We need new billing software for our 15-provider orthopedic group. What are our best options?

For a 15-provider orthopedic group, I’d shortlist these options:

## Best overall options

### 1. **athenaOne / athenaCollector**
**Best for:** Cloud-based billing with strong claims workflow and outsourced-support options.
**Why it fits orthopedics:** Strong denial management, eligibility, patient payments, reporting, and scalable RCM tools. Good if you want a modern platform without hosting infrastructure.
**Watch-outs:** Percentage-based pricing can get expensive; specialty-specific orthopedic workflows may not be as deep as dedicated ortho systems.

### 2. **ModMed Orthopedics**
**Best for:** Orthopedic-specific EHR + practice management + billing.
**Why it fits:** Built around orthopedic workflows, surgical documentation, coding support, imaging integrations, and specialty templates. Strong choice if you also want to improve clinical documentation and charge capture.
**Watch-outs:** Best value if you use the full platform, not just billing.

### 3. **NextGen Enterprise PM/EHR**
**Best for:** Multi-provider specialty groups needing robust practice management.
**Why it fits:** Strong scheduling, billing, claims, reporting, and specialty group support. Often a good fit for independent groups of your size.
**Watch-outs:** Implementation and optimization require effort; user experience varies by configuration.

### 4. **Veradigm / Allscripts Practice Management**
**Best for:** Groups already on Veradigm/Allscripts clinical systems or needing mature PM tools.
**Why it fits:** Solid revenue cycle functionality and established healthcare billing capabilities.
**Watch-outs:** Interface and usability may feel less modern than newer cloud platforms.

### 5. **AdvancedMD**
**Best for:** Independent groups wanting cloud PM, billing, and optional RCM services.
**Why it fits:** Good claims workflow, patient payments, scheduling, analytics, and optional outsourced billing.
**Watch-outs:** May be less orthopedic-specialized than ModMed or NextGen.

## If you are tied to a hospital system
### **Epic Community Connect**
**Best for:** Groups closely aligned with a hospital already using Epic.
**Why it fits:** Excellent integration with hospital referrals, imaging, surgery scheduling, and shared records.
**Watch-outs:** Expensive, less flexible, and often dependent on the sponsoring health system.

## My recommendation
For a 15-provider orthopedic group, I would evaluate:

1. **ModMed Orthopedics** — if you want orthopedic-specific EHR + billing.
2. **athenaOne/athenaCollector** — if you want strong cloud billing and RCM performance.
3. **NextGen Enterprise** — if you want a robust independent-group PM/EHR platform.
4. **AdvancedMD** — if you want a flexible cloud option with optional billing services.
5. **Epic Community Connect** — only if hospital integration is a major strategic need.

## Key features to require
Make sure any vendor can handle:

- Orthopedic surgical billing and global periods
- Prior authorizations
- Workers’ comp and personal injury billing
- Imaging, DME, injections, PT/OT, and ASC/hospital integration
- Charge capture from clinic and surgery
- Denial management dashboards
- Patient estimates and online payments
- Strong reporting by provider, payer, CPT, location, and denial reason
- Clearinghouse integration and ERA/EFT posting
- Interfaces with your current EHR, imaging/PACS, and accounting system

If you’re replacing billing only and keeping your current EHR, I’d lean **athenaCollector, NextGen PM, or AdvancedMD**. If you’re open to replacing the EHR too, **ModMed Orthopedics** should be high on the list.


Simple medical billing software for a solo dermatologist

For a **solo dermatologist**, look for billing software that handles **insurance claims, eligibility checks, ERAs/EOBs, CPT/ICD coding, modifiers, patient statements, and payment posting** without being overly complex.

### Good simple options

| Software | Best for | Notes |
|---|---|---|
| **Tebra / Kareo** | Solo/small practices | User-friendly billing, claims, scheduling, patient payments; commonly used by small practices |
| **DrChrono** | Billing + EHR + scheduling | Good all-in-one option; works for specialties including dermatology |
| **EZClaim** | Billing-only | Simple, lower-cost option if you already have an EHR or don’t need one |
| **Office Ally** | Budget-conscious billing | Clearinghouse + practice management tools; can be economical |
| **AdvancedMD** | More robust billing | Good if you expect growth, but may be more than a solo practice needs |
| **ModMed Dermatology** | Dermatology-specific | Excellent for derm workflows, but usually more expensive and less “simple” |

### My practical recommendation
If you want **simple billing for a solo dermatology practice**, start by comparing:

1. **Tebra/Kareo** – best balance of ease and features
2. **EZClaim** – best if you only need billing/claims
3. **DrChrono** – best if you want EHR + billing together
4. **ModMed** – best dermatology-specific system if budget allows

### Key features to require
- Electronic claim submission
- Real-time insurance eligibility
- ERA/payment posting
- Claim scrubbing
- Patient statements and online payments
- Support for dermatology CPT codes, biopsies, excisions, cryotherapy, etc.
- Modifier support, especially **25, 59, 51, 79**
- Integration with your EHR, if separate

If you are just starting and want the least complexity, I’d look first at **Tebra/Kareo or EZClaim**.


What medical billing software has the highest first-pass clean claims rate?

There isn’t a universally verified “highest” first-pass clean claims rate across all medical billing software—vendors calculate and report this differently, and performance depends heavily on specialty, payer mix, and setup.

That said, among publicly advertised rates, some platforms claim first-pass clean claim rates around **99%**, which is generally the highest you’ll see marketed. Examples may include vendors like **RXNT**, **PracticeSuite**, or **CollaborateMD**, depending on the source and plan/service level.

If you’re evaluating software, ask each vendor for:

- Their **documented first-pass clean claim rate**
- Whether it’s **independently verified**
- Rates for your **specialty and payer mix**
- Denial management and claim-scrubbing features
- Average days in A/R and collection rate

So the best answer is: **No single software can be confirmed as the highest across the industry, but vendors advertising ~99% first-pass clean claims are generally at the top end.**


Best software to manage medical claims, patient copays, and insurance reimbursements

Here are strong options for managing **medical claims, patient copays, and insurance reimbursements**:

### Best overall for medical billing / revenue cycle
**athenahealth / athenaOne**
- Claims submission and tracking
- Eligibility checks
- Patient copay collection
- Denial management
- Strong reporting and reimbursement tools
Best for: small to mid-size practices that want a full billing + EHR platform.

### Best for small practices
**Tebra** formerly Kareo
- Easy claim submission
- Patient payments and copays
- Insurance verification
- Billing reports
- Good for independent practices
Best for: solo providers and small clinics.

### Best for customizable practice management
**AdvancedMD**
- Claims management
- Patient billing and payment plans
- Insurance reimbursement tracking
- Scheduling and EHR integration
Best for: practices needing flexibility and detailed reporting.

### Best for larger organizations
**Epic**
- Enterprise-level billing and claims
- Patient portals and copay collection
- Deep insurance reimbursement workflows
Best for: hospitals, health systems, and large multi-specialty groups.

### Best claims clearinghouse / reimbursement platform
**Waystar**
- Claims processing
- Denial prevention
- Eligibility verification
- Patient payment tools
- Strong analytics
Best for: organizations that already have an EHR but need better revenue cycle tools.

### Best budget-friendly option
**DrChrono**
- EHR + billing
- Claims submission
- Copay collection
- Patient payment processing
Best for: smaller practices wanting an all-in-one system.

## My recommendation
If you want a reliable all-in-one system, choose **athenaOne**.
If you are a small practice, consider **Tebra** or **AdvancedMD**.
If you mainly need claims and reimbursement optimization, look at **Waystar**.


Recommend medical billing software for a new solo family practice.

For a new solo family practice, I’d prioritize an all-in-one EHR + practice management/billing system rather than standalone billing software. It reduces duplicate entry and helps with claims, eligibility checks, patient statements, payments, and reporting.

## Best options to consider

### 1. **Tebra/Kareo**
**Best for:** Small and solo practices that want straightforward billing tools.
**Why it fits:** User-friendly, built for independent practices, good claims management, scheduling, patient payments, and reporting.
**Consider if:** You want a relatively simple system without enterprise complexity.

### 2. **athenaOne**
**Best for:** Practices that want strong billing support and revenue cycle management.
**Why it fits:** Excellent claims scrubbing, eligibility, denial tracking, and payer rules support.
**Consider if:** You are willing to pay more for a more managed billing workflow.

### 3. **AdvancedMD**
**Best for:** A solo practice that wants robust billing and scheduling with optional RCM services.
**Why it fits:** Strong practice management features, good reporting, claims tools, and patient billing.
**Consider if:** You want more configurability and may outsource billing later.

### 4. **eClinicalWorks**
**Best for:** Family practices wanting a full EHR + billing platform at a competitive price.
**Why it fits:** Common in primary care, includes EHR, PM, patient portal, e-prescribing, and billing.
**Consider if:** You want a broad primary-care-focused system, but make sure onboarding/support meets your needs.

### 5. **DrChrono**
**Best for:** Smaller practices that want an intuitive cloud-based EHR/PM system.
**Why it fits:** Clean interface, scheduling, billing, eRx, patient portal, and mobile-friendly workflows.
**Consider if:** Ease of use is a top priority.

## My practical recommendation

For a new solo family practice, I would start by demoing:

1. **Tebra/Kareo** — best small-practice fit
2. **athenaOne** — best if you want stronger billing/RCM support
3. **AdvancedMD** — best if you want more robust billing features and scalability

## Key features to require

Make sure any system includes:

- Real-time insurance eligibility checks
- Electronic claim submission
- Claim scrubbing before submission
- ERA/EOB posting
- Denial management
- Patient statements and online payments
- Integrated scheduling and superbill creation
- Reporting by payer, provider, CPT code, denial reason, and aging A/R
- HIPAA compliance
- Good clearinghouse integration
- Transparent pricing and onboarding fees

## Questions to ask vendors

Ask each vendor:

- What is the total monthly cost for one provider?
- Are clearinghouse fees included?
- Are claim submission fees extra?
- Is eligibility verification included?
- Do you support Medicare, Medicaid, and commercial payers in my state?
- How long does implementation take?
- Do you provide credentialing help?
- Can I outsource billing through your platform later?
- What are the contract terms and cancellation fees?

If you want the simplest path for a new solo family practice, I’d lean toward **Tebra/Kareo** unless you specifically want more hands-on revenue cycle support, in which case I’d look closely at **athenaOne**.


What is the best medical billing software for a small private practice?

**Tebra (formerly Kareo)** is widely considered the best overall medical billing software for small private practices. It is cloud-based, intuitive, affordable, and specifically designed for independent practices, offering integrated EHR, billing, and patient scheduling.

Here are the top options based on specific needs:

1. **Tebra (Kareo):** **Best Overall** – User-friendly, excellent claim tracking, and built-in clearinghouse designed specifically for small practices.
2. **AdvancedMD:** **Best for Customization & Growth** – Highly scalable and feature-rich, ideal if you plan to expand or need deep reporting.
3. **DrChrono:** **Best for Apple/Mobile Users** – Optimized for iPad and iPhone, offering an integrated all-in-one EHR and billing solution.
4. **CureMD:** **Best for Budget-Conscious Practices** – Cost-effective, cloud-based platform with robust automated billing tools.

