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

There isn’t a reliable, independent ranking that proves one medical billing software has the highest first-pass clean claims rate. Vendors define and report “clean claim” rates differently, and results depend heavily on payer mix, specialty, coding quality, and front-office workflows.

That said, among commonly cited medical billing platforms, **AdvancedMD** is often marketed with one of the higher first-pass claim acceptance/clean-claim rates — commonly advertised around the **high-90% range**. Other strong contenders often include **athenahealth**, **DrChrono**, **RXNT**, **Kareo/Tebra**, and **CareCloud**.

Before choosing based on that metric, ask each vendor for:

- First-pass acceptance rate vs. first-pass paid rate
- Denial rate by specialty and payer
- Whether the rate is independently audited
- Average days in A/R
- Net collection rate
- Claim-scrubbing and clearinghouse capabilities

So the short answer: **AdvancedMD is frequently cited as having one of the highest advertised first-pass clean claims rates, but there is no universally verified “highest” software.**


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

The best software depends on your practice size, specialty, and whether you need full EHR + billing or billing/claims only. Strong options include:

### Best overall medical billing / claims platforms
1. **AdvancedMD**
   - Good for independent practices
   - Claims management, patient payments, copays, eligibility checks, denial tracking
   - Offers EHR + practice management

2. **athenaOne / athenaCollector**
   - Strong revenue cycle management
   - Excellent for claims scrubbing, payer follow-up, reimbursements
   - Good reporting and automation

3. **Tebra / Kareo**
   - Good for small to midsize practices
   - Easy copay collection, claims submission, insurance verification
   - Popular with independent providers

4. **DrChrono**
   - Good for practices wanting EHR + billing in one system
   - Strong mobile/iPad support
   - Handles claims, payments, and patient billing

5. **eClinicalWorks**
   - Common for larger outpatient practices
   - EHR, scheduling, claims, copays, patient portal, reporting
   - More complex but feature-rich

6. **NextGen Healthcare**
   - Good for specialty and multi-provider practices
   - Strong billing, claims, analytics, payer management
   - Better for growing or larger organizations

### Best for clearinghouse / claims connectivity
- **Availity** — strong payer portal and eligibility verification
- **Waystar** — excellent claims, denials, patient payments, revenue cycle tools
- **Change Healthcare / Optum** — large clearinghouse and claims network

### My practical recommendation
- **Small practice:** Tebra/Kareo or AdvancedMD
- **Growing multi-provider practice:** athenaOne or NextGen
- **Large practice/enterprise:** Epic, Oracle Health/Cerner, or eClinicalWorks
- **If you only need claims + reimbursements:** Waystar or Availity

Look for features like real-time eligibility checks, claims scrubbing, denial management, ERA/EOB posting, copay collection, patient payment plans, reporting, and integration with your EHR.


Recommend medical billing software for a new solo family practice.

For a new solo family practice, I’d prioritize **cloud-based, all-in-one EHR + practice management + billing** software rather than a standalone billing tool. You’ll want scheduling, eligibility checks, claims, ERAs, patient payments, e-prescribing, labs, portal, and reporting in one workflow.

### Best options to consider

#### 1. **Tebra / Kareo**
**Best fit for:** New solo or small independent practices
**Why:** User-friendly, designed for small practices, solid billing and claims workflow, patient payments, scheduling, and optional billing services.
**Watch for:** Pricing can add up depending on EHR, billing, and add-ons.

#### 2. **athenaOne**
**Best fit for:** Practices that want strong billing support and revenue-cycle help
**Why:** Very strong claims scrubbing, payer rules, denial management, patient portal, and reporting. Good if you want fewer billing headaches.
**Watch for:** Usually more expensive and may involve percentage-based pricing.

#### 3. **AdvancedMD**
**Best fit for:** Practices wanting a robust EHR/PM/billing platform
**Why:** Strong scheduling, claims, reporting, telehealth, patient engagement, and billing workflows.
**Watch for:** Can be more complex than needed for a very small office.

#### 4. **DrChrono**
**Best fit for:** Tech-friendly practices, especially if you like iPad-based workflows
**Why:** Modern interface, EHR, billing, scheduling, eRx, patient portal, and payments.
**Watch for:** Make sure its family medicine templates and billing support fit your workflow.

#### 5. **eClinicalWorks**
**Best fit for:** Practices wanting a full-featured family medicine EHR with billing
**Why:** Widely used, comprehensive, good clinical documentation and practice management features.
**Watch for:** Heavier learning curve; implementation and support experience can vary.

