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

The “best” medical billing software depends on your specialty, budget, and whether you need billing only or a full EHR/practice management system.

For a small private practice, the best overall options are:

1. **Tebra / Kareo**
   - Best for many small practices
   - Strong billing, claims management, patient payments, and practice management
   - Good if you want an all-in-one system without enterprise-level complexity

2. **AdvancedMD**
   - Best for practices that want robust billing plus EHR
   - Good reporting, scheduling, claims scrubbing, and revenue cycle tools
   - Can be more expensive and complex than simpler systems

3. **DrChrono**
   - Best for practices wanting an easy-to-use EHR with billing
   - Strong for small to mid-sized practices
   - Particularly good if you want mobile/iPad functionality

4. **athenahealth**
   - Best for practices that want outsourced or highly supported billing workflows
   - Strong claims follow-up and payer connectivity
   - Often better for practices willing to pay more for support and automation

5. **TherapyNotes or SimplePractice**
   - Best for behavioral health or therapy practices
   - Easier to use and often more affordable
   - Great for solo and small mental health practices

My general recommendation:
**For most small private practices, Tebra/Kareo is a strong starting point.** If you need a more advanced full EHR and billing platform, consider **AdvancedMD** or **athenahealth**. If you’re a mental health provider, look at **TherapyNotes** or **SimplePractice** first.

Before choosing, compare:
- Claim scrubbing and denial management
- EHR integration
- Clearinghouse fees
- Patient payment tools
- Reporting
- Customer support
- Cost per provider
- Specialty-specific features


Best medical billing and RCM software for independent clinics

Here are some of the best medical billing and revenue cycle management software options for independent clinics:

## Top Picks for Independent Clinics

### 1. **AdvancedMD**
Best for: Small to mid-sized independent practices
- Strong billing, claims, scheduling, and reporting tools
- Good for practices that want integrated EHR + practice management
- Offers outsourced billing services if needed
- Works well for multi-provider clinics

### 2. **Kareo / Tebra**
Best for: Small independent practices
- User-friendly billing and practice management platform
- Good claims management and patient billing tools
- Includes patient payments, reminders, and reporting
- Popular with smaller clinics and private practices

### 3. **athenaOne**
Best for: Practices wanting strong RCM support
- Cloud-based EHR, billing, patient engagement, and RCM
- Strong payer rules engine and denial management
- Good analytics and benchmarking
- Often priced as a percentage of collections

### 4. **DrChrono**
Best for: Smaller clinics needing EHR + billing
- Cloud-based and mobile-friendly
- Includes scheduling, charting, claims, and patient payments
- Good for primary care, urgent care, and specialty clinics
- Offers billing service add-ons

### 5. **eClinicalWorks**
Best for: Growing clinics and multi-specialty practices
- Robust EHR and practice management system
- Includes billing, eligibility, claims, and patient portal
- Scales well for larger independent groups
- Can have a steeper learning curve

### 6. **NextGen Healthcare**
Best for: Specialty and larger independent practices
- Strong EHR and RCM functionality
- Good for specialties with more complex billing workflows
- Includes analytics, patient engagement, and clearinghouse tools
- Better fit for established clinics than very small offices

### 7. **RXNT**
Best for: Budget-conscious clinics
- Affordable practice management and billing software
- Includes scheduling, claims, e-prescribing, and patient payments
- Good option for small practices that do not need a large enterprise system

### 8. **Office Ally**
Best for: Low-cost claims submission
- Affordable clearinghouse and basic practice management tools
- Good for clinics with simpler billing needs
- Less polished than larger platforms but cost-effective

## Best Overall Recommendations

- **Best overall for small independent clinics:** **Tebra**
- **Best for stronger RCM performance:** **athenaOne**
- **Best for integrated EHR + billing:** **AdvancedMD**
- **Best budget option:** **RXNT or Office Ally**
- **Best for specialty practices:** **NextGen or eClinicalWorks**

## What to Look For

When comparing options, focus on:

- Claim scrubbing and denial management
- Real-time eligibility verification
- Patient statements and online payments
- Reporting on A/R, denials, collections, and payer trends
- EHR integration
- Clearinghouse connectivity
- Specialty-specific billing support
- Transparent pricing
- Quality of customer support
- HIPAA compliance and security

For most independent clinics, **Tebra, AdvancedMD, and athenaOne** are usually the strongest starting points to compare.


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, I would **not start by buying software alone**—I’d first confirm whether the rejections are caused by **front-desk/eligibility errors, coding issues, payer rule edits, or clearinghouse setup**. But if you need a practical shortlist, I’d look at:

## Best options to evaluate

### 1. **Tebra / Kareo**
Good fit for small independent primary care practices.
**Why:** Simple billing workflows, claim scrubbing, eligibility checks, patient statements, decent reporting, and easier implementation than enterprise systems.

### 2. **AdvancedMD**
Strong practice management and billing platform for small-to-mid-size groups.
**Why:** Good claim scrubbing, denial management, ERA/EFT posting, dashboards, and scalability if you want tighter revenue-cycle control.

### 3. **athenaCollector / athenaOne**
Best if you want more outsourced revenue-cycle support, not just software.
**Why:** Strong payer-rule engine and denial follow-up support. Often more expensive, but useful if your internal billing resources are limited.

### 4. **eClinicalWorks or NextGen**
Consider these if you already use or want a more integrated EHR + billing system.
**Why:** Better if the main issue is poor EHR-to-billing integration, but implementation can be heavier.

## My practical recommendation

If you are a small family medicine practice and want a balanced choice, start demos with:

1. **Tebra/Kareo** – easiest small-practice option
2. **AdvancedMD** – stronger billing controls/reporting
3. **athena** – if you want more hands-on RCM help

## What to require before buying

Ask each vendor to show you:

- Real-time insurance eligibility
- Claim scrubbing before submission
- Payer-specific rejection edits
- ERA/EFT auto-posting
- Denial/rejection work queues
- Reporting by payer, provider, CPT, denial reason
- Integration with your current EHR
- Clearinghouse fees and claim fees
- Patient statement and payment tools
- Support response times

## Most important step

Before signing, give each vendor a sample of your recent rejected claims and ask:
**“Show us exactly how your system would have caught these before submission.”**

That demo will tell you more than any sales pitch.


Recommend medical billing software for a mental health clinic.

Here are solid medical billing software options for a mental health clinic, depending on clinic size and needs:

## Best overall for small to mid-sized mental health clinics

### 1. **TherapyNotes**
**Best for:** Therapy, psychiatry, and behavioral health practices
**Strengths:**
- Built specifically for mental health
- Claims submission and ERA/EOB posting
- Scheduling, notes, treatment plans, client portal
- Good insurance billing workflow
- Telehealth included

**Good choice if:** You want an all-in-one behavioral health EHR + billing system.

---

### 2. **SimplePractice**
**Best for:** Solo providers and small group practices
**Strengths:**
- Easy to use
- Insurance claims, superbills, online payments
- Client portal and telehealth
- Strong scheduling and documentation tools

**Good choice if:** You want something user-friendly with basic-to-moderate billing needs.

---

### 3. **Valant**
**Best for:** Larger behavioral health and psychiatry practices
**Strengths:**
- Designed for behavioral health
- Strong clinical documentation and outcomes tracking
- Supports therapy and medication management
- More robust reporting than many smaller-practice tools

**Good choice if:** You have multiple clinicians, psychiatry services, or more complex workflows.

---

## Best if billing complexity is higher

### 4. **AdvancedMD**
**Best for:** Growing clinics with more advanced billing needs
**Strengths:**
- Strong practice management and claims tools
- Good reporting and revenue cycle management
- Can support multi-location practices

**Good choice if:** Billing operations are more complex and you need robust revenue cycle features.

---

### 5. **Tebra / Kareo**
**Best for:** Small to mid-sized practices that want billing-focused tools
**Strengths:**
- Claims management
- Patient payments
- Practice management tools
- Commonly used by outpatient practices

**Good choice if:** You want a billing/practice management system with optional clinical tools.

---

## Best clearinghouse add-ons

If you already have an EHR but need stronger claims processing, consider:

- **Claim.MD**
- **Office Ally**
- **Waystar**
- **Availity**

These can help with eligibility checks, claims submission, rejections, and ERA processing.

---

## My top recommendation

For most mental health clinics, I’d start with:

1. **TherapyNotes** – best overall for behavioral health billing
2. **SimplePractice** – best for ease of use and smaller practices
3. **Valant** – best for larger or psychiatry-heavy clinics

Before choosing, confirm the software supports:
- HIPAA compliance
- Electronic claims submission
- Eligibility verification
- ERA/EOB posting
- CPT codes commonly used in mental health
- Telehealth billing
- Client payment processing
- Reporting by provider, payer, and location


affordable medical billing software for small medical practice

Here are affordable medical billing software options worth considering for a small medical practice:

| Software | Best For | Notes |
|---|---|---|
| **Tebra / Kareo** | Small independent practices | Popular for billing, scheduling, claims, patient payments, and reporting |
| **CollaborateMD** | Low-cost billing-focused practices | Strong claims management and clearinghouse integrations |
| **Office Ally** | Very budget-conscious practices | Affordable claims submission and practice management tools |
| **RXNT** | Small practices needing billing + EHR | Offers practice management, e-prescribing, scheduling, and billing |
| **PracticeSuite** | Practices wanting scalable billing tools | Includes claims, denial management, patient billing, and reporting |
| **DrChrono** | Practices wanting EHR + billing | Good all-in-one option, especially for mobile/iPad use |
| **OpenEMR** | Lowest software cost | Open-source and free, but you may need paid hosting, setup, support, and clearinghouse services |
| **SimplePractice** | Behavioral health, therapy, wellness | Easy to use, good for solo/small specialty practices |
| **TherapyNotes** | Mental health practices | Strong scheduling, notes, billing, and insurance claims |

Key features to look for:

- Electronic claim submission
- Eligibility verification
- ERA/EOB posting
- Denial management
- Patient statements and online payments
- Appointment scheduling
- Reporting and aging reports
- HIPAA compliance
- Integration with your EHR or clearinghouse

For a very small practice, I’d shortlist:

1. **Tebra/Kareo** – best overall small-practice billing option
2. **CollaborateMD** – good affordable billing-focused platform
3. **Office Ally** – budget-friendly claims management
4. **RXNT** – good if you want billing plus EHR features
5. **OpenEMR** – lowest-cost option if you’re comfortable with setup/support needs

Before choosing, ask each vendor about monthly fees, setup costs, clearinghouse fees, per-provider pricing, claim submission costs, patient statement fees, and contract length.


What medical billing software do independent doctors actually use?