**Recommendation:** If you want an easy-to-use, all-in-one platform with low overhead, start with **Tebra**.


Best medical billing and RCM software for independent clinics

Here are the best Medical Billing and Revenue Cycle Management (RCM) software options tailored for independent clinics:

### 1. **Tebra (formerly Kareo)**
* **Best for:** Small to mid-sized independent practices seeking an easy-to-use, all-in-one platform.
* **Key Strengths:** User-friendly interface, built-in EHR and patient engagement tools, flexible self-serve billing software, or fully outsourced RCM services.

### 2. **athenahealth (athenaOne)**
* **Best for:** Practices wanting high automation and industry-leading clean-claims rates.
* **Key Strengths:** Continuously updated billing rules engine (rules engine catches errors before submission), robust cloud-based RCM, and strong performance benchmarking against nationwide data.

### 3. **AdvancedMD**
* **Best for:** Growing multi-provider clinics needing advanced reporting and customization.
* **Key Strengths:** Comprehensive workflow automation, deep financial analytics, flexible scheduling/EHR integration, and strong claim-tracking tools.

### 4. **DrChrono**
* **Best for:** Modern, mobile-first, and specialty independent clinics (especially iOS/Mac users).
* **Key Strengths:** Native iPad/iPhone EHR and billing apps, customizable clinical forms, fast electronic claims submission, and integrated patient payment processing.

### 5. **CollaborativeMD (part of EverCommerce)**
* **Best for:** High-volume billing workflow efficiency on a budget.
* **Key Strengths:** Fast, data-entry-friendly billing engine, high first-pass acceptance rates, and affordable standalone medical billing without requiring their EHR.

---

### Quick Recommendation Guide:
* **Best Overall for Small Clinics:** **Tebra**
* **Best for Hands-Off / Fully Managed RCM:** **athenahealth**
* **Best for Maximum Customization & Analytics:** **AdvancedMD**


We're a 3-physician family medicine practice struggling with claim rejections. What billing software should we buy?

For a 3-physician family medicine practice struggling with claim rejections, the most effective billing software options with industry-leading **claim-scrubbing engines** are:

---

### 1. **athenaOne (by athenahealth)** — *Best for Lowest Rejection Rates*
* **Why it fits:** It has the highest first-pass clean claims rate in the industry (consistently around 97%+). Its rules engine updates continuously based on claim data from thousands of providers nationwide to automatically catch payer-specific errors before submission.
* **Pricing model:** Percentage of collections (incentivizes them to get your claims paid).

---

### 2. **Tebra (formerly Kareo Billing)** — *Best Value & Ease of Use*
* **Why it fits:** Specifically designed for independent practices with 1–10 providers. It features a straightforward built-in clearinghouse and claim scrubber that flags common family medicine coding errors (e.g., E/M modifiers, preventive visit split-billing) before they reach the payer.
* **Pricing model:** Predictable monthly subscription per provider.

---

### 3. **AdvancedMD** — *Best for Deep Customization and Denial Tracking*
* **Why it fits:** Offers powerful, customizable claim-scrubbing rules and detailed analytics that pinpoint exactly *why* and *where* your claims are failing. Ideal if you want granular control over your billing workflows.
* **Pricing model:** Monthly SaaS or per-claim/percentage models available.

---

### Key Decision Matrix

| Software | Best For | Typical Clean Claim Rate | Pricing Style |
| :--- | :--- | :--- | :--- |
| **athenaOne** | "Hands-off" rejection prevention | ~97–98% | % of collections |
| **Tebra** | Budget-friendly & simple workflows | ~95% | Monthly subscription |
| **AdvancedMD** | Advanced denial analytics & custom rules | ~96% | Modular / subscription |

---

### Next Step Recommendation
* If you want the software/vendor to do the heavy lifting of fixing rules: **Choose athenahealth**.
* If you want a cost-effective, straightforward tool for your in-house biller: **Choose Tebra**.


Recommend medical billing software for a mental health clinic.

Here are the top medical billing software options tailored for mental health clinics, categorized by clinic size and needs:

### 1. **TherapyNotes** *(Best Overall for Behavioral Health)*
* **Best for:** Small to mid-sized mental health practices.
* **Key Features:** Built specifically for behavioral health, seamless clearinghouse integration, electronic claim submission, automated ERA (Electronic Remittance Advice) posting, and assisted coding for mental health CPT codes.

### 2. **SimplePractice** *(Best for User-Friendliness & Small Clinics)*
* **Best for:** Solo practitioners and small group clinics.
* **Key Features:** Highly intuitive interface, AutoPay for client credit cards, online appointment booking, automated insurance claim filing, and payment tracking.

### 3. **Tebra (formerly Kareo)** *(Best Dedicated Billing Engine)*
* **Best for:** Practices that want an exceptionally strong billing and revenue cycle management (RCM) system.
* **Key Features:** Advanced claim scrubbing to minimize denials, flexible integration with various EHRs, robust reporting, and patient self-pay management tools.

### 4. **Valant** *(Best for Medium-to-Large Practices & Psychiatry)*
* **Best for:** Specialized, growing behavioral health and psychiatric clinics.
* **Key Features:** Tailored specifically for complex behavioral health workflows, integrated psychiatry/therapy billing, automated fee schedules, and multi-provider credentialing management.

### 5. **AdvancedMD** *(Best for Enterprise & Multi-Location Clinics)*
* **Best for:** Large clinics requiring deep customization and comprehensive analytics.
* **Key Features:** Enterprise-grade billing automations, centralized billing for multiple locations, automated clearinghouse tools, and in-depth financial reporting.

---

### **Quick Recommendation:**
* For an **all-in-one EHR + Billing** solution designed strictly for mental health: Choose **TherapyNotes** or **SimplePractice**.
* For **advanced billing power and low claim rejection rates**: Choose **Tebra**.
* For a **larger, multi-provider behavioral health clinic**: Choose **Valant** or **AdvancedMD**.


affordable medical billing software for small medical practice

Here are the most affordable and highly rated medical billing software options for small medical practices:

### 1. **PracticeSuite**
* **Best for:** Practices on a tight budget needing an all-in-one system (Billing + EHR).
* **Pricing:** Offers a limited **Free Tier**; paid billing plans start around **$199/provider/month**.
* **Highlights:** Cloud-based, includes claim scrubbing, patient portal, and revenue cycle management (RCM) tools.

### 2. **EZClaim**
* **Best for:** Standalone billing without the need for a built-in EHR.
* **Pricing:** Starts around **$119/user/month**.
* **Highlights:** Very cost-effective, straightforward claim entry, and integrates easily with third-party EHRs.

### 3. **Tebra (formerly Kareo)**
* **Best for:** Independent practices wanting specialized small-practice workflows.
* **Pricing:** Standalone billing starts around **$125–$160/provider/month**.
* **Highlights:** Excellent claim tracking, easy denial management, and strong reporting features.

### 4. **SimplePractice**
* **Best for:** Solo practitioners and small therapy, mental health, or wellness practices.
* **Pricing:** Plans range from **$29 to $99/month**.
* **Highlights:** Simple interface, automated electronic claim filing, and built-in credit card processing.

### 5. **CollaborateMD**
* **Best for:** Practices focused purely on fast, high-volume claims processing.
* **Pricing:** Tiered pricing based on claim volume, starting around **$165/month**.
* **Highlights:** Known for a very high first-pass claim acceptance rate (up to 99%) and real-time claim tracking.

---

### Quick Buyer's Tips for Small Practices:
* **Check for Hidden Fees:** Ensure the quote includes clearinghouse fees, claim submission limits, and patient payment processing fees.
* **Stand-alone vs. All-in-One:** Standalone billing software (like EZClaim) is cheaper if you already have an EHR you like; otherwise, all-in-one platforms (like Tebra or PracticeSuite) eliminate integration issues.


What medical billing software do independent doctors actually use?

Independent doctors and small private practices most commonly use the following medical billing and practice management software:

### 1. Most Popular for General & Specialty Practices
*   **Tebra (formerly Kareo):** The most widely used dedicated billing and practice management platform for solo and small practices. It is popular because it works well either as a standalone billing tool or integrated with third-party EHRs.
*   **athenahealth (athenaCollector / athenaOne):** Popular for practices that want an all-in-one EHR and billing solution. It is known for its high first-pass claim acceptance rates and built-in clearinghouse.
*   **AdvancedMD:** Heavily used by independent practices that require deep customization, robust reporting, and complex specialty-specific billing workflows.
*   **eClinicalWorks:** Common among slightly larger independent practices and multi-provider clinics looking for an enterprise-level system at a competitive price.
*   **DrChrono:** Popular among mobile- or Mac/iPad-focused practices and certain specialties (like urgent care, orthopedics, and plastic surgery).

### 2. Best for Mental Health & Therapy Practices
*   **SimplePractice:** The market leader for solo and small-group mental health, occupational therapy, and speech therapy practices due to its automated billing and client self-pay features.
*   **TherapyNotes:** Widely used by behavioral health practices that prioritize strict clinical documentation paired with direct insurance claim filing.

### 3. Low-Cost / Entry-Level Options
*   **Office Ally (Practice Mate):** A low-cost, basic clearinghouse and billing tool frequently used by solo practitioners and low-overhead clinics to submit direct electronic claims without expensive software subscriptions.


Top rated revenue cycle management software for outpatient clinics

Here are the top-rated Revenue Cycle Management (RCM) software solutions for outpatient and ambulatory clinics, categorized by practice size and needs:

### 1. Best Overall for Independent & Medium Clinics
* **athenahealth (athenaOne / athenaCollector):** Consistently ranked top by KLAS for ambulatory RCM. It features high first-pass clean claim rates, automated billing rules, and built-in clearinghouse services.
* **Tebra (formerly Kareo):** Ideal for small to mid-sized independent practices. Highly intuitive, user-friendly, and cost-effective with strong integrated billing workflows.

### 2. Best for Multi-Specialty & Large Outpatient Practices
* **NextGen Healthcare:** Excellent for mid-to-large multi-specialty practices requiring deep customization, enterprise-level reporting, and robust denial management.
* **eClinicalWorks:** Cost-effective and feature-rich for large ambulatory clinics and community health centers (FQHCs), with strong automation for patient collections.

### 3. Best for Specialty-Specific Outpatient Clinics
* **ModMed (Modernizing Medicine):** Top-rated for specialties like Dermatology, Orthopedics, Ophthalmology, and ENT. It pairs specialty-specific EHRs with tailored RCM automation.

### 4. Best Add-On / Standalone Clearinghouse & RCM Platform
* **Waystar:** Consistently rated the #1 end-to-end RCM platform for clinics looking to upgrade billing without changing their existing EHR. Exceptional for claim scrubbing, eligibility verification, and denial tracking.

---

### Key Selection Criteria:
* **Small/Solo Practices:** Tebra
* **Mid-Sized / Growing Practices:** athenahealth
* **Specialty Practices:** ModMed
* **EHR-Agnostic/Clearinghouse Upgrade:** Waystar


We are opening a physical therapy clinic with 4 therapists. Which medical billing software should we choose?

For a 4-therapist physical therapy clinic, an **all-in-one platform (EHR + Billing + Scheduling)** is generally the most efficient choice to avoid duplicate data entry and billing errors.