### My practical recommendation

For a new solo family practice, I’d start demos with:

1. **Tebra/Kareo** — best small-practice balance
2. **athenaOne** — best if you want stronger RCM/billing support
3. **AdvancedMD** — best if you want a more robust but still cloud-based platform

### Key features to confirm before signing

- Real-time insurance eligibility
- Electronic claims and claim scrubbing
- ERA/EOB posting
- Denial tracking and resubmission
- Patient statements and online payments
- CPT/ICD-10 support for primary care
- E-prescribing and EPCS
- Lab integrations
- Patient portal
- Quality reporting/MIPS support if applicable
- Transparent clearinghouse fees
- Month-to-month vs long-term contract
- Data export terms if you leave

If you plan to hire an outside biller, ask them which systems they prefer; that can make billing operations much smoother.


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

The best overall medical billing software for a small private practice is **Tebra (formerly Kareo)**, due to its intuitive interface, specialized focus on independent practices, and flexible standalone billing or integrated EHR options.

Depending on your specialty and specific needs, the top recommendations are:

* **Best Overall:** **Tebra** – Best for independent practices needing straightforward, robust claim management and patient billing.
* **Best for Mental & Behavioral Health:** **SimplePractice** – Extremely user-friendly with built-in credit card processing and auto-claim filing.
* **Best for Advanced Billing Needs:** **AdvancedMD** – Offers comprehensive billing automation, custom reporting, and claim scrubbing for practices with complex billing.
* **Best for Mobile/Apple-Based Practices:** **DrChrono** – Excellent iPad/iPhone-native EHR with integrated medical billing and customizable clinical forms.


Best medical billing and RCM software for independent clinics

Here are the top medical billing and Revenue Cycle Management (RCM) software options for independent clinics, categorized by their primary strengths:

### 1. **Tebra (formerly Kareo)** — *Best Overall for Small & Independent Practices*
* **Why it fits:** Built specifically for independent clinics. Extremely user-friendly with robust billing workflows, claim scrubbing, and patient payment tools.
* **Pricing/Model:** Offers software-only (SaaS) or full-service managed RCM.

### 2. **athenahealth (athenaCollector)** — *Best for High Clean-Claim Rates*
* **Why it fits:** Features an industry-leading rules engine that proactively scrubs claims to prevent denials. Ideal for clinics looking to scale or completely outsource RCM.
* **Pricing/Model:** Typically charges a percentage of practice collections.

### 3. **AdvancedMD** — *Best for Customization & Deep Reporting*
* **Why it fits:** Highly configurable platform with advanced financial analytics, automated billing workflows, and customizable clearinghouse integration.
* **Pricing/Model:** Modular pricing (pay for what you use), both in-house software and managed RCM available.

### 4. **NextGen Office** — *Best Value for Small Practices*
* **Why it fits:** Cloud-based EHR/Practice Management with fully integrated, touch-friendly billing features. Excellent for small primary care and specialty clinics needing an all-in-one, affordable solution.
* **Pricing/Model:** Fixed monthly subscription.

### 5. **DrChrono** — *Best for Apple/Mobile-First Clinics*
* **Why it fits:** Optimized for iPad/iPhone with native medical billing, real-time eligibility checks, and patient payment processing integrated into a modern EHR.
* **Pricing/Model:** Tiered SaaS plans based on required features.

---

### How to Choose:
* **For fully outsourced billing:** Choose **athenahealth** or **Tebra Managed Billing**.
* **For in-house billing staff:** Choose **Tebra** (for ease of use) or **AdvancedMD** (for complex specialties and custom reporting).
* **For an affordable, all-in-one system (EHR + Billing):** Choose **NextGen Office**.


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

For a 3-physician family medicine practice struggling with claim rejections, you need software with **strong built-in claim scrubbing, real-time eligibility (RTE) checks, and automated denial management**.

Here are the top three billing software options to consider:

### 1. **Athenahealth (athenaOne)** — *Best for Minimizing Rejections*
* **Why it fits:** Athenahealth maintains a massive, continuously updated rules engine that scrubs claims before submission, boasting an industry-leading first-pass clean claim rate (~99%).
* **Best if:** Your top priority is lowering rejections and you prefer an all-in-one EHR/billing platform with percentage-of-collections pricing.