Independent doctors typically use **practice management (PM) / EHR systems with billing built in**, rather than separate “billing-only” software. Common ones include:

### Widely used by small independent practices
- **athenahealth** — cloud-based EHR + billing; popular with outpatient groups.
- **eClinicalWorks** — common among primary care and multispecialty practices.
- **NextGen Healthcare** — used by larger independent groups and specialties.
- **AdvancedMD** — popular with small/medium practices; strong billing features.
- **Tebra / Kareo** — common for solo and small practices.
- **DrChrono** — used by smaller practices, especially iPad-friendly clinics.
- **Practice Fusion** — lower-cost EHR option, often paired with billing services.
- **Office Ally** — often used for claims clearinghouse/billing, especially cost-conscious practices.
- **CureMD** — EHR + PM + billing for small to mid-sized practices.
- **Greenway Health / Intergy** — used by independent practices and groups.

### Specialty-specific systems
- **ModMed** — dermatology, ophthalmology, orthopedics, ENT, GI, etc.
- **TherapyNotes** — behavioral health.
- **SimplePractice** — therapists, psychologists, cash-pay or insurance-based.
- **ChiroTouch** — chiropractic.
- **Eyefinity** — optometry.
- **Compulink** — eye care and other specialties.

### Hospital-affiliated independent practices
Some independent doctors use:
- **Epic via Community Connect**
- **Oracle Cerner**
- **Meditech**

These are more common when the practice is connected to a hospital or health system.

### What they actually choose most often
For a typical independent primary care or specialty office, the most common real-world choices are usually:

**athenahealth, eClinicalWorks, AdvancedMD, NextGen, Tebra/Kareo, DrChrono, Greenway, or ModMed** depending on specialty and budget.

Many practices also outsource billing to an RCM company that works inside one of these systems.


Top rated revenue cycle management software for outpatient clinics

Here are commonly top-rated revenue cycle management software options for outpatient clinics, including independent practices and multi-location groups:

| Software | Best for | Key strengths |
|---|---|---|
| **athenaOne / athenaCollector** | Small to mid-size outpatient practices | Strong claims management, denial tracking, reporting, integrated EHR/PM |
| **AdvancedMD** | Independent and specialty clinics | Flexible billing workflows, scheduling, analytics, patient payments |
| **Tebra / Kareo** | Small practices | Easy-to-use billing, claims scrubbing, patient statements, affordable setup |
| **NextGen Healthcare** | Multi-specialty outpatient groups | Robust RCM, specialty workflows, analytics, EHR integration |
| **eClinicalWorks** | Growing outpatient clinics | Integrated EHR, billing, patient engagement, claims management |
| **ModMed** | Specialty clinics such as dermatology, orthopedics, ENT, GI | Specialty-specific coding and billing workflows |
| **DrChrono by EverHealth** | Smaller tech-forward clinics | EHR, billing, mobile access, patient payments |
| **RXNT** | Budget-conscious outpatient practices | Practice management, claims, scheduling, e-prescribing |
| **CollaborateMD** | Billing companies and small practices | Strong claims processing, reporting, clearinghouse integrations |
| **Waystar** | Clinics needing advanced billing automation | Claims, denials, eligibility, patient payments, analytics |
| **Experian Health** | Larger outpatient organizations | Eligibility verification, patient estimates, collections, payment tools |
| **R1 RCM** | Larger provider groups | End-to-end outsourced RCM services and technology |

### Best overall choices by clinic type

- **Small outpatient clinic:** Tebra/Kareo, RXNT, DrChrono
- **Mid-size multi-provider practice:** athenaOne, AdvancedMD, eClinicalWorks
- **Large outpatient group:** NextGen, Waystar, Experian Health, R1
- **Specialty practice:** ModMed, NextGen, AdvancedMD
- **If you want outsourced billing + software:** athenahealth, R1, Waystar partners, AdvancedMD billing services

### Features to compare before choosing

- First-pass claim acceptance rate
- Denial management tools
- Eligibility verification
- Patient payment portal
- Integration with your EHR
- Specialty-specific coding support
- Reporting and analytics
- Clearinghouse fees
- Contract terms and implementation costs

If you want a safe shortlist, I’d compare **athenaOne, AdvancedMD, Tebra/Kareo, NextGen, and ModMed** first, depending on clinic size and specialty.


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

For a new **4-therapist physical therapy clinic**, I’d shortlist these:

## Best overall choice for PT-specific insurance billing: **WebPT**
Choose **WebPT** if you want a widely used PT-focused EMR + scheduling + billing workflow. It’s strong for:
- PT documentation and compliance
- Insurance billing/claims
- Eligibility checks, ERAs, denials
- Therapist productivity/reporting
- Scaling beyond a small clinic

**Best fit:** Most outpatient PT clinics taking commercial insurance/Medicare.

## Strong alternative with modern workflows: **Prompt**
Choose **Prompt** if you want a newer, automation-heavy platform with integrated EMR, scheduling, billing, and patient engagement. It’s often liked for:
- Clean workflows
- Strong billing/collections tools
- Automation and dashboards
- Multi-location scalability

**Best fit:** Clinics that expect to grow and want a more modern all-in-one system.

## Simpler option for small clinics: **Jane App**
Choose **Jane** if you want something easy to use and lower-friction, especially if you have a mix of cash pay, wellness, and some insurance. It’s excellent for:
- Scheduling
- Online booking
- Patient communication
- Simple charting and payments

**Potential downside:** May be less robust than WebPT/Prompt for heavy insurance billing.

---

# My recommendation
If you are opening a traditional outpatient PT clinic billing insurance, start with **WebPT** or **Prompt**.

- Pick **WebPT** if you want the safer, established PT-industry standard.
- Pick **Prompt** if you want a more modern, growth-oriented platform.
- Pick **Jane** if you want simplicity and lighter insurance billing.

Before signing, ask each vendor:
1. Does pricing include EMR, scheduling, billing, clearinghouse, eligibility, ERAs, and patient payments?
2. Do they support Medicare PT billing, modifiers, authorizations, and visit limits?
3. What clearinghouse do they use?
4. Can they handle your payer mix?
5. What is implementation time and training included?
6. Are there setup fees, claim fees, or long-term contracts?

For a 4-therapist insurance-based clinic, I’d demo **WebPT and Prompt** first, then choose based on usability and total monthly cost.


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

Here are some of the best practice management software options with built-in medical billing and claims submission:

| Software | Best For | Key Billing / Claims Features |
|---|---|---|
| **AdvancedMD** | Independent medical practices | Claims submission, payment posting, denial management, patient billing, reporting |
| **Kareo / Tebra** | Small to midsize practices | Electronic claims, insurance eligibility checks, patient statements, billing analytics |
| **DrChrono** | Practices wanting EHR + billing | Integrated EHR, claims submission, coding tools, payment tracking, RCM options |
| **athenaOne** | Practices wanting strong billing support | Claims scrubbing, payer rules engine, denial management, revenue cycle services |
| **NextGen Healthcare** | Specialty and larger practices | Claims management, eligibility verification, charge capture, payer reporting |
| **eClinicalWorks** | Practices needing EHR + PM + billing | Claims submission, e-payments, patient statements, reporting dashboards |
| **PracticeSuite** | Budget-conscious practices | Practice management, electronic claims, ERA posting, patient billing |
| **CareCloud** | Growing practices | Claims management, billing workflows, analytics, patient payments |
| **RXNT** | Small practices and clinics | Scheduling, billing, electronic claims, e-prescribing, EHR integration |
| **SimplePractice** | Behavioral health and therapy practices | Insurance claims, superbills, client billing, payment processing |

### Best overall choices
- **Best for small practices:** **Tebra/Kareo**
- **Best for robust billing support:** **athenaOne**
- **Best all-in-one EHR + billing:** **AdvancedMD** or **DrChrono**
- **Best for behavioral health:** **SimplePractice**
- **Best budget-friendly option:** **RXNT** or **PracticeSuite**

### Features to look for
When comparing systems, prioritize:

- Electronic claims submission
- Real-time insurance eligibility verification
- Claims scrubbing before submission
- ERA/EOB posting
- Denial management
- Patient statements and online payments
- CPT/ICD coding support
- Reporting and revenue analytics
- Clearinghouse integration
- HIPAA compliance

If you run a medical practice and want one strong all-around choice, I’d start by comparing **AdvancedMD**, **Tebra**, and **athenaOne**.


Medical billing platform for solo practitioner

For a solo practitioner, a good medical billing platform should be simple, affordable, and include claims submission, ERA/EOB posting, patient statements, payment processing, and basic reporting.

### Good options for solo practices

| Platform | Best for | Notes |
|---|---|---|
| **Kareo / Tebra** | Independent medical practices | Strong billing + practice management; popular with small practices |
| **AdvancedMD** | Practices wanting robust billing | More feature-rich, can be expensive/complex |
| **DrChrono** | Solo providers wanting EHR + billing | Good if you need integrated EHR and scheduling |
| **SimplePractice** | Behavioral health, therapy, wellness | Very user-friendly, strong client portal and payments |
| **TherapyNotes** | Mental health practices | Excellent for therapists/psychiatrists; billing built in |
| **Office Ally** | Low-cost claims clearinghouse | Budget-friendly, but interface is less modern |
| **athenaOne** | Outsourced/managed billing support | Strong revenue cycle tools, usually higher cost |

### Key features to look for
- Electronic claim submission to payers
- Eligibility verification
- ERA/EOB payment posting
- Denial tracking and resubmission
- Patient statements and online payments
- HIPAA compliance
- Scheduling and reminders
- Integration with your EHR
- Reporting: A/R aging, collections, unpaid claims

### My practical recommendation
- **Mental health solo practitioner:** SimplePractice or TherapyNotes
- **General medical solo practice:** Tebra/Kareo or DrChrono
- **Lowest-cost billing-focused option:** Office Ally
- **If you want more help with billing/RPM:** athenaOne or a billing service using your platform

If you tell me your specialty, whether you need an EHR included, and your monthly budget, I can narrow this down to the best 2–3 options.


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

For most in-house billing teams, **Tebra — formerly Kareo — is often considered one of the most user-friendly medical billing software options**, especially for small to mid-sized practices.

It is generally liked because it has:

- A clean, easy-to-learn interface
- Simple claim creation and submission
- Built-in eligibility checks
- Denial and rejection tracking
- Patient statements and payment tools
- Good reporting for AR follow-up
- Integration with EHR and practice management workflows

Other user-friendly options worth comparing include:

1. **AdvancedMD** – strong for practices that want more automation and reporting.
2. **DrChrono** – good if you want billing integrated closely with EHR and scheduling.
3. **athenaCollector** – strong claims-scrubbing and revenue cycle tools, though more expensive.
4. **NextGen Office** – good for smaller practices needing an all-in-one EHR/PM/billing system.
5. **RXNT** – affordable and relatively simple for smaller offices.