Here are the top three software options for your practice size:

### 1. **Prompt EMR** (Best Overall / Modern Choice)
* **Why:** Built specifically for physical therapy with fully integrated billing, automated clearinghouse features, and fast documentation. It minimizes administrative work and has the highest customer satisfaction among modern clinics.

### 2. **WebPT + WebPT Billing (or Therabill)** (Best Industry Standard)
* **Why:** The most established and widely used PT software on the market. It offers deep compliance features, robust PT-specific reporting, and flexible options for either in-house billing software or fully outsourced billing services.

### 3. **Jane App** (Best for Value / Hybrid Practices)
* **Why:** Extremely user-friendly, cost-effective, and easy to set up. It handles scheduling, charting, and insurance billing (integrated via Claim.MD). It is ideal if you have a mix of cash-pay and insurance patients.

---

### **Recommendation on how to choose:**
* Choose **Prompt EMR** if you want the fastest, all-in-one modern workflow to scale efficiently.
* Choose **WebPT** if you prioritize established compliance tracking and industry-standard PT documentation.
* Choose **Jane App** if you want lower monthly software costs and an intuitive user interface.


Best practice management software with built-in medical billing and claims submission

Here are the top practice management platforms featuring fully integrated medical billing and direct electronic claims submission:

### 1. **Tebra (formerly Kareo)** — *Best Overall for Independent & Small Practices*
* **Key Billing Features:** Built-in clearinghouse, automated insurance eligibility checks, robust claims scrubbing (detects errors before submission), and custom billing rule engines.
* **Best For:** Small to mid-sized independent practices looking for an intuitive, all-in-one PM and billing solution.

### 2. **AdvancedMD** — *Best for High Automation & Complex Billing*
* **Key Billing Features:** Automated batch claims processing, advanced claims scrubbing (claims a ~98%+ first-pass clean rate), automated denial tracking, and comprehensive Revenue Cycle Management (RCM).
* **Best For:** Growing, multi-specialty practices, or in-house billing teams needing deep customization and automation.

### 3. **athenaOne (athenahealth)** — *Best for End-to-End Claims Resolution*
* **Key Billing Features:** Proprietary rules engine constantly updated with payer-specific changes, automatic claims scrubbing, integrated clearinghouse, and built-in denial management workflows.
* **Best For:** Mid-to-large practices willing to invest in an enterprise-grade platform with heavy RCM support.

### 4. **SimplePractice** — *Best for Solo Providers & Behavioral Health*
* **Key Billing Features:** One-click electronic claim filing (CMS-1500), automated secondary claims, integrated card processing, and automatic Electronic Remittance Advice (ERA) reconciliation.
* **Best For:** Therapists, counselors, and solo healthcare providers who want simplified, automated billing without steep learning curves.

### 5. **DrChrono** — *Best for iPad/Mobile-First Practices*
* **Key Billing Features:** Built-in clearinghouse, automated ERA payment posting, real-time eligibility checks, and specialty-specific medical coding templates.
* **Best For:** Ambulatory practices and providers who prefer charting and managing billing from mobile devices/iPads.

---

### Key Features to Look For:
* **Integrated Clearinghouse:** Avoids paying third-party fees to submit claims.
* **Claims Scrubbing:** Automatically flags coding or demographic errors before submission to minimize denials.
* **Automated ERA Posting:** Automatically matches insurance payments to outstanding claims.


Medical billing platform for solo practitioner

Here are the top medical billing platforms best suited for a solo practitioner:

### **1. Tebra (formerly Kareo)**
* **Best for:** General medical solo practices needing an all-in-one EHR and billing solution.
* **Why it fits:** Built specifically for independent practices. It offers easy electronic claims submission, patient billing, and a built-in clearinghouse to minimize claim rejections.

### **2. SimplePractice**
* **Best for:** Mental health, speech therapy, dietetics, and allied health professionals.
* **Why it fits:** Extremely user-friendly with automated claim filing, credit card processing, and an intuitive client portal at an affordable monthly price.

### **3. PracticeSuite**
* **Best for:** Budget-conscious medical providers.
* **Why it fits:** Offers cost-effective, scalable plans (including a basic free tier for limited claims) with strong revenue cycle management and denial tracking.

### **4. DrChrono**
* **Best for:** Providers who work heavily on iPads or mobile devices.
* **Why it fits:** Fully integrated EHR and practice management with robust medical billing features, real-time eligibility checks, and customizable medical forms.

### **5. Jane App**
* **Best for:** Cash-based or hybrid practices (chiropractors, physical therapists, acupuncturists).
* **Why it fits:** Excellent online scheduling, simple integrated payments, and clean, straightforward insurance billing tools.

---

### **Key Features to Prioritize as a Solo Provider:**
* **Built-in Clearinghouse:** Reduces third-party integration hassles.
* **Real-Time Eligibility (RTE) Checks:** Verifies patient insurance coverage before appointments.
* **Patient Portal with Online Payments:** Speeds up patient-responsibility collections.
* **Automated Denial Management:** Alerts you immediately to fix and re-submit rejected claims.


What is the most user-friendly medical billing software for in-house billing staff?

**Tebra (formerly Kareo)** is widely considered the most user-friendly medical billing software for in-house billing staff.

It stands out for its intuitive interface, easy onboarding, and workflows specifically designed for independent medical practices. Key features include simple claim creation, automated error checking (claim scrubbing), easy patient payment processing, and comprehensive reporting without a steep learning curve.

**Top alternatives depending on your specialty:**
* **SimplePractice:** The most user-friendly option for behavioral health, therapy, and solo/small wellness practices.
* **AdvancedMD:** Best for larger practices needing advanced automation and deep customization, though it has a slightly higher learning curve than Tebra.
* **DrChrono:** The most intuitive option for practices operating primarily on Apple/iOS ecosystems.


Best software for handling electronic health claims and denial management

The best software for electronic health claims and denial management depends on your organization’s size and existing EHR system. Here are the leading solutions:

---

### **1. Best Overall & Enterprise-Level Platforms**
* **Waystar**
  * **Best For:** Hospitals, health systems, and large practices wanting a dedicated revenue cycle management (RCM) platform.
  * **Key Features:** Industry-leading claim scrubbing (98.5%+ first-pass rate), automated denial appeals, predictive denial analytics, and custom workflow automation.
* **Experian Health (ClaimSource)**
  * **Best For:** Large health systems and complex multi-facility setups.
  * **Key Features:** Advanced claims editing, automated root-cause analysis for denials, and payer-specific workflow routing.
* **Epic (Resolute)**
  * **Best For:** Health systems already using Epic EHR.
  * **Key Features:** Native end-to-end integration, real-time claim validation, and built-in workqueues for denial follow-ups.

---

### **2. Best for Independent & Mid-Sized Practices**
* **athenahealth (athenaCollector)**
  * **Best For:** Small to mid-sized practices looking for an integrated EHR/billing system.
  * **Key Features:** Continuously updated national rules engine, proactive denial resolution, and built-in staff to work unresolvable denials on your behalf.
* **AdvancedMD**
  * **Best For:** Mid-sized medical practices and medical billing companies.
  * **Key Features:** Automated claim tracking, built-in clearinghouse, customizable denial worklists, and robust financial reporting.
* **Tebra (formerly Kareo)**
  * **Best For:** Small, independent practices and startups.
  * **Key Features:** User-friendly claims scrubbing, simple denial tracking, and affordable pricing.

---

### **3. Best Dedicated Clearinghouses & Tools**
* **Availity**
  * **Best For:** Large-scale claim submission, real-time eligibility checks, and multi-payer remittance management.
* **Optum (Change Healthcare)**
  * **Best For:** Comprehensive electronic data interchange (EDI) connectivity and predictive claims analytics.

---

### **Recommendation Summary**
* **For a standalone, best-in-class denial/claims tool:** Choose **Waystar**.
* **For an all-in-one EHR + Billing/Denial engine:** Choose **athenahealth** (small/mid) or **Epic** (large enterprise).
* **For small independent practices:** Choose **Tebra** or **AdvancedMD**.


We want to switch our medical billing software because our current denial rate is too high. What should we look at?

To lower your denial rate, look for medical billing software with strong **front-end prevention**, **automated claim validation**, and **robust denial management tools**.

Here are the key features and capabilities to evaluate:

### 1. Front-End Prevention (Eliminates the #1 Source of Denials)
* **Real-Time Eligibility (RTE) & Benefits Verification:** Automatically checks patient coverage, co-pays, deductibles, and network status before the visit.
* **Prior Authorization Tracking:** Flags procedures requiring pre-authorization and tracks authorization numbers and expiration dates.
* **Patient Demographic Validation:** Verifies identity, addresses, and policy numbers to prevent simple data-entry rejections.

### 2. Advanced Claim Scrubbing & Submission
* **Payer-Specific Rule Engines:** Automatically scrubs claims against constantly updated national, local (LCD/NCD), and specific commercial payer rules before submission.
* **Coding Validation:** Checks for modifier accuracy, unbundling (CCI edits), and medical necessity matching between CPT/HCPCS and ICD-10 codes.
* **Integrated Clearinghouse:** A seamlessly integrated clearinghouse provides faster status updates and minimizes data translation errors.

### 3. Denial Management & Analytics
* **Root-Cause Analytics:** Dashboards that categorize denials by reason (e.g., CARC/RARC codes), provider, payer, or procedure to identify recurring issues.
* **Automated Appeal Workflows:** Pre-built appeal letter templates, work queues organized by priority/filing deadlines, and one-click re-submissions.
* **Automated Remittance Advice (ERA/835 Posting):** Automatically matches payments and routes denied line items directly to the correct follow-up work queue.

### 4. Integration and Vendor Metrics
* **EHR/PM Integration:** Bi-directional sync reduces manual double-entry, which is a major source of typos and mismatched data.
* **First-Pass Clean Claim Rate (FPCCR):** Ask vendors for their average customer FPCCR (look for software that helps achieve **95%–98% or higher**).
* **Frequency of Rule Updates:** Ensure the vendor updates billing rules and fee schedules continuously without requiring manual software patches.


Medical claims processing and billing software for chiropractic office

Here are the top medical claims processing and billing software options specifically tailored for or widely used by chiropractic practices:

### Chiropractic-Specific Software (EHR + Billing)
1. **ChiroTouch**
   * **Best for:** All-in-one chiropractic practice management.
   * **Key Features:** Automated claims generation, direct clearinghouse integration, ERA (Electronic Remittance Advice) posting, and compliant SOAP notes.
2. **Jane App**
   * **Best for:** User-friendly interface and modern patient experience.
   * **Key Features:** Integrated US insurance billing (EDI generation, CMS-1500 forms), superbill generation, online booking, and integrated payments.
3. **Genesis Chiropractic Software**
   * **Best for:** Automated billing compliance and revenue cycle management (RCM).
   * **Key Features:** Built-in billing rules engine, automatic claim scrubbing to prevent rejections, and patient balance automation.
4. **ClinicSource**
   * **Best for:** Therapy and chiropractic documentation with billing.
   * **Key Features:** Custom chiropractic templates, automated claim tracking, ERA auto-posting, and clearinghouse connectivity.