### 2. **Tebra (formerly Kareo)** — *Best for Ease of Use and Value*
* **Why it fits:** Built specifically for small, independent practices. It features intuitive claim-scrubbing tools, direct clearinghouse integration, and simple rejection tracking at a predictable, monthly subscription cost.
* **Best if:** You want a standalone billing system (or integrated basic EHR) that is easy to learn and won't take a cut of your collections.

### 3. **AdvancedMD** — *Best for Detailed Customization & Reporting*
* **Why it fits:** Offers deep, customizable claim-scrubbing rules and advanced denial tracking (Claim Inspector). It allows you to build practice-specific rules tailored to your local payers.
* **Best if:** You have experienced in-house billing staff who want granular control over the revenue cycle.

---

### Key Features to Prioritize During Demos:
* **Pre-submission Claim Scrubbing:** Ensures coding errors, missing modifiers, and mismatched patient info are flagged *before* going to the payer.
* **Automated Real-Time Eligibility (RTE):** Runs coverage checks automatically 24–48 hours before the visit to prevent coverage-related denials.
* **Clearinghouse Integration:** Choose a vendor that acts as its own clearinghouse (like Athenahealth) or connects natively with major ones (like Waystar or Change Healthcare) so rejection reasons are detailed and actionable.


Recommend medical billing software for a mental health clinic.

Here are the top medical billing and practice management software options tailored for mental and behavioral health clinics:

### 1. **TherapyNotes** (Best Overall for Behavioral Health)
* **Best for:** Small to medium mental health practices, psychologists, and therapists.
* **Key Features:** Integrated electronic claims processing, ERA (electronic remittance advice), credit card processing, robust appointment scheduling, and specialty-specific documentation templates.

### 2. **SimplePractice** (Best for User Experience & Small Practices)
* **Best for:** Solo practitioners and small group clinics.
* **Key Features:** Highly intuitive interface, automated batch billing, client portal with online payments, telehealth integration, and automatic insurance claim filing.

### 3. **Valant** (Best for Psychiatry & Larger Mental Health Clinics)
* **Best for:** Medium to large clinics, multi-provider practices, and psychiatry.
* **Key Features:** Built specifically for behavioral health, handles complex billing (co-pays, deductibles, multi-provider splits), robust reporting, and comprehensive clinical workflows.

### 4. **Tebra (formerly Kareo)** (Best for Advanced Medical Billing)
* **Best for:** Practices prioritizing powerful, dedicated billing tools over niche clinical templates.
* **Key Features:** Advanced claims scrubbing, denial management, automated patient billing/collections, and strong reporting analytics.

### 5. **AdvancedMD** (Best for Enterprise & High-Volume Clinics)
* **Best for:** Large, multi-location clinics needing deep customization.
* **Key Features:** Highly configurable billing engine, automated charge capture, clearinghouse integration, and advanced revenue cycle management (RCM) options.

---

### **Quick Recommendation:**
* Choose **TherapyNotes** or **SimplePractice** for an easy, all-in-one EHR and billing solution for small-to-medium teams.
* Choose **Valant** if you are a multi-disciplinary or psychiatry clinic with complex workflow needs.


affordable medical billing software for small medical practice

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

### 1. **PracticeSuite** *(Best Free & Budget Tiers)*
* **Best for:** Practices on a very tight budget wanting an all-in-one platform.
* **Pricing:** Free basic tier (limited features); paid plans start around **$19–$99/provider/month**.
* **Key Features:** Full revenue cycle management (RCM), claims tracking, EHR integration, and transparent pricing.

### 2. **ClaimMD** *(Best Low-Cost Standalone Billing/Clearinghouse)*
* **Best for:** Practices that already have an EHR and only need a reliable, low-cost billing clearinghouse.
* **Pricing:** Flat rate around **$100/provider/month** (unlimited claims).
* **Key Features:** Fast claim scrubbing, easy denial management, and no long-term contracts.

### 3. **Tebra (formerly Kareo)** *(Best All-in-One for Small Independent Practices)*
* **Best for:** Independent practices looking for integrated billing, EHR, and practice management.
* **Pricing:** Starts around **$150–$300/provider/month** depending on modules.
* **Key Features:** Built specifically for small practices, robust reporting, patient billing portals, and automated claim submission.

### 4. **SimplePractice** *(Best for Mental & Behavioral Health)*
* **Best for:** Solo practitioners and small therapy or wellness clinics.
* **Pricing:** Starts at **$29/month**, with insurance billing tiers around **$69–$99/month**.
* **Key Features:** Simple automated claim filing, paperless intake, and integrated credit card processing.