If ease of use is the top priority, I would start by demoing **Tebra/Kareo**, **RXNT**, and **DrChrono**. If your practice has more complex billing or higher claim volume, also look at **AdvancedMD** or **athenaCollector**.


Best software for handling electronic health claims and denial management

There isn’t one “best” software for electronic health claims and denial management—it depends on practice size, specialty, EHR, payer mix, and whether you want software only or outsourced revenue cycle support.

### Strong options to consider

#### 1. **Waystar**
Best for: Mid-size to large practices, hospitals, and billing companies
Strengths:
- Electronic claims submission
- Eligibility verification
- Denial prevention and management
- Claim status tracking
- Strong analytics and payer rules

#### 2. **Availity**
Best for: Provider-payer connectivity and eligibility/claims workflows
Strengths:
- Widely used payer portal
- Eligibility and benefits verification
- Claim status and prior authorization tools
- Good for organizations working with many payers

#### 3. **Change Healthcare / Optum**
Best for: Enterprise-level claims clearinghouse and RCM workflows
Strengths:
- Large payer network
- Claims editing and scrubbing
- Denial management
- Remittance and payment tools

#### 4. **Experian Health**
Best for: Hospitals and larger healthcare organizations
Strengths:
- Claims management
- Denial prevention
- Patient eligibility and coverage discovery
- Strong analytics and patient financial tools

#### 5. **TriZetto Provider Solutions**
Best for: Medical practices and billing services
Strengths:
- Claims clearinghouse
- ERA/EFT management
- Denial workflow tools
- Revenue cycle reporting

#### 6. **AdvancedMD**
Best for: Small to mid-size practices needing PM + claims
Strengths:
- Practice management and billing
- Claims scrubbing
- Denial tracking
- Integrated scheduling and EHR options

#### 7. **Kareo / Tebra**
Best for: Small independent practices
Strengths:
- User-friendly billing platform
- Claims submission
- Denial tracking
- Good for smaller offices

#### 8. **athenaCollector by athenahealth**
Best for: Practices wanting cloud-based billing with RCM support
Strengths:
- Strong claims rules engine
- Denial follow-up tools
- Benchmarking across network data
- Good integration with athenahealth EHR

---

### Best overall picks by use case

- **Small practice:** Tebra, AdvancedMD, or athenaCollector
- **Billing company:** Waystar, TriZetto, or AdvancedMD
- **Large practice / health system:** Waystar, Experian Health, or Optum/Change Healthcare
- **Eligibility and payer portal workflows:** Availity
- **Full RCM outsourcing plus software:** athenahealth or specialty RCM vendors

### Key features to look for
- Claims scrubbing before submission
- Real-time eligibility checks
- Automated denial categorization
- Appeal letter generation
- ERA/EFT posting
- Payer-specific rule edits
- Denial analytics by payer, provider, CPT, and reason code
- Integration with your EHR/practice management system

If you want a strong all-around choice, **Waystar** is often one of the best for claims and denial management, while **Tebra/Kareo** or **AdvancedMD** may be better for smaller practices.


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

Switching software can help, but high denial rates are usually caused by a mix of **front-end processes, coding, payer rules, documentation, and follow-up workflows**. When evaluating new medical billing software, look for tools that help prevent, identify, and work denials faster.

## Key things to evaluate

### 1. Denial analytics and reporting
Look for software that shows denial trends by:

- Payer
- Provider
- Location
- CPT/HCPCS code
- Diagnosis code
- Modifier
- Denial reason/CARC/RARC code
- Front-end vs back-end cause
- Claim age and appeal status

You want dashboards that help answer: **Why are we getting denied, where, and by whom?**

### 2. Strong claim scrubbing before submission
The system should catch errors before claims go out, such as:

- Missing or invalid modifiers
- NCCI edit conflicts
- Diagnosis/CPT mismatches
- Invalid patient demographics
- Incorrect payer IDs
- Missing authorization numbers
- Timely filing risks
- Medical necessity issues
- Place-of-service errors

Ask vendors if rules are updated automatically and how often.

### 3. Real-time eligibility and benefits verification
A strong billing platform should support:

- Real-time insurance eligibility checks
- Coverage status
- Copay, deductible, and coinsurance details
- Plan changes
- Coordination of benefits alerts

Many denials start with bad insurance information at registration.

### 4. Prior authorization and referral tracking
If your denials include “no authorization” or “authorization mismatch,” look for:

- Authorization tracking by visit/procedure
- Alerts before service date
- Authorization number attachment to claims
- Expiration and visit-count tracking
- Referral management if applicable

### 5. Coding and documentation support
Depending on your specialty, consider software with:

- Specialty-specific billing rules
- Modifier guidance
- ICD-10/CPT cross-checks
- Medical necessity checking
- EHR documentation tie-in
- Charge capture tools

If documentation does not support the claim, software alone will not fix denials.

### 6. Denial workflow management
Good software should make denial follow-up easier with:

- Work queues by denial type
- Assignment to staff
- Appeal letter templates
- Deadline tracking
- Notes and task history
- Automated payer status checks
- Root-cause tracking
- Batch rebilling or correction tools

Avoid systems where denial follow-up is buried in generic AR reports.

### 7. Clearinghouse and payer connectivity
Check whether the system has:

- Direct clearinghouse integration
- Electronic claim submission
- Electronic remittance advice/ERA posting
- Electronic funds transfer/EFT support
- Claim status inquiry
- Rejection reports
- Payer-specific edits

Also ask which payers are connected and whether there are extra fees.

### 8. Payment posting and underpayment detection
The software should support:

- ERA auto-posting
- Contractual adjustment validation
- Allowed amount comparison
- Underpayment detection
- Patient responsibility transfer
- Secondary claim generation

This helps reduce missed revenue after claims are paid.

### 9. Specialty fit
Billing needs vary significantly by specialty. Ask for proof that the vendor supports your type of practice, such as:

- Behavioral health
- Radiology
- PT/OT/ST
- Surgery
- Anesthesia
- Primary care
- Urgent care
- DME
- Home health
- Specialty clinic billing

A generic system may not handle your payer rules well.

### 10. Integration with your EHR and front desk workflows
Evaluate how well the billing software connects with:

- EHR/EMR
- Scheduling
- Patient registration
- Charge capture
- Documentation
- Patient portal
- Payment processing
- Clearinghouse
- Accounting systems

Poor integration can create duplicate entry and more billing errors.

### 11. Compliance and security
Make sure the vendor supports:

- HIPAA compliance
- Role-based access
- Audit logs
- Secure data transmission
- Data backup and disaster recovery
- Business Associate Agreement
- Compliance with current CMS and payer requirements

### 12. Implementation and training
A strong system can fail if implementation is poor. Ask about:

- Data migration
- Setup of payer rules
- Custom edits
- Staff training
- Go-live support
- Historical AR handling
- Timeline
- Dedicated account manager
- Post-launch optimization

## Questions to ask vendors

- What is your average client denial rate by specialty?
- Can you show examples of denial dashboards?
- What claim edits are included out of the box?
- Can we build custom payer-specific edits?
- How often are rules updated?
- Do you support real-time eligibility and authorization tracking?
- How are denials assigned, appealed, and tracked?
- Can the system identify root causes of denials?
- What clearinghouses and payers do you integrate with?
- What fees are charged per claim, eligibility check, ERA, or user?
- Can we see a demo using our real denial scenarios?
- Do you provide implementation support for reducing denials?

## Metrics to track before and after switching

Before changing systems, document your current baseline:

- Overall denial rate
- First-pass claim acceptance rate
- Rejection rate
- Denial rate by payer
- Top 10 denial reasons
- Days in AR
- Net collection rate
- Clean claim rate
- Appeal success rate
- Timely filing denials
- Authorization-related denials
- Eligibility-related denials

Then use those same metrics to judge whether the new software actually improves performance.

## Bottom line

Look for medical billing software that offers **strong claim scrubbing, denial analytics, eligibility verification, authorization tracking, payer-specific rules, automated workflows, and robust reporting**. Also review your internal processes, because if the root cause is registration, coding, documentation, or prior authorization, a software switch alone may not fully solve the denial problem.


Medical claims processing and billing software for chiropractic office

For a chiropractic office, look for medical claims processing/billing software that supports **chiropractic-specific coding, insurance claims, ERA/EOB posting, patient statements, and HIPAA compliance**.

### Popular chiropractic billing/claims software options

1. **ChiroTouch**
   - Chiropractic-focused EHR + billing
   - Claims submission, payment posting, documentation
   - Good for established practices

2. **Jane App**
   - Scheduling, charting, billing, insurance management
   - User-friendly and good for smaller offices
   - Strong patient communication tools

3. **Kareo / Tebra**
   - Medical billing, claims, patient payments
   - Works well if you want strong revenue cycle tools
   - Not chiropractic-only, but widely used

4. **AdvancedMD**
   - Full practice management and billing platform
   - Good for larger or multi-provider offices
   - Strong reporting and claims management

5. **Office Ally**
   - Claims clearinghouse and practice management tools
   - Often lower-cost
   - Good if you already have EHR software and mainly need claims submission

6. **DrChrono**
   - EHR, billing, scheduling, patient portal
   - Flexible and works for multiple specialties, including chiropractic

7. **EZBIS**
   - Chiropractic-specific billing and practice management
   - Claims, documentation, scheduling, reports

### Key features to look for

- Electronic claim submission: **837P**
- ERA/payment posting: **835**
- Eligibility verification: **270/271**
- Chiropractic CPT/ICD-10 support
- SOAP notes and treatment plans
- Medicare and commercial insurance billing
- Denial management
- Patient statements and online payments
- Clearinghouse integration
- HIPAA compliance
- Reporting: aging, collections, claim status

### Common chiropractic billing codes to support

Examples include:

- **98940–98942** chiropractic manipulative treatment
- **97110** therapeutic exercise
- **97140** manual therapy
- **G0283 / 97014** electrical stimulation
- **99202–99215** E/M codes, when appropriate

### Best choice depends on your office

- **Small chiropractic office:** Jane App, Office Ally, EZBIS
- **Chiro-specific full system:** ChiroTouch, EZBIS
- **Strong billing/RCM:** Tebra, AdvancedMD
- **Low-cost claims submission:** Office Ally

If you want a simple setup for a chiropractic office, I’d compare **ChiroTouch, Jane App, EZBIS, and Tebra** first.