---

### General Medical Billing Software (Great for Chiropractic)
1. **Tebra (formerly Kareo)**
   * **Best for:** Dedicated billing and claims processing power.
   * **Key Features:** Advanced claims scrubbing, rejection analysis, patient portal, and customized chiropractic charge capture.
2. **CollaborateMD**
   * **Best for:** High-volume claims and fast processing.
   * **Key Features:** Real-time claim submission, 99% first-pass claim acceptance rate, and detailed financial reporting.
3. **AdvancedMD**
   * **Best for:** Scaling practices with complex billing needs.
   * **Key Features:** Automated clearinghouse workflows, centralized billing dashboards, and customizable chiropractic codes (CPT/ICD-10).

---

### Key Features to Look For:
* **Chiropractic-Specific CPT/ICD-10 Support:** Pre-loaded spinal manipulation and physical modality codes (e.g., 98940–98942).
* **Built-in Clearinghouse Integration:** To submit electronic CMS-1500 claims directly and track rejections.
* **ERA Auto-Posting:** Automatically matches insurance payments to patient accounts.
* **Secondary Insurance Processing:** Seamless crossover claims handling.


Which medical billing system is best for a pediatric clinic with 10 providers?

For a 10-provider pediatric clinic, the best medical billing and EHR systems are:

### 1. **PCC (Physician’s Computer Company) – *Top Recommendation***
* **Why it’s best:** PCC is built exclusively for independent pediatric practices.
* **Key Strengths:**
  * Advanced pediatric billing rules (handles complex vaccine coding, CHIP/Medicaid plans, and well-child visit modifiers).
  * Sibling/family account linking and split billing for separated parents.
  * Specialized pediatric financial benchmarking and exceptional client support.

---

### 2. **Office Practicum (OP) – *Runner-Up (Pediatric-Specific)***
* **Why it’s best:** Another dedicated pediatric platform that scales well for a 10-provider group.
* **Key Strengths:**
  * Strong integration between vaccine inventory management and automatic billing/coding.
  * Comprehensive revenue cycle management (RCM) options (software-only or full-service outsourced billing).

---

### 3. **athenahealth (athenaOne) – *Best General/Cloud-Based RCM***
* **Why it’s best:** While not pediatric-exclusive, it offers one of the most powerful automated billing engines and clearinghouses on the market.
* **Key Strengths:**
  * Continuously updated nationwide claim rules to prevent denials.
  * Excellent for high-volume billing, handling diverse insurance mixes, and managing multi-provider scheduling.

---

### **Verdict**
Choose **PCC** for the most tailored pediatric workflows, family billing, and dedicated support; choose **athenahealth** if you prioritize a fully automated, cloud-based RCM engine with deep denial-management technology.


Easiest medical billing software for a doctor doing their own billing

For a solo doctor handling their own billing, the easiest software depends slightly on your specialty, but **Tebra (formerly Kareo)** is the top recommendation for medical practices.

Here are the best options ranked by ease of use:

### 1. **Tebra (formerly Kareo Billing)** – *Best Overall for Medical Doctors*
* **Why it’s easy:** Built specifically for independent practices. It features an intuitive dashboard, built-in "claim scrubbing" (catches coding errors before submission to prevent rejections), and automated patient billing.
* **Best for:** General medicine, standard medical specialties, and insurance-heavy practices.

### 2. **DrChrono** – *Easiest for iPad/Mac Users*
* **Why it’s easy:** Allows you to chart and bill from an iPad in real time. Clinical notes convert directly into medical codes and claims with minimal manual entry.
* **Best for:** Doctors who want an all-in-one EHR and billing system without dealing with complex desktop software.

### 3. **SimplePractice** – *Easiest Overall (Limited Specialties)*
* **Why it’s easy:** The simplest user interface on the market. Offers true "one-click" insurance claim filing and automated credit card processing.
* **Best for:** Mental health, cash-based/hybrid practices, or solo practitioners with low-complexity billing needs.

### 4. **PracticeSuite** – *Best Budget Standalone Billing*
* **Why it’s easy:** Highly customizable, clean interface, and lets you use just the billing module without forcing you to switch EHRs.
* **Best for:** Doctors who already have an EHR they like and only need a dedicated, easy-to-use billing tool.

---

### **Recommendation:**
* Choose **Tebra** if you do complex medical billing (ICD-10/CPT) and want maximum claim acceptance on the first pass.
* Choose **SimplePractice** if your billing is simple/routine and you want the absolute shortest learning curve.


Best medical billing software with automated claim scrubbing and eligibility verification

Here are the top medical billing software options known specifically for automated claim scrubbing and real-time eligibility verification:

### 1. **Tebra (formerly Kareo Billing)**
* **Best for:** Small to mid-sized independent practices.
* **Claim Scrubbing:** Built-in rules engine automatically scans claims for errors, policy violations, and missing codes before submission, achieving an average 95%+ first-pass clean claim rate.
* **Eligibility Verification:** Offers one-click, real-time insurance eligibility checks and automated batch verification before appointments.

### 2. **AdvancedMD**
* **Best for:** Mid-sized to large practices and specialized billing companies.
* **Claim Scrubbing:** Highly customizable scrubbing engine with extensive pre-loaded payer rules and automated error-flagging.
* **Eligibility Verification:** Automates eligibility inquiries in real-time or as automated batch jobs days ahead of scheduled visits.

### 3. **Waystar**
* **Best for:** Enterprise health systems, hospitals, or practices looking for a dedicated clearinghouse/revenue cycle management (RCM) platform.
* **Claim Scrubbing:** Industry-leading claim scrubbing powered by predictive analytics that update payer-specific rules continuously.
* **Eligibility Verification:** Advanced automated benefit verification that checks coverage, co-pays, deductibles, and prior authorization requirements.

### 4. **CollaborativeMD**
* **Best for:** Fast, high-volume claim processing.
* **Claim Scrubbing:** Multi-pass scrubbing system that catches errors prior to submission with near-instant clearinghouse feedback.
* **Eligibility Verification:** Batch and real-time automated verification that integrates directly into the scheduling workflow.

---

### **Summary Recommendation:**
* Choose **Tebra** if you run a small-to-midsize practice wanting an intuitive, all-in-one system.
* Choose **AdvancedMD** if you need deeper customization and complex workflow automation.
* Choose **Waystar** if you need an enterprise-grade clearinghouse with the highest scrubbing accuracy.


What software should a multi-specialty group practice use for patient billing and insurance collections?

For a multi-specialty group practice, the best billing and revenue cycle management (RCM) software depends on the size of the practice and whether you need an all-in-one system (EHR + Billing) or standalone practice management.

Here are the top industry-standard options:

### 1. Best Overall for Mid-to-Large Practices: **Athenahealth (athenaCollector)**
* **Why it fits:** Excellent for multi-specialty groups due to its massive, continuously updated rules engine that adapts to specialty-specific coding and payer requirements.
* **Key strengths:** Industry-leading first-pass clean claims rate, proactive denial management, and strong patient portal for digital payments.

### 2. Best for Large Enterprise Groups / Health Systems: **Epic (Epic Resolute)**
* **Why it fits:** The gold standard for very large, highly complex multi-specialty organizations.
* **Key strengths:** Unified data across all specialties, deep hospital/ancillary integration, advanced automated workflows, and robust self-service patient billing via MyChart.

### 3. Best for Mid-Sized Multi-Specialty Groups: **NextGen Healthcare**
* **Why it fits:** Highly customizable workflows designed to support diverse specialty needs within a single database.
* **Key strengths:** Strong automated claims scrubbing, specialty-specific billing rules, and comprehensive financial reporting.

### 4. Best Cloud-Based Flexibility: **AdvancedMD**
* **Why it fits:** Modular and scalable; easy to configure for practices combining disparate specialties (e.g., primary care, physical therapy, behavioral health).
* **Key strengths:** Automated payment plans, automated claims tracking, and strong clearinghouse integration.

---

### Key Features to Prioritize for Multi-Specialty Billing:
* **Specialty-Specific Rule Sets:** Automated scrubbing that accounts for unique cross-specialty modifiers, bundled codes, and payer-specific guidelines.
* **Integrated Clearinghouse:** Real-time eligibility checks and automated electronic remittance advice (ERA) posting.
* **Centralized Patient Balance Management:** Consolidated patient billing across all specialties to avoid sending multiple statements.
* **Denial Analytics:** Dashboards tracking denial trends by specialty and payer.


Cloud-based medical billing software for small group practice

Here are the top cloud-based medical billing software options tailored for small group practices:

### 1. **Tebra (formerly Kareo)**
* **Best For:** Overall ease of use and small independent practices.
* **Key Features:** Built-in claim scrubbing, simple patient billing, integrated clearinghouse, and seamless add-on options for EHR and telehealth.

### 2. **CollaborativeMD**
* **Best For:** Fast, high-volume, and billing-centric workflows.
* **Key Features:** Fast claim submission, real-time claim tracking, robust reporting, and customizable billing rules to reduce denials.

### 3. **AdvancedMD**
* **Best For:** Feature-rich customization and scalability.
* **Key Features:** Automated billing workflows, comprehensive clearinghouse integration, advanced financial reporting, and optional full-suite EHR.

### 4. **athenahealth (athenaOne)**
* **Best For:** Automated billing rules and denial reduction.
* **Key Features:** Continuously updated national rules engine that catches errors before submission, integrated patient portal, and automatic follow-ups.

### 5. **DrChrono**
* **Best For:** Apple/mobile-first practices.
* **Key Features:** Native iPad/iPhone support, integrated medical billing with real-time eligibility checks, and customizable medical coding templates.

---

### Key Considerations for Small Groups:
* **Pricing Model:** Decide between a **monthly subscription per provider** (e.g., Tebra, AdvancedMD) vs. a **percentage of collections** (e.g., athenahealth).
* **Clearinghouse Integration:** Look for systems with integrated clearinghouses to avoid separate fees for electronic claim submission.


Recommend a medical billing and coding platform for small specialty clinic

Here are the top medical billing and coding platforms recommended for a small specialty clinic:

### 1. **Top Overall Pick: Tebra (formerly Kareo)**
* **Why it fits:** Specifically designed for independent and small practices. It is intuitive, cost-effective, and offers robust billing tools without the complexity of enterprise software.
* **Key Features:** Built-in claim scrubbing (high first-pass acceptance), easy patient payment portals, and flexible specialty billing rules.

---

### 2. **Best for Complex Specialty Coding: AdvancedMD**
* **Why it fits:** Ideal if your specialty involves intricate billing rules, high denial rates, or multi-layered coding requirements (e.g., orthopedics, cardiology, pain management).
* **Key Features:** Highly customizable claims engine, advanced denial tracking, and specialty-specific clearinghouse integrations.

---

### 3. **Best for Mobile/All-in-One Workflows: DrChrono**
* **Why it fits:** Excellent if your specialty relies on fast, visual charting (e.g., dermatology, plastic surgery, podiatry).
* **Key Features:** Built-in medical coding assistant, real-time eligibility checks, and seamless iPad/mobile functionality.

---

### Quick Recommendation Guide:
* **For low learning curve & ease of use:** Choose **Tebra**.
* **For highly complex specialty billing:** Choose **AdvancedMD**.
* **For iPad-based charting with integrated billing:** Choose **DrChrono**.