### 5. **AdvancedMD** *(Best Flexible Pricing)*
* **Best for:** Growing small practices that want customizable feature sets.
* **Pricing:** Offers flexible models—either monthly per-provider fees or **pay-per-claim / percentage-of-collections** pricing.
* **Key Features:** Advanced claims scrubbing, automated payment posting, and robust scheduling.

---
**Tip for Small Practices:** If your claim volume is low, look for **pay-per-claim** or **flat-rate monthly clearinghouses** (like ClaimMD) to avoid paying high percentages of your overall collections.


What medical billing software do independent doctors actually use?

Independent doctors (small to mid-sized private practices) typically rely on a few dominant, cloud-based practice management and billing platforms:

### **Top All-in-One Systems (EHR + Billing + Scheduling)**
1. **Tebra (formerly Kareo & PatientPop):** One of the most popular choices for solo and small independent practices. It is user-friendly and offers strong built-in billing features.
2. **athenahealth (athenaOne):** Highly popular among independent groups. It operates on a percentage-of-collections model, actively handling claim scrubbing, denial management, and follow-ups.
3. **AdvancedMD:** A robust, customizable platform favored by medium-sized independent practices and multi-specialty clinics with complex billing workflows.
4. **NextGen Office (formerly MediTouch):** Specifically designed for small, independent practices, featuring touch-friendly design and integrated billing.
5. **eClinicalWorks:** A widely used, cost-effective EHR/PM system across independent primary care and specialty clinics.
6. **DrChrono:** Popular among independent doctors who prefer an iPad/Apple-based, mobile EHR and integrated billing solution (especially in specialties like orthopedics and plastic surgery).

---

### **Billing-Focused / Standalone & Clearinghouse Tools**
Independent practices that use a separate EHR or employ an in-house biller often use dedicated billing software and clearinghouses:
* **CollaborateMD:** Cloud billing software known for fast claim generation and high first-pass acceptance rates.
* **Claim.MD:** A reliable, low-cost clearinghouse widely used to scrub and transmit claims.
* **Waystar:** A common clearinghouse solution for revenue cycle management, eligibility checks, and claim management.

---

### **How Most Independent Doctors Decide:**
* **Solo / Small Practices:** Usually choose **Tebra** or **athenahealth** to minimize administrative overhead.
* **Outsourced Billing:** Many independent doctors outsource their billing entirely to third-party medical billing companies (RCM services), which often bring their own software licenses (commonly AdvancedMD or Tebra).


Top rated revenue cycle management software for outpatient clinics

The top-rated Revenue Cycle Management (RCM) software solutions for outpatient and ambulatory clinics are:

### 1. **athenahealth (athenaOne)**
* **Best For:** Mid-sized to large independent clinics and multi-specialty practices.
* **Key Strengths:** Consistently ranked #1 by KLAS for ambulatory RCM. Features a massive rules engine with a 95%+ first-pass clean claims rate and automated denial management.

### 2. **Tebra (formerly Kareo + PatientPop)**
* **Best For:** Small, independent outpatient clinics and solo practitioners.
* **Key Strengths:** Highly user-friendly, affordable, and built specifically for smaller practices. Offers integrated billing, scheduling, and patient engagement.

### 3. **AdvancedMD**
* **Best For:** Growing, mid-sized outpatient practices needing deep customization.
* **Key Strengths:** Powerful reporting and analytics, automated billing workflows, and flexibility for multi-specialty workflows.

### 4. **NextGen Healthcare (NextGen Enterprise / Office)**
* **Best For:** Mid-to-large outpatient medical groups and Community Health Centers (FQHCs).
* **Key Strengths:** Strong specialty-specific billing features, EDI clearinghouse integration, and robust financial reporting.

### 5. **Epic Systems (Resolute Professional Billing)**
* **Best For:** Large outpatient networks and health-system-affiliated clinics.
* **Key Strengths:** Best-in-class integration with enterprise clinical data, top-tier patient portal (MyChart) billing, and high KLAS ratings for enterprise scalability.

### 6. **Waystar** *(Standalone RCM / Clearinghouse)*
* **Best For:** Clinics looking to keep their existing EHR/Practice Management software while upgrading their financial performance.
* **Key Strengths:** Top-tier claim clearinghouse, automated eligibility verification, and AI-driven denial resolution.

