an uphill task, to find the right documents. All they need to do is enter the patient’s ID, and the system will retrieve the entire records data under it, almost instantly.

Patients who find themselves in an emergency can benefit a lot from EHRs. It stores information regarding the medical history and treatment logs of a person’s entire life. So, the doctors immediately get to know what was wrong with the patient before the accident. Ultimately, some critical and life-saving information is supplied which is highly beneficial in emergency care units.

What are the EHR benefits for healthcare providers?

Patients generally tend to consult multiple doctors for numerous different purposes, which can make tracking their data a tough ask. There are several factors that can render them unable to convey the problems thoroughly and reliably. But when you see the history of a patient logged in an EHR by a professional, it’s much easier to review the past treatments that the patient has been through. Thus, you can make a conclusive diagnosis and prescribe the right medications.

Then, there are times when multiple doctors are working on one patient case at the same time. So, sharing the information and sending data promptly is very crucial. With the old method in practice, other doctors were likely to face delay because a clinician was busy or unable to successfully send the data. But with this system in place, all you have to do is update the information in the EHR and other practitioners can access it in within minutes!

EHR systems also reduce the burden of record management and problems associated with improper tracking. There were cases when patients were given the wrong dosage merely because the medical history of the patient given to the doctor was not right. Thus, it is quite relieving for doctors to use a reliable EHR system with accurate data in place.

Why must I move on to EHR?

There are countless pros if we look at EHR benefits. We analyzed the benefits of using an EHR from the perspective of a patient as well as from a clinician. As a hospital authority or a healthcare service provider you may have questions as to why you should consider adopting an EHR software and abandon the traditional paper record trails.

First of all, doing paperwork in itself is an uphill task. You need a dedicated staff to deal with this part of the job. You need members to note down every detail and updates. Then you need an individual who can store and retrieve that data. Moreover, there are stationery requirements and management concerns and possibilities of data loss, to be taken into account. But with an EHR, you don’t have to deal with any such thing. There is minimal to no paperwork and no storage issues.

An EHR system enables you to improve the quality of the healthcare services you provide. By offering real-time data and easy access to the information of a patient, you can consider the requirements and address them appropriately. Starting from diagnosis to proper medication and following treatment, the healthcare continuum experiences an improvement thoroughly.

What’s more, it increases the overall efficiency and productivity of the medical facility. One of the biggest EHR benefits is that you can have a more streamlined workflows, organized care system that ultimately ends in better ROI and financial prosperity of the practice.

EHR also helps in lowering the overall cost by decreasing the paperwork and reducing the duplicate testing problems. You need fewer individuals to deal with EHR systems. It also provides powerful tools to keep track of patients’ medical history.