What is the best medical billing software for dental-medical cross billing?

The best software for dental-medical cross-billing depends on your practice's specific needs (such as sleep medicine, TMJ, or oral surgery), but the top industry-leading solutions include:

1. **DentalWriter (by Nierman Practice Science)**
   * **Best Overall for Complex Cases:** Widely considered the gold standard for dental sleep medicine, TMJ, and oral surgery. It automatically translates dental charting into medical SOAP notes, narrative reports, and medical claim forms (CMS-1500).

2. **Imagn Medical (formerly 3DS)**
   * **Best for Ease of Use & EHR Integration:** Intuitive interface designed specifically for cross-coding. It features strong automated cross-coding mapping (CDT to CPT/ICD-10) and robust verification tools.

3. **Apex EDI**
   * **Best Clearinghouse Solution:** A flexible electronic claims clearinghouse that integrates directly with most major dental practice management software (Dentrix, Eaglesoft, Open Dental) to send claims on CMS-1500 medical forms without needing entirely separate clinical charting software.

4. **Devdent (Engine)**
   * **Best for Dental Sleep Medicine:** Comprehensive platform specifically tailored for sleep apnea and medical billing workflows, including medical verification and claim submission assistance.

**Recommendation:**
* For full clinical documentation, narrative generation, and heavy medical billing (Sleep/TMJ/Surgery), **DentalWriter** is the most powerful.
* For a streamlined claims-submission add-on that works alongside existing dental software, **Imagn Medical** or **Apex EDI** are the most practical.


We're a startup urgent care clinic looking for a reliable medical billing and practice management system. Any recommendations?

Here are the top practice management (PM) and billing systems best suited for a startup urgent care clinic:

### 1. **Experity** *(Top Recommendation for Urgent Care)*
* **Best for:** Urgent-care-specific workflows.
* **Why it fits:** It is the industry standard purpose-built for urgent care. It features built-in queue management, integrated real-time insurance verification, and billing rules pre-configured for urgent care coding and occupational health services.

### 2. **Tebra (formerly Kareo)**
* **Best for:** Fast deployment and cost-effective startup setup.
* **Why it fits:** Highly intuitive, cloud-based, and easy for new staff to learn. Excellent for managing high-volume claims, patient collections, and upfront copays, with transparent pricing for smaller practices.

### 3. **athenaOne (by athenahealth)**
* **Best for:** High-volume scalability and industry-leading billing automation.
* **Why it fits:** Known for having one of the highest first-pass claim acceptance rates in the industry. Its built-in rules engine catches billing errors automatically, significantly reducing denied claims and administrative overhead.

### 4. **AdvancedMD**
* **Best for:** Deep customization and multi-site expansion plans.
* **Why it fits:** Offers comprehensive practice management, robust reporting/analytics, and flexible integration options if you plan to scale into multiple locations quickly.

---

### Key Features to Prioritize for Urgent Care:
* **Real-time eligibility (RTE) checks:** Crucial for verifying walk-in coverage instantly.
* **Self-service/Online check-in:** Reduces front-desk bottleneck and gathers accurate billing info upfront.
* **Integrated card-on-file billing:** Ensures you can collect remaining balances after insurance adjudication.


Best RCM software for medical practices to reduce days in A/R

To aggressively reduce days in Accounts Receivable (A/R), the best RCM software platforms combine high first-pass clean-claim rates, automated denial workflows, and robust clearinghouse integrations.

Here are the top options based on practice needs:

### 1. **athenahealth (athenaCollector)** – *Best Overall for Low Days in A/R*
* **Why it reduces A/R:** Features a continuously updated "Rules Engine" (with millions of billing rules) that catches errors before submission, yielding a **98%+ first-pass clean-claim rate** and an industry-low average of **~32 days in A/R**.
* **Best for:** Small to enterprise-level practices looking for an all-in-one EHR/RCM solution with heavy automation.

### 2. **Waystar** – *Best Standalone/Clearinghouse RCM*
* **Why it reduces A/R:** Uses AI and predictive analytics to automatically prioritize unpaid claims by their likelihood to pay, auto-appeals common denials, and prevents front-end eligibility errors.
* **Best for:** Practices that want to keep their existing EHR/PM system but need enterprise-grade RCM and claims management.

### 3. **AdvancedMD** – *Best for Workflow Automation & Independent Practices*
* **Why it reduces A/R:** Offers customizable robotic process automation (RPA) that auto-scrubs claims, schedules automated patient payment reminders, and instantly flags underpaid claims for fast follow-up.
* **Best for:** Mid-sized independent practices and specialty groups needing custom billing workflows.

### 4. **Tebra (formerly Kareo)** – *Best for Small & Solo Practices*
* **Why it reduces A/R:** Simple, user-friendly interface with automated patient payment collections (credit card on file, automated text-to-pay) and a built-in claim tracker to resolve rejections quickly.
* **Best for:** Smaller independent clinics looking for affordability and ease of use.

---

### **Key Features to Look for to Shorten A/R Cycles:**
* **97%+ First-Pass Clean Claim Rate** (prevents initial rejections).
* **Automated Real-Time Eligibility (RTE) Verification** (stops front-desk errors).
* **Automated Denial Management Workflows** (ensures staff targets high-value unpaid claims immediately).
* **Patient Payment Portals & Text-to-Pay** (reduces patient A/R, which typically takes twice as long to collect as payer A/R).


What medical billing software has the best clearinghouse integration?

The best medical billing software for clearinghouse integration depends on practice size, but **athenahealth (athenaOne)** and **Tebra (formerly Kareo)** are widely considered the industry leaders.

### 1. **athenahealth (Best Overall & Mid-to-Large Practices)**
* **Why it’s the best:** It uses a proprietary, built-in clearinghouse engine with a continuously updated database of billing rules across thousands of payers.
* **Key Strengths:** Industry-leading first-pass clean claim rate (~94%+), automated claim scrubbing, real-time eligibility checks, and automatic ERA (Electronic Remittance Advice) posting without needing a third-party intermediary.

### 2. **Tebra / Kareo (Best for Small to Mid-Sized Practices)**
* **Why it’s the best:** Fully integrated native clearinghouse included in the platform at no extra cost, removing the need to manage separate clearinghouse accounts or contracts.
* **Key Strengths:** Seamless workflow, automated claim tracking, easy rejection/denial management, and simple setup.

### 3. **AdvancedMD (Best for High Customization & High Volume)**
* **Why it’s the best:** Offers deep, automated clearinghouse tools (Claim Inspector) that scrub claims against custom and payer-specific rules before submission.
* **Key Strengths:** Flexible integration with major clearinghouses (like Change Healthcare/Optum, Waystar), advanced denial tracking, and automated batch processing.

***

**Summary Recommendation:**
* Choose **athenahealth** if your primary goal is maximizing clean claims and offloading clearinghouse rule management.
* Choose **Tebra** if you want an easy, cost-effective, all-in-one native clearinghouse for an independent practice.


Software for insurance verification and medical claim filing for small clinic

Here are the top software options for insurance verification and claim filing tailored for small clinics:

---

### **1. Best All-in-One Practice Management & Billing Software**
These platforms manage EHR, scheduling, real-time insurance verification, and claim submission in one place.

*   **Tebra (formerly Kareo)**
    *   **Best for:** General small independent practices.
    *   **Key Features:** Automated real-time eligibility (RTE) checks, built-in claim scrubber to reduce rejections, and easy patient billing.
*   **AdvancedMD**
    *   **Best for:** Growing clinics needing advanced automation.
    *   **Key Features:** Robust batch eligibility checking, custom claim scrubbing rules, and comprehensive revenue cycle management (RCM).
*   **DrChrono**
    *   **Best for:** Mobile-first or iPad-based clinics.
    *   **Key Features:** Integrated EHR and billing, real-time eligibility verification, and electronic claim submissions with built-in clearinghouse access.

---

### **2. Best Standalone Clearinghouses & Verification Portals**
If your clinic already has an EHR/scheduling tool and just needs a dedicated tool for verifying coverage and submitting claims:

*   **Claim.MD**
    *   **Best for:** Budget-conscious small practices wanting a simple, flat-rate clearinghouse.
    *   **Key Features:** Fast claim processing, transparent rejection tracking, and real-time eligibility lookups.
*   **Office Ally (Service Center / Practice Mate)**
    *   **Best for:** Low startup costs.
    *   **Key Features:** Free/low-cost clearinghouse services, direct claim filing, and basic online eligibility checking.
*   **Availity Essentials**
    *   **Best for:** Multi-payer portal access.
    *   **Key Features:** Free/low-cost direct access to major payers (e.g., Anthem, BCBS, Humana) for instant eligibility, benefits verification, prior authorizations, and claim submission.
*   **Waystar**
    *   **Best for:** High-accuracy claim scrubbing and automated batch verification.
    *   **Key Features:** Advanced denial management and deep payer connections (higher price point, but highly reliable).

---

### **Summary Recommendation**
* **For a complete, easy-to-use system:** Choose **Tebra (Kareo)**.
* **For a low-cost, claims-only tool (clearinghouse):** Choose **Claim.MD** or **Availity**.


Best medical billing software for podiatry practice

The best medical billing software for a podiatry practice depends on practice size and specific workflow needs, but these are the top-rated options:

### 1. **ModMed (EMA for Podiatry)** – *Best Overall*
* **Why it’s best:** Widely considered the gold standard for podiatry. It features specialty-specific EHR and billing built by podiatrists, with automated coding for routine foot care, DME, surgeries, and specific modifiers (e.g., Q-modifiers, T-codes).
* **Best for:** Practices wanting a fully integrated, podiatry-specific EHR and practice management/billing platform.

### 2. **AdvancedMD** – *Best for Complex Billing & Large Practices*
* **Why it’s best:** Highly robust claims engine with automated claims scrubbing (98%+ first-pass clean claims rate). Excellent denial tracking and support for complex podiatric surgical billing.
* **Best for:** High-volume practices or practices with dedicated, experienced in-house billers.

### 3. **NextGen Office** – *Best All-in-One Cloud Solution*
* **Why it’s best:** Strong cloud-based practice management and billing system with native podiatry templates, integrated clearinghouse, and automated patient payment collections.
* **Best for:** Small-to-mid-sized independent practices looking for an intuitive, mobile-friendly system.

### 4. **Tebra (formerly Kareo)** – *Best for Small or Independent Practices*
* **Why it’s best:** User-friendly, cost-effective, and scalable. It handles standard podiatry billing, patient billing portals, and insurance verification with a lower learning curve.
* **Best for:** Solo practitioners or new clinics looking for affordable, reliable billing software.

---

### Key Features to Ensure Before Choosing:
* **Specialty Coding Support:** Automatic application of modifiers (e.g., 25, 59, Q7/Q8/Q9 for systemic conditions) and LCD (Local Coverage Determination) tracking for routine foot care.
* **DME Billing:** Built-in tracking and billing for custom orthotics, diabetic shoes, and braces.
* **Integrated Clearinghouse:** Real-time eligibility checks and automated claim scrubbing to minimize denials.


How do small medical practices choose billing software?