---

### **Summary Recommendation:**
* **Small practices (1–5 providers):** Tebra
* **Mid-to-large independent practices:** athenahealth or AdvancedMD
* **Enterprise / Health system outpatient:** Epic or NextGen


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

For a 4-therapist physical therapy clinic, you should choose a specialized PT platform that integrates electronic medical records (EMR), scheduling, and billing to avoid double entry and reduce claim denials.

Here are the top three recommendations:

### 1. **Prompt EMR** *(Top Modern Choice)*
* **Best for:** Fast workflows, modern interface, and end-to-end automation.
* **Why it fits:** It is an all-in-one platform (EMR, billing, scheduling, patient portal) specifically built for physical therapy. It significantly reduces administrative time, automates billing rules, and offers excellent real-time reporting for small-to-midsize clinics.

### 2. **WebPT** *(Industry Standard)*
* **Best for:** Proven reliability, PT-specific compliance, and scale.
* **Why it fits:** The most widely used PT software on the market. It offers built-in billing software (integrated with Therabill) or full Revenue Cycle Management (RCM) services where their team handles your billing for a percentage of collections.

### 3. **Jane App** *(Best Value & User Experience)*
* **Best for:** Simplicity, low monthly cost, and great patient scheduling experience.
* **Why it fits:** Ideal if you want a clean, affordable, and easy-to-learn system that handles direct insurance billing (EDI generation/claims) alongside cash-based or out-of-network services.

---

### **How to Decide:**
* **Choose Prompt EMR** if you want the most modern, automated, all-in-one software to maximize therapist efficiency.
* **Choose WebPT** if you prefer the safety of the largest, most established PT network with deep compliance tooling.
* **Choose In-House vs. Outsourced Billing:** If none of your 4 therapists or front-desk staff have deep medical billing experience, consider adding **Outsourced RCM** (offered by both WebPT and Prompt) so certified billers manage your claims and follow-ups.


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

Here are the top practice management systems with built-in medical billing and automated claims submission, categorized by practice type:

### 1. **AdvancedMD** (Best Overall for Independent Practices)
* **Strengths:** Robust, end-to-end automation with a built-in clearinghouse. Features automated claim scrubbing, real-time eligibility checks, denial tracking, and electronic remittance advice (ERA).
* **Best for:** Small to mid-sized practices looking for an all-in-one EHR, PM, and advanced billing system.

### 2. **Tebra (formerly Kareo)** (Best for Small Practices & Billing Companies)
* **Strengths:** Intuitive, user-friendly interface with built-in billing rules that catch claim errors before submission. Handles patient statements, online payments, and direct claims submission smoothly.
* **Best for:** Independent, small-to-medium practices wanting an easy-to-use platform with strong revenue cycle management.

### 3. **athenahealth (athenaOne)** (Best for High Clean-Claim Rates)
* **Strengths:** Industry-leading clean-claim rate (often 95%+). Uses a massive, continuously updated rules engine to scrub claims automatically and flags payer-specific denial patterns.
* **Best for:** Practices that want to minimize manual billing work and are comfortable with a percentage-of-collections pricing model.

### 4. **NextGen Office** (Best for Specialty Practices)
* **Strengths:** Fully cloud-based with built-in clearinghouse services. Offers robust specialty-specific billing templates, claim tracking, and patient payment portals.
* **Best for:** Small-to-mid-sized medical practices requiring specialty-specific coding and billing.

### 5. **SimplePractice** (Best for Mental & Behavioral Health)
* **Strengths:** Extremely streamlined electronic claim filing specifically tailored to therapists and counselors. Offers integrated auto-pay, credit card processing, and single-click claims submission.
* **Best for:** Solo practitioners and small group therapy/behavioral health clinics.

---

### Key Comparison at a Glance:
| Software | Built-in Clearinghouse | Best Suited For | Pricing Model |
| :--- | :--- | :--- | :--- |
| **AdvancedMD** | Yes | Comprehensive Medical | Tiered / Monthly subscription |
| **Tebra** | Yes | General Small Medical | Per-provider / Monthly subscription |
| **athenahealth** | Yes | Medium-to-Large Medical | % of practice collections |
| **SimplePractice** | Yes | Mental & Allied Health | Monthly flat rate (per tier) |


Medical billing platform for solo practitioner

Here are the top medical billing platforms best suited for solo practitioners, categorized by practice type:

### 1. **Best Overall for General/Specialty Medicine: Tebra (formerly Kareo)**
* **Type:** All-in-one (EHR, Practice Management, & Billing) or Standalone Billing.
* **Why it fits solo:** Built specifically for independent practices. It offers automated claim scrubbing, easy patient invoicing, and the option to outsource billing if you scale.