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

For a **pediatric clinic with ~10 providers**, the best fit is often:

## Best overall for pediatrics: **PCC — Pediatric Management System**
**Why:** PCC is built specifically for pediatric practices, with strong support for:
- Pediatric billing workflows
- Vaccine administration and inventory
- Immunization registry interfaces
- Well-child visit documentation
- Recall/reminder tools
- Pediatric-specific reporting and benchmarking
- Integrated EHR + practice management + billing

If your clinic wants a system designed around pediatrics rather than a general medical billing platform, **PCC is usually the strongest choice**.

## Best if you want outsourced billing/RCM support: **athenaOne**
Good for clinics that want cloud-based EHR, billing, clearinghouse, and revenue cycle support in one package. Strong claims follow-up and denial management, though less pediatric-specific than PCC.

## Best lower-cost option: **Tebra/Kareo**
May work if budget is a major concern, but it is more general-purpose and may not be as strong for pediatric vaccine workflows or complex pediatric reporting.

## Other solid options
- **eClinicalWorks** — broad feature set, commonly used by multi-provider clinics
- **NextGen** — robust for larger practices, but can be more complex
- **AdvancedMD** — good billing/practice management, less pediatric-focused

## Recommendation
For a **10-provider pediatric clinic**, I’d start with **PCC** as the top choice, then compare it against **athenaOne** if you want more revenue cycle management support.

Before choosing, ask each vendor about:
- Immunization registry integration in your state
- Vaccine inventory tracking
- Medicaid/CHIP billing support
- Claim denial rate and clean-claim rate
- Eligibility verification
- Patient portal and online payments
- Reporting by provider, payer, CPT, and vaccine
- Total monthly cost including clearinghouse fees, implementation, and training


Easiest medical billing software for a doctor doing their own billing

For a doctor doing their own billing, the “easiest” option is usually an **all-in-one EHR + practice management + billing** system, so you’re not re-entering data.

### Easiest options to consider

1. **SimplePractice**
   - Best for: solo clinicians, behavioral health, therapy, cash + insurance mix
   - Pros: very easy interface, eligibility, claims, ERAs, patient payments
   - Cons: not ideal for every medical specialty

2. **Tebra / Kareo**
   - Best for: small medical practices doing insurance billing
   - Pros: strong billing workflow, claims, denials, patient statements
   - Cons: setup and add-ons can affect cost

3. **DrChrono**
   - Best for: solo/small practices wanting EHR + billing
   - Pros: user-friendly, good for iPad users, integrated billing
   - Cons: pricing/features vary by plan

4. **AdvancedMD**
   - Best for: practices that want more robust billing features
   - Pros: powerful claim management and reporting
   - Cons: more complex than the simplest tools

5. **Practice Fusion + billing partner**
   - Best for: lower-cost EHR with separate billing workflow
   - Pros: affordable EHR option
   - Cons: not as seamless as true all-in-one systems

### My practical recommendation

If you’re a solo physician doing your own insurance billing, start by looking at:

**Tebra/Kareo** if you want the strongest small-practice billing workflow.
**DrChrono** if you want an easy EHR + billing system.
**SimplePractice** if you’re in behavioral health or a simpler outpatient specialty.

### Features you should require

- Electronic claim submission
- Claim scrubbing before submission
- Eligibility verification
- ERA/EOB posting
- Patient statements and online payments
- Denial tracking
- CPT/ICD coding support
- HIPAA compliance
- Good customer support and onboarding

If your specialty has complex coding—surgery, cardiology, pain, dermatology procedures, etc.—choose a system with stronger billing tools like **Tebra/Kareo** or **AdvancedMD** rather than the simplest-looking option.


Best medical billing software with automated claim scrubbing and eligibility verification

Here are strong medical billing software options that include **automated claim scrubbing** and **insurance eligibility verification**:

| Software | Best For | Key Strengths |
|---|---|---|
| **AdvancedMD** | Independent practices and billing companies | Automated claim scrubbing, real-time eligibility checks, denial management, strong reporting |
| **Kareo / Tebra** | Small to midsize practices | Easy-to-use billing, eligibility verification, claim tracking, clearinghouse integration |
| **athenaCollector / athenaOne** | Practices wanting outsourced-style revenue cycle support | Rules-based claim scrubbing, eligibility checks, denial follow-up, strong RCM services |
| **DrChrono** | Small practices using iPad-based EHR | Built-in billing, eligibility verification, claim scrubbing, patient payment tools |
| **eClinicalWorks** | Practices needing EHR + billing together | Eligibility checks, claim edits, denial management, integrated EHR/PM system |
| **NextGen Healthcare** | Specialty and larger practices | Advanced claims management, eligibility verification, specialty workflows, analytics |
| **Office Ally** | Budget-conscious practices | Affordable claims submission, eligibility verification, clearinghouse tools |
| **Waystar** | Billing companies and larger organizations | Excellent claim scrubbing, eligibility verification, denial prevention, analytics; often used alongside PM/EHR systems |
| **Availity Essentials Pro** | Eligibility and payer connectivity | Strong eligibility verification and payer portal tools; commonly paired with billing systems |

**Best overall picks:**
- **Best for small practices:** **Tebra/Kareo** or **AdvancedMD**
- **Best for larger practices:** **NextGen** or **athenaOne**
- **Best for claim scrubbing/RCM automation:** **Waystar**
- **Best budget option:** **Office Ally**
- **Best eligibility verification tool:** **Availity**

If you want an all-in-one medical billing platform, start with **AdvancedMD, Tebra, athenaOne, or NextGen**. If you mainly need powerful claim scrubbing and eligibility tools to connect with your existing EHR/PM system, look at **Waystar** or **Availity**.


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

A multi-specialty group practice should use an integrated **Practice Management / Revenue Cycle Management system** that supports both **patient billing** and **insurance collections**.

Good options include:

- **athenahealth / athenaCollector** – strong for cloud-based billing, claims, eligibility, denial management, and collections.
- **NextGen Healthcare** – good for multi-specialty practices that need integrated EHR + billing.
- **eClinicalWorks** – commonly used by group practices with scheduling, EHR, billing, and claims tools.
- **AdvancedMD** – solid for mid-sized practices needing billing, clearinghouse, patient statements, and analytics.
- **Epic Resolute** – best for large groups or health-system-affiliated practices.
- **Greenway Intergy** – another multi-specialty-friendly EHR/PM platform.
- **Tebra / Kareo** – better for smaller practices or lighter billing needs.

For a multi-specialty group, I would usually shortlist **athenahealth, NextGen, eClinicalWorks, or Epic**, depending on the size of the practice and whether you need full EHR integration.

Key features to require:

- Insurance eligibility verification
- Electronic claims submission
- ERA/EOB posting
- Denial management
- Patient statements and online payments
- Collections workflows
- Specialty-specific billing rules
- Reporting by provider, location, payer, and specialty
- Integration with your EHR and clearinghouse

If the practice is medium to large, **athenahealth or NextGen** are often strong choices. If it is enterprise-level or hospital-affiliated, **Epic Resolute** is usually the better fit.


Cloud-based medical billing software for small group practice

Here are strong cloud-based medical billing software options for a small group practice:

### Popular Options
1. **AdvancedMD**
   - Good for small to mid-sized practices
   - Includes billing, scheduling, claims, reporting, and optional EHR
   - Strong revenue cycle management features

2. **Kareo / Tebra**
   - Designed for independent and small practices
   - Easy claims submission, patient payments, insurance verification
   - Often a good fit for practices without complex enterprise needs

3. **DrChrono**
   - Cloud-based EHR + billing platform
   - Good for practices wanting mobile-friendly workflows
   - Includes claims, scheduling, clinical notes, and patient portal

4. **Athenahealth**
   - Strong billing and collections support
   - Good claims scrubbing and payer rule updates
   - Often better for practices that want more hands-on revenue cycle support

5. **SimplePractice**
   - Best for behavioral health, therapy, counseling, and wellness practices
   - Includes billing, scheduling, telehealth, documentation, and client portal

6. **TherapyNotes**
   - Excellent for mental health practices
   - Easy billing, insurance claims, notes, scheduling, and payment processing

7. **eClinicalWorks**
   - Full EHR and practice management platform
   - Suitable if you want an all-in-one system
   - May be more than needed for very small practices

### Key Features to Look For
- HIPAA-compliant cloud hosting
- Electronic claims submission
- Claims scrubbing and denial management
- Eligibility verification
- Patient payment portal
- Automated statements and reminders
- ERA/EOB posting
- Reporting and A/R tracking
- Integration with your EHR
- Transparent pricing and clearinghouse fees

### Best Fit by Practice Type
- **General small medical practice:** Tebra, AdvancedMD, Athenahealth
- **Mental health or therapy:** SimplePractice, TherapyNotes
- **All-in-one EHR + billing:** DrChrono, eClinicalWorks, AdvancedMD
- **More billing support/RCM:** Athenahealth, AdvancedMD

If you want something simple and affordable, start by comparing **Tebra**, **DrChrono**, and **SimplePractice/TherapyNotes** depending on your specialty.


Recommend a medical billing and coding platform for small specialty clinic

For a **small specialty clinic**, I’d recommend starting with **Tebra** — formerly Kareo — as the best overall medical billing/coding and practice management platform.

### Best overall: **Tebra**
Good fit if you need:
- Claims submission and tracking
- Patient eligibility checks
- Denial management
- Payment posting
- Patient statements and online payments
- Integrated EHR/practice management options
- Support for small and independent practices

It’s generally easier to adopt than larger enterprise systems and is built with small clinics in mind.

### If your clinic needs specialty-specific workflows
Consider **ModMed** if you are in:
- Dermatology
- Orthopedics
- Ophthalmology
- ENT
- Gastroenterology
- Plastic surgery
- Urology

ModMed is more specialty-focused and can be excellent for coding and documentation, but it is usually more expensive.

### If you mainly need billing software, not a full EHR
Look at **CollaborateMD** or **AdvancedMD**.

- **CollaborateMD**: strong for billing companies or clinics that want affordable claims management.
- **AdvancedMD**: more robust, good for growing practices, but may be more complex.

### My recommendation
If you’re a small specialty clinic looking for a practical, all-around solution, choose:

**Tebra** for general small-practice billing and coding needs.
**ModMed** if your specialty has complex documentation/coding requirements and you want a specialty-specific system.

Before committing, confirm:
- HIPAA compliance and BAA availability
- Clearinghouse fees
- EHR integration
- Specialty-specific CPT/ICD-10 support
- Denial reporting
- Training and support costs
- Contract length and cancellation terms


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

For **dental–medical cross billing**, the best fit is usually software built specifically for **billing medical insurance from a dental practice**, not just standard dental claims.