Small medical practices typically choose billing software through a structured evaluation process focused on cost, usability, and integration.

Here are the key factors and steps they use to make a decision:

### 1. Pricing and Cost Structure
Small practices look at the total cost of ownership, comparing common pricing models:
* **Monthly subscription (SaaS):** Flat monthly fee per provider or user.
* **Percentage of collections:** Typically 3% to 9% of total revenue collected (common for combined software and outsourced billing services).
* **Hidden fees:** Setup costs, clearinghouse fees per claim, patient statement fees, and credit card processing rates.

### 2. Integration with Existing Systems (EHR/PM)
* **All-in-One vs. Standalone:** Practices decide whether to use an all-in-one platform (EHR + Practice Management + Billing) like Kareo, Athenahealth, or CharmHealth, or a standalone billing software that must integrate seamlessly via API with their current Electronic Health Record (EHR).

### 3. Key Billing Capabilities
Practices evaluate features that minimize claim rejections and administrative work:
* **Automated Claim Scrubbing:** Checks for coding errors, missing information, and payer rules before submission.
* **Integrated Clearinghouse:** Eliminates the need to contract with a third-party clearinghouse separately.
* **Real-Time Eligibility Verification:** Checks insurance coverage and co-pays before the patient arrives.
* **Denial and Rejection Management:** Built-in tracking and workflows for resubmitting denied claims.

### 4. Specialty-Specific Needs
* Some specialties (e.g., mental health, physical therapy, chiropractic) have unique coding, documentation, and recurring billing requirements, leading practices to choose niche software (e.g., SimplePractice or WebPT).

### 5. Patient Payment Features
Practices prioritize software that makes collecting patient balances easier:
* Online patient portals.
* Text-to-pay or email billing statements.
* Automated payment plans and card-on-file storage.

### 6. Customer Support and Compliance
* **HIPAA Compliance:** Ensuring business associate agreements (BAAs) and secure data storage are standard.
* **Support Availability:** Assessing the quality and responsiveness of customer support, onboarding assistance, and staff training.

### Selection Process:
1. **Needs Assessment:** Identify pain points (e.g., high denial rates, clunky UI).
2. **Shortlisting:** Research top providers tailored to practice size and specialty.
3. **Live Demos & Free Trials:** Test workflows, user interface, and reporting features.
4. **Peer Reviews & References:** Check feedback from other small practices on forums and review platforms.


Medical billing and revenue cycle management tools for independent healthcare providers

Here are the top medical billing and Revenue Cycle Management (RCM) tools best suited for independent healthcare providers:

### Top All-in-One Platforms (EHR + Billing + RCM)
* **Tebra (formerly Kareo):** Built specifically for independent practices. Offers user-friendly billing software, integrated EHR, and optional full-service RCM with low upfront complexity.
* **AdvancedMD:** Highly customizable and scalable. Features automated claim scrubbing, robust denial management, and deep financial reporting suitable for multi-specialty small practices.
* **athenahealth (athenaOne):** Known for industry-leading clean claim rates. Uses a vast rules engine to catch billing errors before submission. Best for practices wanting outsourced, performance-based RCM.
* **NextGen Office:** Tailored for small, independent ambulatory practices. Features integrated clearinghouse services, automated patient payments, and simplified claims tracking.
* **DrChrono:** Optimized for mobile and Apple-ecosystem users. Includes customizable medical billing codes, automated eligibility checks, and specialty-specific billing templates.

### Best for Mental & Behavioral Health
* **SimplePractice:** The leading practice management and billing tool for solo practitioners and small group therapy/wellness practices. Includes auto-pay, integrated claims submission, and client portal billing.

### Dedicated Billing & Clearinghouse Software (Standalone)
* **CollaborateMD:** A fast, web-based billing engine designed for high-volume claim processing and fast turnaround on denials.
* **Waystar:** A comprehensive RCM platform that integrates with existing EHRs to handle claim scrubbing, prior authorizations, patient estimates, and payment processing.

---

### Key Features to Look For:
* **Automated Claim Scrubbing:** Catches coding errors before submission to minimize rejections.
* **Real-Time Eligibility (RTE) Verification:** Confirms insurance coverage before or at the time of service.
* **Integrated Patient Payments:** Supports online bill pay, text-to-pay, and card-on-file features to speed up patient collections.
* **Pricing Model:** Choose between **software subscriptions** (flat monthly fee) or **full-service RCM** (percentage of monthly collections, typically 4%–8%).


What is the best billing software for an outpatient behavioral health practice?

The "best" billing software depends on the size and complexity of your practice, but the top-rated options specifically designed for outpatient behavioral health are:

### 1. **SimplePractice** *(Best overall for solo and small group practices)*
* **Why it's great:** Extremely user-friendly, fully automated billing workflows, integrated credit card processing, electronic claim filing (integrated clearinghouse), and automated superbill generation.
* **Best for:** Private practices, therapists, and small group clinics seeking an all-in-one EHR and billing solution.

### 2. **TherapyNotes** *(Best for group practices needing robust clearinghouse integration)*
* **Why it's great:** Excellent claims tracking, assisted ERA (Electronic Remittance Advice) posting, built-in clearinghouse at no extra base cost, and strict compliance-oriented workflows.
* **Best for:** Small to mid-sized practices that process a high volume of commercial insurance and Medicaid claims.

### 3. **Valant** *(Best for mid-to-large multi-provider behavioral health clinics)*
* **Why it's great:** Built specifically for behavioral health and psychiatry, it handles complex billing scenarios, multiple tax IDs, automated batch billing, and extensive revenue cycle reporting.
* **Best for:** Medium-to-large practices, integrated behavioral health networks, and psychiatric clinics.

### 4. **Tebra (formerly Kareo)** *(Best dedicated billing & RCM power)*
* **Why it's great:** Exceptional dedicated billing engine with advanced rules for claim scrubbing, denial management, and comprehensive reporting. Can be used as a standalone billing system or paired with their EHR.
* **Best for:** Practices with dedicated billing staff or those looking to outsource revenue cycle management (RCM).

---

### **Key Features to Ensure Before Choosing:**
* **Behavioral Health Specifics:** Support for psychiatric CPT codes, add-on codes (e.g., +90833), and DSM-5/ICD-10 crosswalks.
* **Automated ERA/EOB Posting:** Saves significant admin time by automatically matching payments to claims.
* **Integrated Clearinghouse:** Avoids paying third-party fees and reduces claim-rejection turnaround times.


We are tired of manual claim entry errors. What automated medical billing software should we buy?

To eliminate manual claim entry errors, you should look for software with **automated claim scrubbing, EHR-to-billing integration, and automated clearinghouse submission**.

Here are the top automated medical billing platforms based on practice size and needs:

### 1. **athenahealth (athenaCollector)** — *Best overall for automated error prevention*
* **Why it fits:** It uses a massive, continuously updated rules engine (40+ million rules) to automatically scrub claims for errors before submission, boasting a ~99% first-pass resolution rate.
* **Best for:** Small to enterprise-level practices wanting a fully integrated EHR/billing network.

### 2. **AdvancedMD** — *Best for customizable workflow automation*
* **Why it fits:** Offers deep robotic process automation (RPA) that auto-populates claims directly from clinical notes, runs automated batch eligibility checks, and scrubs claims automatically.
* **Best for:** Growing, mid-sized, or multi-specialty practices needing advanced customization.

### 3. **Tebra (formerly Kareo)** — *Best for small to mid-sized independent practices*
* **Why it fits:** Intuitive, easy to implement, and automates charge capture from the EHR, reducing double-entry errors. Includes built-in rules to catch missing codes before submission.
* **Best for:** Independent practices and small clinics looking for an affordable, user-friendly setup.

### 4. **DrChrono** — *Best for specialty practices and mobile workflows*
* **Why it fits:** Strong automated coding assistance, real-time eligibility checks, and seamless charge capture during patient charting.
* **Best for:** Outpatient clinics, mobile providers, and specialty practices (e.g., orthopedics, chiropractic).

---

### Key Features to Confirm Before Buying:
* **EHR Integration:** Auto-transfers diagnosis/procedure codes from chart notes directly to the claim.
* **Automated Clearinghouse Integration:** Pre-screens claims against payer-specific rules before transmission.
* **Batch Real-Time Eligibility (RTE):** Automatically verifies patient insurance status before appointments to prevent front-end denials.


HIPAA-compliant medical billing software for small telehealth and in-person practice

Here are the top HIPAA-compliant medical billing and practice management platforms best suited for a small hybrid (telehealth and in-person) practice:

### 1. **SimplePractice** (Best for Mental Health, Allied Health & Solo/Small Practices)
* **Key Features:** Fully integrated credit card processing, insurance billing (electronic claim filing), auto-pay, and built-in HIPAA-compliant telehealth with screen sharing.
* **Why it fits:** Extremely user-friendly, paperless intake, and manages in-person appointments and virtual sessions seamlessly.

### 2. **Tebra / Kareo** (Best for Independent Medical Practices & Strong Billing Needs)
* **Key Features:** Robust medical billing engine with automated claims scrubbing, clearinghouse connectivity, denial management, and integrated telehealth.
* **Why it fits:** Purpose-built for small independent medical practices that require complex medical coding, insurance claim tracking, and patient payment portals.

### 3. **CharmHealth** (Best Budget-Friendly & Customizable Option)
* **Key Features:** Pay-as-you-go or monthly plans, integrated medical billing, e-prescribing, patient portal, and integrated Zoom/telehealth for healthcare.
* **Why it fits:** Highly affordable for low-volume or starting practices, while scaling well as in-person and telehealth patient volume grows.

### 4. **DrChrono** (Best for Mobile & Apple-Centric Workflows)
* **Key Features:** iPad-native EHR with built-in medical billing, real-time eligibility checks, patient check-in kiosks for in-person visits, and integrated telehealth.
* **Why it fits:** Excellent for practitioners who want to move easily between exam rooms for in-person care and a home office for telehealth.

---

### Key Features to Verify Before Choosing:
* **Business Associate Agreement (BAA):** Ensure they sign a BAA (all options above do).
* **Integrated Clearinghouse:** Look for software that submits claims directly to payers to minimize manual entry.
* **Place of Service (POS) Codes:** Ensure the billing module makes it easy to toggle between **POS 11** (In-Person Office) and **POS 02/10** (Telehealth) with correct modifiers (e.g., 95 or GT).


Best medical billing platform for submitting CMS-1500 and UB-04 claims

The best platform depends on whether you need a full practice management system or a dedicated clearinghouse to scrub and transmit claims.

Here are the top options that excel at handling **both CMS-1500 (professional)** and **UB-04 (institutional)** claims:

### 1. Best Overall Practice Management & Billing: **AdvancedMD**
* **Best for:** Practices and facilities needing an all-in-one EHR, practice management, and billing system.
* **Why:** AdvancedMD natively supports complex billing workflows for both ambulatory (CMS-1500) and institutional/facility (UB-04) claims, featuring built-in claim scrubbing and high first-pass acceptance rates.

### 2. Best Dedicated Billing Software: **CollaborativeMD**
* **Best for:** Medical billing companies, outpatient facilities, and specialty clinics.
* **Why:** It is purpose-built for fast, high-volume data entry and processing. It features specialized templates for UB-04 (revenue codes, occurrence codes, value codes) alongside standard CMS-1500 claims.

### 3. Best Direct Clearinghouses (Claim Scrubbing & Submission)
If you already use an EHR/billing software and need a direct, reliable bridge to payers:
* **Claim.MD:** Cost-effective, user-friendly, and supports direct online entry and transmission for both CMS-1500 and UB-04 with real-time error checking.
* **Waystar:** The enterprise-grade standard for revenue cycle management with powerful claim-scrubbing rules for institutional and professional claims.

---

### Quick Recommendation:
* **For an all-in-one clinical + billing solution:** Choose **AdvancedMD**.
* **For a fast, billing-focused system for facilities/billing services:** Choose **CollaborativeMD**.
* **For an affordable, direct-entry clearinghouse:** Choose **Claim.MD**.


Cost-effective medical billing software for a 2-doctor clinic

Here are the most cost-effective medical billing software options for a 2-doctor clinic:

### 1. **Tebra (formerly Kareo Billing)**
* **Best for:** Small, independent practices wanting dedicated, intuitive billing.
* **Why it fits:** It can be used as standalone billing software (integrating with your existing EHR) or as an all-in-one system. It has robust claim scrubbing to reduce rejections.
* **Estimated Cost:** Starts around **$125–$300/provider/month** depending on modules selected.

### 2. **CureMD**
* **Best for:** Affordable all-in-one (Billing + EHR + Practice Management).
* **Why it fits:** Cloud-based, highly customizable, and designed for small practices to streamline revenue cycle management at a low entry cost.
* **Estimated Cost:** Starts at approximately **$295/provider/month** (all-inclusive) or a percentage-of-collections model (~4–6%).

### 3. **CollaborateMD**
* **Best for:** Pure, high-speed billing and claims processing without paying for a full EHR suite.
* **Why it fits:** Extremely fast claim generation and a 99% first-pass claim acceptance rate. It scales well by claim volume rather than just per-provider.
* **Estimated Cost:** Tiered plans start around **$165–$275/month** based on monthly claim volume.

### 4. **DrChrono**
* **Best for:** Modern, iPad/Apple-friendly workflows with integrated billing.
* **Why it fits:** Combines scheduling, EHR, and medical billing into one seamless platform. It automates eligibility checks and denial tracking.
* **Estimated Cost:** Custom quote, but plans with medical billing typically run **$250–$400/provider/month**.

### 5. **OpenEMR + Third-Party Clearinghouse (e.g., Claim.MD)**
* **Best for:** Absolute lowest cost (if you have basic technical support).
* **Why it fits:** OpenEMR is free, open-source software. You only pay for hosting (e.g., AWS, ~$20–$50/mo) and a clearinghouse service like Claim.MD (~$100/mo flat rate per provider for unlimited claims).
* **Estimated Cost:** **Under $150/month total for the entire clinic.**

---

### Recommendation:
* If you **already have an EHR you like:** Choose **CollaborateMD** or **Tebra**.
* If you want a **complete, affordable EHR + Billing replacement:** Choose **CureMD**.


What medical billing software do medical billing services and billers recommend?

Medical billing services and independent billers commonly recommend the following software, categorized by practice size and workflow needs:

### **Best for Third-Party Billing Services & Multi-Client Management**
* **AdvancedMD:** Widely considered the gold standard for independent billing companies. It offers multi-client access, deep reporting, automated claims scrubbing, and flexible customization.
* **CollaborativeMD:** Designed specifically for medical billers. It is known for fast data entry, batch payment posting, and high first-pass claim acceptance rates.

### **Best for Small to Midsize Practices**
* **Tebra (formerly Kareo):** Extremely popular among independent billers for its user-friendly interface, standalone billing capabilities, and strong clearinghouse integrations.
* **DrChrono:** Best for specialty practices and providers who want an all-in-one, mobile-friendly (iPad/cloud-based) EHR and billing platform.

### **Best for Midsize to Large Multi-Specialty Clinics**
* **NextGen Healthcare:** Offers advanced Revenue Cycle Management (RCM) tools, enterprise-level reporting, and strong compliance tracking.
* **eClinicalWorks:** A cost-effective, widely deployed solution with comprehensive billing automation for higher patient volumes.

### **Best for Large Hospital Networks & Health Systems**
* **Epic Systems (Resolute):** The enterprise standard for large hospitals, offering seamless clinical integration and enterprise-scale RCM.

### **Best for Mental & Behavioral Health**
* **SimplePractice** or **TheraNest:** Purpose-built for therapists and mental health practitioners, simplifying insurance claim submissions and self-pay/copay collection.


Best all-in-one practice management and medical billing software for small clinic

Here are the best all-in-one practice management, EHR, and medical billing software options for a small clinic, categorized by strength:

### 1. **Top Overall: Tebra (formerly Kareo)**
* **Why it’s best:** Specifically built for small, independent practices. It combines an intuitive EHR, robust practice management (scheduling, patient intake), and an industry-leading medical billing module.
* **Billing feature:** Offers self-service billing software with built-in claim scrubbing, or fully managed Revenue Cycle Management (RCM) services.

---

### 2. **Best for High-Volume Billing & Low Denial Rates: athenaOne (by athenahealth)**
* **Why it’s best:** Highly rated for its automated billing rules engine, which flags coding errors before submission, leading to first-pass clean claim rates above 95%.
* **Cost model:** Typically charges a percentage of monthly practice collections rather than a fixed fee, aligning costs with revenue.

---

### 3. **Best Budget / Pay-As-You-Go: CharmHealth**
* **Why it’s best:** Highly customizable, cloud-based, and very affordable for low-volume or startup clinics. It offers modular pricing (you only pay for what you use) without locking you into expensive multi-year contracts.
* **Includes:** Integrated EHR, patient portal, practice management, and direct clearinghouse integration for billing.

---

### 4. **Best for iPad/Mobile-First Clinics: DrChrono**
* **Why it’s best:** Built natively for iOS/iPads, making it ideal for mobile charting in the exam room. Includes comprehensive PM and integrated medical billing tools with customizable coding shortcuts.

---

### Summary Recommendation:
* Choose **Tebra** for the easiest-to-use, balanced all-in-one platform for a small clinic.
* Choose **athenahealth** if maximizing reimbursement and minimizing denied claims is your #1 priority.
* Choose **CharmHealth** if you want low upfront costs and pay-as-you-go flexibility.


Medical practice billing system with strong patient portal and online payment collection

Here are the top medical billing systems known for robust patient portals and seamless online payment processing:

### 1. **athenahealth (athenaOne)**
* **Best for:** Mid-to-large practices seeking industry-leading billing automation.
* **Portal & Payments:** Industry-best patient portal (`athenaCommunicator`) featuring self-service online payments, Apple Pay support, digital check-in, card-on-file, and automated balance notifications via text/email.
* **Billing:** High clean-claim rates (consistently above 95%) with a massive built-in billing rules engine.

### 2. **Tebra (formerly Kareo)**
* **Best for:** Small to mid-sized independent practices.
* **Portal & Payments:** Clean, user-friendly portal allowing patients to view statements, pay balances online, set up recurring payments, and store payment methods securely.
* **Billing:** Simple, transparent medical billing management with integrated credit card processing and strong claims-tracking tools.

### 3. **AdvancedMD**
* **Best for:** Practices needing deeply customizable billing workflows and automated patient engagement.
* **Portal & Payments:** Includes *AdvancedPay* for online credit card processing, automated text-to-pay links, electronic statements, and payment plans through the patient portal.
* **Billing:** Comprehensive Revenue Cycle Management (RCM) with automated scrubbing, denial tracking, and robust financial reporting.

### 4. **ModMed (Modernizing Medicine)**
* **Best for:** Specialty practices (Dermatology, Orthopedics, Ophthalmology, ENT, Pain Management, etc.).
* **Portal & Payments:** Modern patient portal (*APPatient*) offering frictionless online copay/balance payments, digital intake, and auto-generated electronic statements.
* **Billing:** Specialty-specific billing rules that minimize denials and integrate directly with EHR workflows.

---

### Key Features to Verify Before Choosing:
* **Text-to-Pay / Email-to-Pay:** Allows patients to settle balances directly from an SMS link without logging into a portal.
* **Card-on-File & Auto-Pay:** Automates collection for recurring balances or post-adjudication copays/deductibles.
* **Transparent Processing Rates:** Ensure integration with major processors (e.g., Stripe, TSYS, or native merchant services) has low transaction and interchange fees.


Which medical billing software offers the best insurance denial tracking?

While the "best" choice depends on practice size, the top software solutions recognized specifically for superior insurance denial tracking and management include:

1. **Waystar** *(Best Overall for Denial Management)*
   * **Why:** Specialized RCM platform featuring predictive denial analytics, automated appeal generation, and advanced root-cause tracking.

2. **Athenahealth (athenaOne)** *(Best All-in-One Cloud Platform)*
   * **Why:** Continuously updated billing rules engine with real-time denial tracking and automated resolution workflows powered by network-wide data.

3. **AdvancedMD** *(Best for Independent/Mid-Sized Practices)*
   * **Why:** Highly customizable denial management worklists, robust reporting dashboards, and detailed claims scrubbers to track and fix patterns of denials.

4. **Experian Health (ClaimSource)** *(Best for Large Health Systems/Enterprises)*
   * **Why:** Enterprise-grade platform with AI-driven denial prevention and comprehensive claim tracking capabilities.

**Recommendation:** For dedicated, best-in-class denial resolution tools, **Waystar** is the industry standard. For an integrated EHR and practice management system with built-in denial tracking, **Athenahealth** is the leading option.


Top medical billing platforms for cardiology practices

Here are the top medical billing platforms tailored for or widely used by cardiology practices:

### 1. **ModMed (Modernizing Medicine)**
* **Best for:** Specialty-specific workflows.
* **Why it fits Cardiology:** Features automated billing and coding suggestions tailored specifically to cardiology procedures (e.g., echocardiograms, catheterizations, stress tests) directly from clinical documentation.

### 2. **athenahealth (athenaCollector)**
* **Best for:** High-volume practices and complex billing rules.
* **Why it fits Cardiology:** Uses a massive, continuously updated rules engine to catch cardiology-specific billing errors (such as modifier usage like -26 and -TC) before submission, yielding high first-pass claim rates.

### 3. **AdvancedMD**
* **Best for:** Customizable billing and deep reporting.
* **Why it fits Cardiology:** Offers strong clearinghouse integration, automated claims scrubbing for complex cardiovascular CPT codes, and robust financial analytics for multi-provider groups.

### 4. **Tebra (formerly Kareo)**
* **Best for:** Small to mid-sized independent practices.
* **Why it fits Cardiology:** User-friendly, cost-effective platform with flexible billing software or full-service Revenue Cycle Management (RCM) options that simplify outpatient cardiology billing.

### 5. **NextGen Healthcare**
* **Best for:** Multi-location practices and ambulatory surgical centers (ASCs).
* **Why it fits Cardiology:** Deep integration with diagnostic cardiology devices, PACS, and outpatient surgical centers, making device-billing and technical/professional component splits seamless.