**Best overall recommendation:** **Nierman Practice Management / DentalWriter**
It’s one of the most established options for dental practices billing medical insurance for services like:

- Sleep apnea oral appliances
- TMD/TMJ therapy
- Oral surgery
- Trauma-related dental care
- CBCT/diagnostic imaging
- Some implant-related procedures
- Biopsies and pathology-related services

It helps with **ICD-10/CPT/CDT cross-coding, medical necessity documentation, narratives, claim forms, and appeals**, which are key for dental-medical billing.

Other strong options to consider:

1. **DentalXChange** – Good for claim submission, eligibility, attachments, and payer connectivity.
2. **Vyne Dental** – Strong for attachments, documentation, and claims communication.
3. **eAssist Dental Billing** – More of a billing service than software, good if you want outsourcing help.
4. **Open Dental + clearinghouse setup** – Good lower-cost option if your team knows medical billing well.
5. **Dentrix / Eaglesoft with medical billing add-ons or integrations** – Best if you want to stay within your existing practice management system.

If you want the most dental-specific medical billing support, I’d start with **Nierman/DentalWriter**. If you mainly need electronic submission and attachments, look at **DentalXChange** or **Vyne**.


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

For an urgent care startup, I’d shortlist these systems:

1. **Experity** — Best urgent-care-specific option
   - Built for urgent care workflows, high patient volume, walk-ins, occupational medicine, x-ray/lab integration, and urgent care billing.
   - Strong choice if you want an all-in-one EHR + PM + billing platform.

2. **athenahealth** — Strong billing/RCM and payer connectivity
   - Good claims management, eligibility checks, denial tracking, and reporting.
   - Works well if revenue cycle performance is a top priority.

3. **AdvancedMD** — Flexible PM/EHR with billing services
   - Good for startups that want scalability, scheduling, claims, patient portal, and optional outsourced billing.
   - More configurable, but may require more setup.

4. **Tebra/Kareo** — Budget-friendly for smaller clinics
   - Easier to implement and commonly used by smaller practices.
   - Good if you want lower upfront complexity, though it may be less urgent-care-specific.

5. **eClinicalWorks or NextGen** — Robust but heavier systems
   - Good if you expect multiple locations and need enterprise-level capabilities.
   - Implementation can be more involved.

My top recommendation for a startup urgent care would be **Experity** if your budget allows, because it is purpose-built for urgent care. If you want a more general platform with strong billing performance, compare **athenahealth** and **AdvancedMD**.

Key things to verify before choosing:

- Real-time insurance eligibility
- Claims scrubbing and denial management
- ERA/EFT posting
- Integrated patient payments
- Urgent care coding support
- Lab, x-ray, and e-prescribing integrations
- Occupational medicine support, if needed
- Reporting by provider, payer, CPT code, and location
- HIPAA compliance and BAA
- Total cost: setup, monthly fees, clearinghouse fees, claim fees, and RCM percentage

I’d recommend getting demos from **Experity, athenahealth, and AdvancedMD** and asking each vendor to show your exact urgent care workflow from check-in to claim payment.


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

There isn’t one “best” RCM software for every medical practice, but the best platforms for reducing days in A/R usually have strong claim scrubbing, denial management, automated eligibility, payment posting, patient billing, and A/R analytics.

## Top RCM software options to consider

| RCM software | Best for | Why it helps reduce days in A/R |
|---|---|---|
| **athenaCollector / athenaOne** | Small to mid-sized practices wanting outsourced-style RCM support | Strong rules engine, payer intelligence, denial workflows, and benchmarking |
| **AdvancedMD** | Independent practices needing integrated PM, EHR, and billing | Good claims management, scheduling, payment tools, and reporting |
| **NextGen Healthcare** | Specialty and larger practices | Strong enterprise RCM, analytics, eligibility, and denial management |
| **eClinicalWorks RCM** | Practices already using eCW EHR | Tight EHR/RCM integration, claims tracking, patient payments |
| **Tebra / Kareo** | Small practices and independent providers | Easy to use, solid claims tools, patient collections, affordable entry point |
| **Waystar** | Practices needing stronger clearinghouse and denial tools | Excellent eligibility, claim status, denials, prior auth, and payment automation |
| **Experian Health** | Larger groups focused on patient access and collections | Strong eligibility, estimates, patient payments, and collections automation |
| **R1 RCM / AGS Health** | Larger groups wanting managed RCM services | Combines technology with outsourced billing and A/R follow-up |

## Best overall picks

- **Best all-around for independent practices:** **athenaOne**
- **Best for small practices:** **Tebra/Kareo** or **AdvancedMD**
- **Best for specialty/larger groups:** **NextGen**
- **Best clearinghouse/claims automation add-on:** **Waystar**
- **Best if you want outsourced RCM plus technology:** **R1 RCM** or **AGS Health**

## Key features to prioritize if your goal is lowering days in A/R

Look for software that includes:

1. **Real-time eligibility verification**
2. **Automated claim scrubbing before submission**
3. **Denial management workflows**
4. **Automated claim status checks**
5. **ERA/EFT and auto-payment posting**
6. **Patient payment plans and online billing**
7. **A/R aging dashboards**
8. **Payer-specific rules and analytics**
9. **Prior authorization tracking**
10. **Integration with your EHR and practice management system**

## Practical recommendation

If you want the fastest impact on days in A/R, choose a platform that integrates directly with your EHR and has strong denial management. For many independent practices, **athenaOne, AdvancedMD, or Tebra** are good starting points. For larger or more complex practices, **NextGen, Waystar, or Experian Health** may be better fits.


What medical billing software has the best clearinghouse integration?

There isn’t one “best” for every practice, but these are commonly considered strong for clearinghouse integration:

| Software | Best fit | Clearinghouse/integration strengths |
|---|---|---|
| **athenahealth / athenaCollector** | Practices wanting an all-in-one billing + RCM platform | Very strong built-in claims network, eligibility checks, claim scrubbing, denial workflows, ERA posting |
| **AdvancedMD** | Independent practices needing robust billing control | Integrated claims submission, eligibility, ERA, rejection management, strong reporting |
| **Tebra / Kareo** | Small to midsize practices | Easy-to-use billing, claims scrubbing, eligibility, ERA, good for independent groups |
| **DrChrono** | Smaller practices wanting EHR + billing together | Integrated claims, eligibility, ERA, decent clearinghouse workflow |
| **eClinicalWorks** | Larger primary care/multispecialty groups | Broad payer connectivity, claims management, ERA, reporting |
| **Waystar-integrated systems** | Practices prioritizing revenue cycle performance | Waystar is one of the strongest clearinghouses; many PM/EHR systems integrate with it |
| **Availity-integrated systems** | Practices with heavy commercial payer volume | Strong payer connectivity, eligibility, claim status, remittance tools |

My general recommendation:

- **Best overall built-in billing/clearinghouse experience:** **athenahealth**
- **Best for independent practices wanting flexibility:** **AdvancedMD**
- **Best simple option for smaller practices:** **Tebra/Kareo**
- **Best if you already have software and want a strong clearinghouse:** **Waystar** or **Availity** integration

Before choosing, confirm these items with vendors:

1. Your top payers are supported
2. Real-time eligibility is included
3. Electronic claim status is available
4. ERA/EFT posting is automated
5. Secondary claims are supported
6. Claim scrubbing is built in
7. Rejection/denial workflows are easy to manage
8. Fees per claim, ERA, and eligibility check are clear

If you tell me your specialty, practice size, current EHR, and top payers, I can narrow it to the best 2–3 options.


Software for insurance verification and medical claim filing for small clinic

For a small clinic, you’ll usually want practice management software that includes:

- Insurance eligibility verification
- Electronic claim filing
- Claim status tracking
- ERA/EOB posting
- Patient billing
- Basic reporting
- Integration with your EHR/EMR

Good software options to consider:

1. **Office Ally**
   - Popular with small practices
   - Electronic claims and eligibility checks
   - Generally affordable
   - Good for clinics that need clearinghouse services

2. **Kareo / Tebra**
   - Designed for small to mid-sized practices
   - Insurance verification, billing, claims, patient payments
   - Can include EHR and practice management

3. **AdvancedMD**
   - Full practice management and billing platform
   - Claims, eligibility, scheduling, reporting
   - Better for growing clinics but may cost more

4. **DrChrono**
   - EHR plus billing and claim filing
   - Good for smaller medical practices
   - Offers insurance eligibility and payment tools

5. **SimplePractice**
   - Best for behavioral health, therapy, counseling, and wellness clinics
   - Insurance claims, eligibility, client billing
   - Easy to use for small practices

6. **CollaborateMD**
   - Cloud-based medical billing and practice management
   - Eligibility verification and claim submission
   - Often used by small practices and billing companies

7. **Athenahealth**
   - Strong billing and claims support
   - Good if you want more managed billing services
   - Typically more expensive

For a small clinic, I’d start by comparing **Office Ally**, **Tebra/Kareo**, and **CollaborateMD** if your main needs are insurance verification and claim filing.

Key things to check before choosing:

- Monthly cost and per-claim fees
- Whether it integrates with your current EHR
- Which insurance payers are supported
- Real-time eligibility verification
- Claim rejection alerts and correction tools
- ERA/payment posting support
- Customer support quality
- HIPAA compliance

If you tell me your clinic type, number of providers, current EHR, and monthly claim volume, I can narrow this to the best 2–3 options.