---

### Key Features to Prioritize for Cardiology Billing:
* **Built-in Modifiers & Bundling Rules:** Automated handling of professional/technical split billing (-26/-TC) and NCCI edits.
* **Device & Imaging Integration:** Compatibility with ECG, Echo, and Holter monitor billing feeds.
* **Prior Authorization Tools:** Automated tracking for high-cost imaging (e.g., PET, SPECT) and procedures.


Medical billing software comparison for small private medical offices

Here is a comparison of the top medical billing software options tailored for small, independent medical practices.

---

### Quick Comparison Table

| Software | Best For | Typical Pricing | Key Strength | Potential Drawback |
| :--- | :--- | :--- | :--- | :--- |
| **Tebra** *(formerly Kareo)* | **Best Overall** for independent practices | Quote-based (~$125–$300/provider/mo) | Built specifically for small practices; very user-friendly | Add-on modules can increase total cost |
| **DrChrono** | **Best for Mobile/iPad** & clinical integration | Tiered packages (Quote-based; starts ~$200/mo) | Highly customizable templates; strong all-in-one EHR/billing | Customer support can be slow on lower tiers |
| **PracticeSuite** | **Best Budget Option** | Free tier available; Paid plans from ~$195/mo | Affordable, solid claims scrubbing, standalone billing option | Interface looks somewhat dated |
| **AdvancedMD** | **Best for High Feature Needs** & growth | Modular/Quote-based (Mid-to-high range) | Advanced reporting, high automation, robust clearinghouse | Steeper learning curve; higher cost |
| **NextGen Office** | **Best for Integrated EHR/PM** | Quote-based (~$300–$500/provider/mo) | Top-tier claims acceptance rates (98%+), built for small teams | Less flexibility if you only want billing without the EHR |

---

### Top Software Profiles

#### 1. Tebra (Kareo)
* **Overview:** The market standard for independent medical practices. It offers robust billing features, scheduling, and optional EHR.
* **Key Features:** Built-in clearinghouse, automated patient billing/statements, denial management, and simple appointment scheduling.
* **Why Small Offices Choose It:** Minimal training required; allows practices to manage their own billing or outsource it to Tebra’s managed service.

#### 2. DrChrono
* **Overview:** An all-in-one EHR, Practice Management, and Medical Billing platform designed natively for iPad, iPhone, and web.
* **Key Features:** Real-time eligibility checks, patient payment processing, computerized physician order entry (CPOE), and customizable medical forms.
* **Why Small Offices Choose It:** Ideal for modern, paperless practices that prefer mobile charting and integrated billing.

#### 3. PracticeSuite
* **Overview:** A cost-effective cloud solution that provides modular billing, EHR, and portal tools.
* **Key Features:** 99%+ first-pass claim acceptance, revenue cycle management (RCM), integrated clearinghouse, and automated patient reminders.
* **Why Small Offices Choose It:** Offers transparent pricing, low upfront commitment, and the ability to use just the billing software without switching EHRs.

#### 4. AdvancedMD
* **Overview:** A powerhouse platform offering deep automation and advanced reporting for practices planning to scale.
* **Key Features:** Automated claims scrubbing, comprehensive financial analytics, automated batch eligibility checking, and a dedicated patient portal.
* **Why Small Offices Choose It:** Best if you have experienced in-house billing staff who want maximum control, automation, and reporting depth.

---

### How to Choose:

* **For the easiest setup and standalone billing:** Choose **Tebra (Kareo)**.
* **For a low-cost, high-value option:** Choose **PracticeSuite**.
* **For iPad-based clinical workflows and integrated billing:** Choose **DrChrono**.
* **For advanced reporting and complex billing rules:** Choose **AdvancedMD**.


We need new billing software for our 15-provider orthopedic group. What are our best options?

Here are the best billing and practice management (PM) options tailored for a 15-provider orthopedic group:

### 1. **ModMed (Modernizing Medicine – Orthopedics)**
* **Best for:** An all-in-one, orthopedic-specific EHR and billing system.
* **Why it fits:** It includes built-in orthopedic billing rules, handles complex surgical bundling/modifiers, and manages Durable Medical Equipment (DME) and physical therapy billing seamlessly.

### 2. **athenahealth (athenaOne)**
* **Best for:** Revenue cycle performance and clean claims automation.
* **Why it fits:** Ideal for a 15-provider practice with high claim volumes. Its continuously updated rules engine delivers industry-leading first-pass clean claim rates and strong handling of Workers’ Comp and commercial payers.

### 3. **NextGen Healthcare**
* **Best for:** Large, multi-location orthopedic groups needing deep customization.
* **Why it fits:** Extremely robust financial reporting, excellent surgical workflow management, and proven scalability for practices combining clinic visits, surgery centers, and physical therapy.

### 4. **AdvancedMD**
* **Best for:** Standalone billing/PM flexibility.
* **Why it fits:** Highly configurable claims engine that integrates well with various orthopedic EHRs. Excellent for practices that need advanced scheduling, specialized fee schedules, and distinct billing tracks for Workers' Comp/PI cases.

---

### Key Orthopedic Features to Verify Before Choosing:
* **Workers' Comp & Personal Injury:** Ensure native support for required forms (e.g., C-4 forms), attachment handling, and split-billing.
* **DME & PT Billing:** Ability to bill distinct service lines within the same practice entity.
* **Surgical Global Period Tracking:** Automatic tracking of post-op care periods to prevent improper billing or missed follow-up revenue.


Simple medical billing software for a solo dermatologist

Here are the best simple, user-friendly billing software options for a solo dermatologist:

### 1. **Tebra (formerly Kareo)**
* **Best for:** Pure billing simplicity and ease of use.
* **Why it fits:** Designed specifically for independent, solo practices. It features intuitive claim tracking, automated billing rules, patient invoicing, and integrates easily with third-party clinical EHRs if you already have one.

### 2. **CharmHealth**
* **Best for:** Budget-friendly, simple all-in-one practice management and billing.
* **Why it fits:** Extremely straightforward, cloud-based platform. It has a pay-as-you-go or low monthly tier that makes it very cost-effective for a solo provider handling their own billing and claims.

### 3. **DrChrono**
* **Best for:** iPad/mobile-first dermatology charting and billing.
* **Why it fits:** Highly visual (useful for skin mapping and photo storage) with integrated billing. Features real-time eligibility checks, automated claim scrubbing, and easy patient payment processing.

---

### *Note on Dermatology-Specific Software:*
* **ModMed (EMA):** While it is the industry gold-standard specifically built for dermatology with built-in Derm-specific billing codes (ICD-10/CPT), it can be more complex and expensive than general solo-practitioner tools.

**Recommendation:**
* Choose **Tebra** if you just want a reliable, simple medical billing engine.
* Choose **CharmHealth** if you want the lowest learning curve and lowest cost.


What medical billing software has the highest first-pass clean claims rate?

**athenahealth (athenaOne)** consistently reports the highest first-pass clean claims rate in the industry, averaging approximately **99%**. This is largely driven by its automated, continuously updated rules engine that scrubs claims against billions of historical transactions before submission.

Other top-performing billing platforms with clean claim rates of 97% to 98%+ include:

* **AdvancedMD** (averaging ~98%)
* **CureMD** (averaging ~98%)
* **Kareo / Tebra** (averaging 95%–97%)
* **Waystar** (leading clearinghouse solution, reporting ~98.5%+)

*Note: While software capabilities are a primary factor, a practice's actual clean claims rate also depends on front-desk demographic collection and clinical coding accuracy.*


Best software to manage medical claims, patient copays, and insurance reimbursements

Here are the top software solutions for managing medical claims, patient copays, and insurance reimbursements, categorized by practice size and needs:

### 1. **athenahealth (athenaCollector)** — *Best Overall for Reimbursements*
* **Best for:** Small to large practices looking to maximize collection rates.
* **Key Features:** Industry-leading first-pass claims resolution rate (~98%), automated denial management, integrated point-of-sale copay collection, and real-time insurance eligibility checks.

### 2. **Tebra (formerly Kareo)** — *Best for Small & Independent Practices*
* **Best for:** Independent providers wanting an intuitive, cost-effective billing platform.
* **Key Features:** Easy claims scrubbing, automated patient billing and copay processing, denial tracking, and simple patient payment portals.

### 3. **AdvancedMD** — *Most Robust & Customizable*
* **Best for:** Medium to large practices with complex billing workflows or multiple specialties.
* **Key Features:** Advanced claims tracking, automated clearinghouse integration, customizable financial reporting, and credit card processing for copays.

### 4. **NextGen Healthcare** — *Best for Multi-Specialty Ambulatory Practices*
* **Best for:** Mid-to-large ambulatory clinics.
* **Key Features:** Robust Revenue Cycle Management (RCM) rules engine, automated patient copay and balance notifications, and strong compliance tracking.

### 5. **Epic Systems (Resolute)** — *Best for Large Health Systems & Hospitals*
* **Best for:** Enterprise-level healthcare organizations.
* **Key Features:** End-to-end revenue cycle management, unified patient portals (MyChart) for pre-service copays, and enterprise-grade claims scrubbing.

---

### **How to Choose:**
* **Solo/Small Practice:** Choose **Tebra** for simplicity and low setup overhead.
* **Growth/High-Volume Claims:** Choose **athenahealth** for automated claims scrubbing and higher first-pass payment rates.
* **Complex Multi-Specialty Billing:** Choose **AdvancedMD** for deep customization.


Recommend medical billing software for a new solo family practice.

For a new solo family practice, the best billing software balances affordability, ease of use, and integrated EHR/practice management features.

Here are the top recommendations:

### 1. **Tebra (formerly Kareo)** – *Best Overall for Solo Practices*
* **Why it fits:** Specifically designed for independent practices. It is intuitive, cloud-based, and offers transparent pricing.
* **Key Features:** Built-in claim scrubbing, integrated clearinghouse, patient billing portal, and seamless integration with its EHR module.

### 2. **CharmHealth** – *Best Budget-Friendly Option*
* **Why it fits:** Extremely cost-effective for new startups. They offer a free tier (up to 50 encounters/month) and pay-as-you-go pricing as your patient panel grows.
* **Key Features:** Complete EHR + Practice Management + Billing suite, claim generation, and integrated clearinghouses (like Change Healthcare/Optum).

### 3. **athenahealth (athenaOne)** – *Best for Minimal Administrative Burden*
* **Why it fits:** Operates on a percentage-of-collections model, meaning you don't pay high upfront software fees; they only get paid when you get paid.
* **Key Features:** Industry-leading first-pass claim acceptance rates (consistently above 95%), automated claim-scrubbing rules engine, and full revenue cycle management (RCM) support.

### 4. **AdvancedMD** – *Best for Scalability & Customization*
* **Why it fits:** Highly configurable, all-in-one clinical and financial platform that can support a solo doctor now and scale if you add staff or mid-levels later.
* **Key Features:** Robust financial reporting, automated payment plans, and customizable billing workflows.

---

### Recommendation for a Solo Startup:
* Choose **CharmHealth** if your primary concern is keeping **startup overhead as low as possible**.
* Choose **Tebra** if you want the **easiest learning curve** with reliable, all-in-one software.
* Choose **athenahealth** if you prefer to **outsource the heavy lifting** of billing and follow-ups to minimize back-office work.