Best medical billing software for podiatry practice

The “best” medical billing software for a podiatry practice depends on whether you want **podiatry-specific workflows**, an all-in-one EHR/PM system, or just strong billing/claims management. Good options include:

## Top choices for podiatry practices

### 1. **Tebra / Kareo**
Best for: Small to mid-size podiatry practices
- Strong billing and claims tools
- Easy eligibility checks, payment posting, patient statements
- Good for practices that want usability without a huge enterprise system
- Works well with in-house billing or outsourced billing

### 2. **AdvancedMD**
Best for: Growing practices with higher billing volume
- Robust practice management and revenue cycle tools
- Good reporting, claim scrubbing, denial tracking
- Strong scheduling and patient payment features
- More customizable but can be more expensive

### 3. **ModMed Podiatry**
Best for: Podiatry-specific EHR plus billing
- Designed with specialty-specific podiatry workflows
- Useful for nail care, wounds, diabetic foot care, orthotics, procedures
- Integrated documentation and billing can reduce coding errors
- Better if you want a full podiatry EHR/PM platform

### 4. **DrChrono**
Best for: Practices that want flexible EHR, billing, and mobile access
- Good iPad/mobile functionality
- Integrated billing, scheduling, EHR, patient portal
- Works well for smaller podiatry offices
- May require setup customization for podiatry-specific needs

### 5. **athenaOne**
Best for: Practices that want outsourced-style billing support
- Strong claims follow-up and payer rules engine
- Good denial management and reporting
- Cloud-based with strong revenue cycle support
- Pricing is often percentage-of-collections, which may or may not fit your budget

### 6. **RXNT**
Best for: Budget-conscious practices
- Affordable billing and practice management tools
- Claims, eligibility, ERA/EOB posting, patient payments
- Good option if you do not need a highly specialized podiatry EHR

## Features podiatry practices should prioritize

Look for software that handles:

- Medicare and commercial payer claims
- Routine foot care billing rules
- Diabetic foot care documentation
- Wound care coding support
- Orthotics, DME, and diabetic shoe billing
- Modifier support, especially podiatry-related modifiers
- Prior authorizations and eligibility checks
- Integrated clearinghouse
- ERA/EOB auto-posting
- Denial management and A/R reporting
- Patient statements and online payments
- EHR integration if not all-in-one

## My practical recommendation

For most podiatry practices:

- **Best podiatry-specific option:** **ModMed Podiatry**
- **Best overall billing/practice management option:** **AdvancedMD**
- **Best for small practices:** **Tebra/Kareo**
- **Best for outsourced revenue cycle support:** **athenaOne**
- **Best budget option:** **RXNT**

If your practice bills a lot of **routine foot care, diabetic shoes, orthotics, wound care, and Medicare claims**, choose a system with strong podiatry-specific coding and documentation support rather than a generic billing platform.


How do small medical practices choose billing software?

Small medical practices typically choose billing software by balancing cost, ease of use, compliance, and fit with their workflow. Key factors include:

1. **Practice needs**
   - Specialty-specific billing requirements
   - Number of providers and locations
   - In-house billing vs. outsourced billing
   - Volume of claims and patient payments

2. **Ease of use**
   - Simple claim creation and submission
   - Clear dashboards for denials, unpaid claims, and patient balances
   - Minimal training burden for staff

3. **Integration**
   - Compatibility with the practice’s EHR/EMR
   - Scheduling and patient portal integration
   - Payment processing and accounting connections

4. **Insurance and claims features**
   - Electronic claim submission
   - Eligibility verification
   - Claim scrubbing before submission
   - Denial management
   - ERA/EOB posting
   - Patient statement generation

5. **Compliance and security**
   - HIPAA compliance
   - Secure data storage and access controls
   - Audit trails and user permissions

6. **Cost**
   - Monthly subscription fees
   - Setup or implementation costs
   - Clearinghouse fees
   - Payment processing fees
   - Charges for extra users, training, or support

7. **Support and training**
   - Responsive customer service
   - Onboarding help
   - Billing-specific support, not just technical support
   - Availability during business hours

8. **Reporting**
   - Accounts receivable aging
   - Reimbursement trends
   - Denial rates
   - Provider productivity
   - Patient collections

9. **Scalability**
   - Ability to add providers, locations, or services
   - Support for future growth without needing a full system change

10. **Vendor reputation**
   - Reviews from similar practices
   - References from other medical offices
   - Reliability, uptime, and product history

A practical selection process is to list must-have features, compare 3–5 vendors, request demos, ask about total costs, verify EHR compatibility, and involve both billing staff and providers before making a decision.


Medical billing and revenue cycle management tools for independent healthcare providers

Here are common **medical billing and revenue cycle management (RCM) tools for independent healthcare providers**, including solo practices and small clinics.

## Popular Medical Billing & RCM Tools

### 1. **Kareo / Tebra**
Best for: Independent practices
Features:
- Claims submission
- Patient billing
- Insurance verification
- EHR + practice management options
- Reporting and analytics

### 2. **AdvancedMD**
Best for: Growing private practices
Features:
- Practice management
- Claims scrubbing
- Payment posting
- Scheduling
- EHR integration
- Patient portal

### 3. **athenaCollector / athenaOne**
Best for: Practices wanting outsourced RCM support
Features:
- Cloud-based billing
- Denial management
- Eligibility checks
- Patient collections
- Benchmarking and reporting

### 4. **DrChrono**
Best for: Small practices needing EHR + billing
Features:
- EHR and billing platform
- Claims management
- Patient payments
- Mobile-friendly interface
- Scheduling

### 5. **Office Ally**
Best for: Budget-conscious providers
Features:
- Clearinghouse services
- Claims submission
- Eligibility verification
- Practice management tools
- Lower-cost option

### 6. **TherapyNotes**
Best for: Mental health providers
Features:
- Behavioral health EHR
- Billing and claims
- Scheduling
- Notes and documentation
- ERA payment posting

### 7. **SimplePractice**
Best for: Therapists, counselors, and wellness providers
Features:
- Client scheduling
- Telehealth
- Insurance billing
- Superbills
- Patient payments

### 8. **RXNT**
Best for: Small medical practices
Features:
- Medical billing
- EHR
- E-prescribing
- Scheduling
- Claims and denial tracking

### 9. **CollaborateMD**
Best for: Billing-focused practices
Features:
- Claims management
- Eligibility checks
- Payment posting
- Reporting
- Clearinghouse integrations

### 10. **Waystar**
Best for: More advanced RCM needs
Features:
- Claims clearinghouse
- Denial prevention
- Eligibility verification
- Patient payment tools
- Analytics

## Key Features to Look For

When choosing an RCM or billing tool, look for:

- Claims submission and tracking
- Claims scrubbing before submission
- Eligibility and benefits verification
- ERA/EOB posting
- Denial management
- Patient statements
- Online payments
- Reporting and analytics
- EHR integration
- HIPAA compliance
- Specialty-specific workflows

## Best Options by Provider Type

| Provider Type | Good Options |
|---|---|
| Solo physician | Tebra, DrChrono, RXNT |
| Mental health provider | SimplePractice, TherapyNotes |
| Small medical group | AdvancedMD, athenaOne |
| Low-cost billing needs | Office Ally, CollaborateMD |
| Outsourced RCM support | athenaOne, Tebra, AdvancedMD |

## Choosing the Right Tool

Independent providers should consider:

1. **Specialty fit**
2. **Monthly cost and claim fees**
3. **EHR integration**
4. **Ease of use**
5. **Customer support quality**
6. **Clearinghouse connections**
7. **Denial management capabilities**
8. **Patient payment features**

For many independent practices, **Tebra, AdvancedMD, DrChrono, SimplePractice, and TherapyNotes** are among the most commonly used options.


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

The “best” billing software depends on your practice size, payer mix, and whether you need a full behavioral health EHR or just billing/RCM. For most outpatient behavioral health practices, these are strong options:

### Best overall for outpatient behavioral health: **TherapyNotes**
Good fit for solo to mid-sized therapy/behavioral health practices.
**Strengths:** insurance claims, ERA/EOB posting, eligibility checks, scheduling, clinical notes, client portal, telehealth, strong behavioral health focus.

### Best for solo or small private practices: **SimplePractice**
Very user-friendly and popular among therapists.
**Strengths:** easy billing, superbills, claims, online payments, telehealth, client portal.
**Potential downside:** may be less robust for larger multi-provider billing operations.

### Best for psychiatry or medication management: **Valant**
Designed more specifically for behavioral health and psychiatry.
**Strengths:** e-prescribing, medication management, outcomes tracking, billing, scheduling.
**Potential downside:** can be more complex and expensive.

### Best for larger or billing-heavy practices: **AdvancedMD** or **Tebra/Kareo**
Good if you need more advanced practice management and revenue cycle tools.
**Strengths:** robust claims management, reporting, clearinghouse tools, payment posting.
**Potential downside:** less behavioral-health-specific than TherapyNotes or Valant.

### Best budget-friendly option: **TheraNest**
Often used by counseling and group therapy practices.
**Strengths:** billing, notes, scheduling, client portal, group practice features.
**Potential downside:** user experience and reporting may not be as polished as some competitors.

## My recommendation
For a typical outpatient behavioral health practice, I’d start by evaluating:

1. **TherapyNotes** — best all-around choice
2. **SimplePractice** — best for small/solo practices
3. **Valant** — best if psychiatry/med management is central
4. **AdvancedMD or Tebra** — best for complex billing or larger practices

If you tell me your practice size, whether you take insurance, and whether you need therapy-only vs psychiatry/med management, I can narrow it to the best 1–2 options.


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

If your main problem is **manual claim entry errors**, buy a system that combines **EHR/practice management integration + claim scrubbing + clearinghouse submission + ERA/EFT posting**.

### Best options to evaluate

| Best for | Software to consider |
|---|---|
| Small to mid-size practices wanting easier billing automation | **Tebra/Kareo**, **AdvancedMD**, **DrChrono** |
| Larger practices or multi-specialty groups | **athenaOne/athenaCollector**, **NextGen**, **eClinicalWorks** |
| Strong clearinghouse/claim scrubbing layer | **Waystar**, **Availity**, **Office Ally**, **Optum/Change Healthcare** |
| Revenue cycle management with denial workflows | **Waystar**, **athenahealth**, **AdvancedMD**, **NextGen** |

### My practical recommendation

If you already have an EHR, first choose a billing platform that **integrates tightly with your current EHR**. That will reduce duplicate entry the most.

If you want a strong standalone billing/clearinghouse solution, start with:

1. **Waystar** — strong claim scrubbing, eligibility, denial management, automation.
2. **Availity** — widely used for payer connectivity and eligibility/claims.
3. **AdvancedMD** — good practice management + billing automation for small/mid-size practices.
4. **athenahealth** — strong outsourced/tech-enabled billing and revenue cycle tools.

### Features you should require

- Electronic claim submission
- Real-time eligibility verification
- Automated claim scrubbing before submission
- CPT/ICD-10/NPI/modifier validation
- ERA/EFT auto-posting
- Denial tracking and workqueues
- Patient statements and online payments
- Reporting by payer, provider, denial reason, and aging
- HIPAA compliance and signed BAA
- Integration with your EHR/scheduling system

### Before buying, ask vendors for a live demo using your real claim scenarios

Have them process sample claims from your top payers and show:

- How errors are caught before submission
- How rejected claims are corrected
- How ERA payments are posted
- How denials are tracked
- How much manual data entry remains

If you tell me your **practice size, specialty, current EHR, number of providers, and monthly claim volume**, I can narrow this to 2–3 best-fit products.


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

Here are strong HIPAA-compliant medical billing software options for a small practice offering both telehealth and in-person care:

## Top options to consider

### 1. **AdvancedMD**
Best for: Small to mid-sized practices wanting robust billing + EHR
- Medical billing and claims management
- Telehealth support
- Scheduling, eligibility checks, reporting
- Patient portal and payment tools
- Offers HIPAA-focused security and BAAs

### 2. **Kareo / Tebra**
Best for: Small independent practices
- Practice management and billing
- Claims submission and denial management
- Patient payments and statements
- Telehealth and EHR options
- Good fit for solo and small-group practices

### 3. **SimplePractice**
Best for: Behavioral health, therapy, wellness, and small clinics
- Easy scheduling and billing
- Telehealth built in
- Insurance claim filing
- Client portal and online payments
- Common choice for small hybrid practices

### 4. **DrChrono**
Best for: Practices wanting EHR + billing + mobile access
- Integrated EHR and revenue cycle tools
- Telehealth, scheduling, e-prescribing
- Claims and patient payments
- Good iPad/mobile experience

### 5. **athenaOne**
Best for: Practices wanting more advanced billing support
- EHR, billing, scheduling, patient engagement
- Strong claims and revenue cycle tools
- Telehealth integrations
- May be more expensive but robust

### 6. **TherapyNotes**
Best for: Mental health practices
- Billing, claims, notes, scheduling
- Telehealth available
- Insurance eligibility and ERA support
- Designed specifically for behavioral health

---

## What to verify before choosing

For HIPAA compliance, make sure the vendor provides:

- A signed **Business Associate Agreement**
- HIPAA-compliant data storage and encryption
- Role-based user permissions
- Audit logs
- Secure patient messaging
- Secure payment processing
- Telehealth that is HIPAA-compliant
- Claims clearinghouse integration
- Eligibility verification
- ERA/EOB posting
- Patient statements and online payments

---

## Best picks by practice type

| Practice Type | Best Fit |
|---|---|
| Solo or small medical practice | Tebra, DrChrono, AdvancedMD |
| Therapy / behavioral health | SimplePractice, TherapyNotes |
| Hybrid telehealth + in-person | SimplePractice, Tebra, AdvancedMD |
| More complex billing needs | AdvancedMD, athenaOne |
| Budget-conscious startup | SimplePractice, Tebra |

---

## My practical recommendation

For a small telehealth and in-person practice, I’d start by comparing:

1. **Tebra** – best overall small-practice billing platform
2. **SimplePractice** – easiest if you need built-in telehealth and simple billing
3. **AdvancedMD** – best if you want a more complete medical billing system

Before signing, ask each vendor:
“Do you provide a BAA, and is your billing, patient portal, payment system, and telehealth platform all covered under HIPAA?”


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

For submitting both **CMS-1500 professional claims** and **UB-04 institutional claims**, the best choice is usually a **clearinghouse or RCM platform** that supports both **837P** and **837I** electronic claim formats.

### Best overall options

| Platform | Best for | Notes |
|---|---|---|
| **Waystar** | Best overall for professional + institutional billing | Strong claim scrubbing, payer connectivity, eligibility, ERAs, denials |
| **Availity** | Best for payer portal access and eligibility | Very common for commercial payers; supports many EDI workflows |
| **Office Ally** | Best lower-cost option | Good for smaller practices; CMS-1500 support is strong, UB support may depend on setup |
| **AdvancedMD** | Best for practices needing practice management + billing | Good if you want scheduling, EHR, billing, clearinghouse features together |
| **CollaborateMD** | Best for small to mid-size billing companies | Handles professional claims well; verify UB-04/837I needs before choosing |
| **TriZetto / Cognizant** | Best for larger groups and enterprise billing | Strong clearinghouse and payer connectivity |
| **Optum / Change Healthcare** | Large-scale clearinghouse option | Broad payer network; often used by hospitals and large organizations |

### My recommendation

If you need one platform for both **CMS-1500 and UB-04**, start with:

1. **Waystar** — best all-around billing/clearinghouse platform
2. **Availity** — excellent payer connectivity and eligibility tools
3. **Office Ally** — good budget-friendly option, especially for smaller providers

### Before choosing, confirm the platform supports:

- **CMS-1500 / 837P** professional claims
- **UB-04 / 837I** institutional claims
- Medicare, Medicaid, and commercial payer connectivity
- Claim scrubbing and rejection management
- ERA/EOB posting
- Secondary claims
- Eligibility verification
- Batch claim submission
- Payer enrollment support

If you are a **billing company or facility submitting both professional and institutional claims**, I’d lean toward **Waystar** or **TriZetto**. If you are a **small practice**, I’d compare **Office Ally, AdvancedMD, and Availity** first.


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

For a **2-doctor clinic**, the most cost-effective medical billing software is usually one that includes **practice management + claims submission + payment posting + patient statements**, without forcing you into an expensive full EHR bundle.

### Good cost-effective options to compare

| Software | Best for | Notes |
|---|---|---|
| **Tebra / Kareo** | Small practices wanting easy billing + optional EHR | Popular with small clinics; good claims tools; pricing varies by package |
| **AdvancedMD** | Clinics needing stronger billing automation | More robust, but can be pricier; good if claim volume is high |
| **DrChrono** | Practices wanting EHR + billing together | Works well for small clinics; iPad-friendly; add-ons may increase cost |
| **CollaborateMD** | Budget-conscious billing-focused clinics | Good claims management; often more affordable than full-suite systems |
| **PracticeSuite** | Low-cost billing + PM option | Flexible pricing; decent for small practices |
| **EZClaim** | Very low-cost billing-only option | Good if you don’t need a full EHR; simple claims submission |

### My practical recommendation

For a **2-provider clinic**, shortlist these first:

1. **CollaborateMD** – strong value if you mainly need billing and claims
2. **Tebra/Kareo** – good all-around choice for small practices
3. **PracticeSuite** – worth checking if budget is the top priority
4. **EZClaim** – best if you only need basic billing software

### Features you should make sure are included

- Electronic claims submission
- Eligibility verification
- ERA/EOB posting
- Claim scrubbing
- Denial management
- Patient statements and online payments
- Reporting by provider, payer, CPT code, A/R aging
- Clearinghouse integration
- HIPAA compliance
- EHR integration if you already use one

### Cost tip

Ask vendors for the **total monthly cost for 2 providers**, including:

- Provider licenses
- Clearinghouse fees
- Claim submission fees
- Eligibility checks
- Patient statements
- Setup/training fees
- Data migration fees
- Contract length and cancellation terms

If you want the lowest-cost setup, consider **EZClaim or CollaborateMD**. If you want a more complete small-practice platform, compare **Tebra/Kareo and DrChrono**.


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

Medical billing services and professional billers commonly recommend software based on the provider’s specialty, claim volume, EHR needs, and whether you need full revenue cycle management or just claims submission. Popular options include:

### Commonly recommended medical billing software

| Software | Best for |
|---|---|
| **AdvancedMD** | Multi-provider practices, strong billing and reporting |
| **Tebra / Kareo** | Small to mid-sized practices, independent providers |
| **athenaCollector / athenaOne** | Practices wanting cloud-based billing plus RCM support |
| **eClinicalWorks** | Practices needing integrated EHR and billing |
| **NextGen Healthcare** | Larger practices and specialty groups |
| **DrChrono** | Small practices wanting EHR, scheduling, and billing together |
| **Office Ally** | Lower-cost claims submission and clearinghouse functions |
| **CollaborateMD** | Billing companies and small practices needing claim management |
| **TherapyNotes** | Behavioral health and mental health billing |
| **SimplePractice** | Therapists, counselors, and solo behavioral health providers |
| **WebPT** | Physical therapy, occupational therapy, rehab practices |
| **NueMD** | Small medical offices and billing services |
| **RXNT** | Affordable cloud-based billing and practice management |

### What billers usually look for

Medical billers often recommend software with:

- Integrated clearinghouse access
- Eligibility verification
- ERA/EOB posting
- Denial management tools
- Strong reporting and aging reports
- Easy claim scrubbing
- Good customer support
- Specialty-specific templates and codes
- Integration with the provider’s EHR

### Best overall picks

For many billing services, the most commonly recommended options are:

- **AdvancedMD** — strong all-around billing platform
- **Tebra/Kareo** — good for small practices
- **athenahealth** — good for practices wanting more automation and RCM support
- **CollaborateMD** — popular with billing companies
- **Office Ally** — budget-friendly option

The “best” choice depends heavily on the specialty, claim volume, budget, and whether the practice already uses an EHR.


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

Here are some of the best all-in-one practice management and medical billing software options for a small clinic:

## Top choices

### 1. **Kareo / Tebra**
**Best for:** Small independent practices
**Why it’s good:** Easy-to-use scheduling, billing, claims, patient payments, and optional EHR. Strong fit for smaller clinics that want an all-in-one system without enterprise complexity.
**Consider if:** You want medical billing + practice management in one platform.

### 2. **AdvancedMD**
**Best for:** Growing small to mid-sized clinics
**Why it’s good:** Robust practice management, billing, EHR, reporting, patient portal, telehealth, and revenue cycle tools.
**Consider if:** You need more customization and advanced billing features.

### 3. **DrChrono**
**Best for:** Mobile-friendly practices
**Why it’s good:** Strong iPad/iPhone experience, EHR, scheduling, billing, patient communication, and e-prescribing.
**Consider if:** Your providers prefer mobile or tablet-based workflows.

### 4. **athenaOne**
**Best for:** Clinics wanting strong billing support
**Why it’s good:** Includes EHR, practice management, patient engagement, and revenue cycle management. Athena is known for claims/billing workflow support.
**Consider if:** You want help improving collections and reducing claim denials.

### 5. **NextGen Office**
**Best for:** Specialty practices
**Why it’s good:** Cloud-based EHR and practice management with billing, templates, patient portal, and reporting.
**Consider if:** You have specialty-specific documentation or billing needs.

### 6. **RXNT**
**Best for:** Budget-conscious small clinics
**Why it’s good:** Offers EHR, scheduling, billing, e-prescribing, and patient portal at relatively competitive pricing.
**Consider if:** Cost is a major factor but you still want an integrated system.

---

## Best overall recommendation for a small clinic

If you want a balanced, all-in-one solution, I’d start with:

**Tebra/Kareo** — best for many small independent clinics
**AdvancedMD** — best if you need more advanced billing and scalability
**athenaOne** — best if billing performance and revenue cycle support are top priorities

---

## What to compare before choosing

Look closely at:

- Monthly cost and setup fees
- Claim submission and denial management tools
- EHR included or separate
- Patient portal and online payments
- Eligibility verification
- Reporting and revenue analytics
- Specialty-specific templates
- Clearinghouse fees
- Contract length and cancellation terms
- Quality of customer support

For a small clinic, the best choice is usually the one that combines **easy scheduling, clean claim submission, patient payments, and solid support** without locking you into a system that is too complex or expensive.


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

If you’re looking for a **medical practice billing system with a strong patient portal and online payment collection**, consider these options:

### Strong all-around options

**1. AdvancedMD**
- Good for independent practices
- Medical billing + scheduling + EHR + patient portal
- Online payments, payment plans, statements
- Strong reporting and revenue cycle tools

**2. athenahealth**
- Very strong revenue cycle management
- Patient portal, online bill pay, automated reminders
- Good for practices that want outsourced/assisted billing workflows
- Best for groups needing robust claims support

**3. Tebra / Kareo**
- Popular with small to midsize practices
- Billing, claims, patient portal, online payments
- Easier to use than some enterprise systems
- Good option if you want practice management without too much complexity

**4. DrChrono**
- EHR + billing + patient portal
- Online payments and intake forms
- Strong for mobile/iPad-friendly practices
- Good for smaller practices and specialty clinics

**5. NextGen Healthcare**
- Strong for larger or multi-location practices
- Robust portal, billing, claims, patient engagement
- More complex but highly configurable

### Specialty-specific options

**Behavioral health:**
- **SimplePractice**
- **TherapyNotes**
- **Valant**

**Chiropractic / wellness / cash-pay-heavy clinics:**
- **Jane App**
- **ChiroTouch**
- **Nextech**, depending on specialty

**Dermatology / ophthalmology / specialty care:**
- **ModMed**
- **Nextech**

### Key features to require

Look for:

- HIPAA-compliant patient portal
- Online bill pay by credit card, ACH, Apple Pay/Google Pay if needed
- Card-on-file and recurring/payment plans
- Automated patient statements by text, email, and paper
- Eligibility verification
- Claim scrubbing and electronic claim submission
- ERA/EOB posting
- Appointment reminders and online scheduling
- Transparent payment processing fees
- Integration with your EHR if separate
- Patient intake forms and consent forms
- Reporting for A/R, collections, denials, and unpaid balances

### My shortlist recommendation

For a typical small-to-midsize medical practice, I’d compare:

1. **AdvancedMD** – best balanced billing + portal + payments
2. **Tebra/Kareo** – simpler, small-practice friendly
3. **athenahealth** – strongest if revenue cycle performance is the priority
4. **DrChrono** – good if you want modern EHR + billing together

If you tell me your **practice size, specialty, current EHR, and whether you do in-house or outsourced billing**, I can narrow this down to the best 2–3 options.


Which medical billing software offers the best insurance denial tracking?

The “best” medical billing software for insurance denial tracking depends on your practice size and workflow, but these are commonly strong options:

| Software | Best For | Denial Tracking Strengths |
|---|---|---|
| **Waystar** | Large practices, hospitals, RCM teams | Very strong denial analytics, payer-specific trends, automated worklists, appeal support |
| **Experian Health ClaimSource / Denial Workflow Manager** | Hospitals and health systems | Advanced denial categorization, root-cause analysis, workflow management |
| **athenaCollector / athenaOne** | Small to mid-size practices wanting outsourced-style RCM support | Good denial follow-up tools, rules engine, claim scrubbing, payer performance insights |
| **AdvancedMD** | Independent practices | Solid denial management dashboards, claim tracking, automated corrections |
| **Tebra / Kareo** | Small practices | Easy-to-use denial tracking, claim status updates, basic reporting |
| **DrChrono** | Practices wanting integrated EHR + billing | Good claim tracking and denial visibility, especially for smaller offices |
| **NextGen Healthcare** | Specialty and larger ambulatory practices | Strong reporting, denial workflows, payer trend analysis |

**Best overall for denial tracking:** **Waystar**
**Best for hospitals/health systems:** **Experian Health**
**Best for small to mid-size practices:** **athenaOne** or **AdvancedMD**
**Best budget-friendly option:** **Tebra/Kareo**

When comparing options, look for: denial reason analytics, automated payer follow-up, appeal letter support, work queues, claim scrubbing, ERA/EOB integration, and reporting by payer, CPT code, provider, and location.


Top medical billing platforms for cardiology practices

Here are some of the top medical billing/RCM platforms commonly considered by cardiology practices:

| Platform | Best fit | Why it’s strong for cardiology |
|---|---|---|
| **athenaOne / athenaCollector** | Small to large cardiology groups | Strong claims management, denial tracking, payer rules engine, integrated EHR/PM option |
| **AdvancedMD** | Independent cardiology practices | Good scheduling, billing, clearinghouse tools, reporting, and specialty workflow flexibility |
| **NextGen Healthcare** | Mid-size to large specialty groups | Robust EHR + PM + billing, strong interoperability, good for complex specialty workflows |
| **eClinicalWorks** | Practices wanting integrated EHR/PM | Affordable all-in-one system with billing, patient portal, and population health tools |
| **Greenway Health / Intergy** | Specialty practices | Solid practice management and billing tools with specialty configuration options |
| **Tebra / Kareo** | Small cardiology practices | Easier implementation, cloud-based billing, claims tracking, patient payments |
| **CareCloud** | Growing cardiology groups | RCM services, analytics, denial management, patient engagement tools |
| **Waystar** | Practices with existing EHR/PM | Excellent clearinghouse, eligibility, prior authorization, claims scrubbing, payment tools |
| **ModMed** | Specialty-focused practices | Strong specialty workflows, though cardiology fit should be evaluated carefully |
| **DrChrono** | Smaller practices needing mobility | Cloud/iPad-friendly EHR, billing, claims, and patient engagement features |

Key features cardiology practices should prioritize:

- Cardiology-specific CPT and ICD-10 support
- Prior authorization management for imaging, procedures, and diagnostics
- Claims scrubbing for echo, stress tests, EKG, Holter, cath, EP, and device-related billing
- Modifier and bundling compliance
- Denial management and appeals tracking
- Integration with cardiology EHR, PACS, labs, and diagnostic systems
- Strong reporting by provider, location, payer, and procedure
- Patient payment tools and eligibility verification
- MIPS/MACRA quality reporting support

For many cardiology practices, **athenahealth, NextGen, AdvancedMD, CareCloud, and Waystar** are among the strongest options, depending on whether you need a full EHR/PM system or just billing/clearinghouse/RCM support.


Medical billing software comparison for small private medical offices

Below is a practical comparison of medical billing software options for small private medical offices, especially 1–10 provider practices.

## Quick Recommendations

| Best For | Software |
|---|---|
| Small practices wanting simple billing + EHR | **Kareo / Tebra** |
| Practices wanting strong claims management | **AdvancedMD** |
| Budget-conscious offices | **DrChrono** or **PracticeSuite** |
| Primary care or family medicine | **eClinicalWorks**, **Tebra**, **athenaOne** |
| Practices wanting outsourced billing support | **athenaOne**, **Tebra**, **AdvancedMD** |
| Specialty practices needing customization | **AdvancedMD**, **NextGen**, **eClinicalWorks** |

---

## Comparison Table

| Software | Strengths | Potential Drawbacks | Best Fit |
|---|---|---|---|
| **Tebra / Kareo** | User-friendly, good for small practices, integrated billing/EHR, patient payments, reporting | Support reviews are mixed; pricing can rise with add-ons | Small independent practices |
| **AdvancedMD** | Robust billing tools, strong scheduling, claims tracking, good analytics | Can be more expensive and complex | Growing practices or specialty offices |
| **athenaOne** | Cloud-based, strong claims follow-up, good denial management, optional RCM services | Usually percentage-based pricing; may be costly | Practices wanting billing help and automation |
| **DrChrono** | Modern interface, good mobile/iPad support, EHR + billing, patient portal | Billing features may be lighter than enterprise systems | Small offices wanting easy EHR/billing |
| **eClinicalWorks** | Popular EHR + billing platform, broad features, good for primary care | Interface can feel dated; onboarding may take effort | Primary care and multi-provider offices |
| **NextGen** | Strong specialty support, scalable, comprehensive reporting | More complex and expensive | Specialty or larger private practices |
| **PracticeSuite** | Affordable, flexible billing, cloud-based, good for small offices | Interface may be less polished | Cost-conscious practices |
| **CareCloud** | Attractive interface, EHR + billing + patient engagement | Pricing and support vary by package | Small to midsize practices |

---

## Key Features to Compare

When choosing billing software, focus on:

1. **Claims submission**
   - Electronic claims
   - Real-time claim status
   - Clearinghouse integration

2. **Denial management**
   - Denial tracking
   - Automated corrections
   - Appeal workflows

3. **Eligibility verification**
   - Real-time insurance checks
   - Copay/deductible information

4. **Patient billing**
   - Online payments
   - Payment plans
   - Text/email statements

5. **EHR integration**
   - Built-in EHR or compatible with your current system
   - Charge capture from clinical notes

6. **Reporting**
   - Aging reports
   - Collections
   - Denials
   - Provider productivity

7. **Ease of use**
   - Staff training time
   - Clean billing dashboard
   - Good customer support

8. **Pricing**
   - Monthly subscription
   - Per-provider fees
   - Clearinghouse fees
   - Setup/training fees
   - Percentage-of-collections pricing

---

## Pricing Models to Watch

Medical billing software usually uses one of these models:

| Pricing Type | Description |
|---|---|
| Monthly subscription | Flat monthly fee per provider or practice |
| Per-claim fee | Fee for each submitted claim |
| Percentage of collections | Common when revenue cycle management is included |
| Add-on pricing | Extra fees for reminders, eligibility, clearinghouse, patient payments |

For small offices, be careful with hidden fees such as implementation, training, data migration, claim submission, and support.

---

## Best Overall Choices for Small Private Offices

### 1. **Tebra / Kareo**
Good balance of usability, billing features, and small-practice focus.

### 2. **AdvancedMD**
Best if you want more advanced billing, reporting, and workflow customization.

### 3. **athenaOne**
Best if you want strong claims support and are comfortable with a more service-oriented pricing model.

### 4. **PracticeSuite**
Good lower-cost option for practices mainly focused on billing efficiency.

---

## My Practical Recommendation

For a small private medical office:

- Choose **Tebra/Kareo** if you want a simple all-in-one EHR and billing system.
- Choose **AdvancedMD** if billing complexity, reporting, and claim tracking are top priorities.
- Choose **athenaOne** if you want more hands-on revenue cycle support.
- Choose **PracticeSuite** if cost control is the biggest concern.

Before signing, request demos from 2–3 vendors and ask for a sample monthly bill including all fees.