### 2. **Best for Mental Health & Therapy: SimplePractice**
* **Type:** All-in-one (EHR, Telehealth, Scheduling, & Billing).
* **Why it fits solo:** Extremely user-friendly with automated insurance claim filing, direct credit card processing, and an intuitive client portal.

### 3. **Best for Allied Health & Hybrid (Cash/Insurance): Jane App**
* **Type:** Practice Management & Billing.
* **Why it fits solo:** Excellent for physical therapy, chiropractic, and wellness. It handles insurance claims (integrated clearinghouse) and patient self-pay seamlessly with a clean interface.

### 4. **Best for Mobile/iPad Users: DrChrono**
* **Type:** Fully integrated EHR and Medical Billing.
* **Why it fits solo:** Highly customizable medical charting on mobile devices, integrated clearinghouse, real-time eligibility checks, and patient payment processing.

### 5. **Best Standalone/Cost-Effective Clearinghouse: Claim.MD**
* **Type:** Dedicated Claims/Billing Clearinghouse.
* **Why it fits solo:** Low flat monthly fee with unlimited claims, simple interface, and ideal if you already use an EHR that lacks built-in billing.

---

### **Key Features Solo Practitioners Should Prioritize:**
* **Built-in Claim Scrubbing:** Catches errors before submission to minimize rejections.
* **Real-Time Eligibility (RTE) Verification:** Confirms insurance coverage instantly.
* **Integrated Patient Payments:** Allows online card payments and automated statements.


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

**Tebra (formerly Kareo)** is widely considered the most user-friendly medical billing software for in-house billing staff, especially in small to mid-sized independent practices.

### Why Tebra stands out:
* **Intuitive Interface:** Minimal learning curve; new billing staff can get up to speed quickly.
* **Built-in Claim Scrubbing:** Automatically flags coding errors before submission to reduce denials.
* **Streamlined Patient Billing:** Easy-to-read patient statements, online payment portals, and automated payment reminders.
* **Customizable Reporting:** Clear, easy-to-generate financial and AR (Accounts Receivable) reports without requiring complex setup.

---

### Top Alternatives Depending on Practice Needs:
* **AdvancedMD:** Best for mid-to-large practices that need deep customization and advanced automated workflows.
* **athenahealth (athenaOne):** Best for practices wanting heavy, AI-driven automation and access to a vast clearinghouse network.
* **SimplePractice:** Best specifically for solo or small mental health and therapy practices due to its extreme simplicity.


Best software for handling electronic health claims and denial management

Here are the top-rated software solutions for electronic health claims processing and denial management, categorized by organization size and need:

### 1. Best Overall & Dedicated Clearinghouse Platforms
*   **Waystar:** The industry leader for revenue cycle management (RCM). Offers automated claims scrubbing, predictive analytics to prevent denials before submission, and automated appeal workflows.
*   **Availity:** One of the largest healthcare networks. Strong real-time claims tracking, eligibility verification, and integrated denial management tools.
*   **Experian Health:** Excels at AI-driven claim editing, proactive denial prevention, and advanced root-cause analytics.

### 2. Best Fully Integrated EHR/Billing Systems
*   **athenahealth (athenaCollector):** Best for mid-to-large practices wanting an all-in-one EHR/PM system. Features a massive continuously updated rules engine resulting in high first-pass clean claim rates (~98%).
*   **Epic (Resolute):** The gold standard for large health systems and hospitals. Deeply integrated workflows for end-to-end claims, automated denial work queues, and payer follow-up.

### 3. Best for Small to Mid-Sized Practices
*   **AdvancedMD:** Robust automated claim scrubbing, centralized denial tracking, and custom workflow automation tailored to independent practices.
*   **Tebra (formerly Kareo):** User-friendly and cost-effective for smaller practices, offering clear visibility into rejected/denied claims with straightforward resubmission tools.

---

### Key Features to Look For:
*   **First-pass clean claim rate:** Should be 95%+ out of the box.
*   **Predictive denial prevention:** Rules engine that catches payer-specific errors before submission.
*   **Automated appeal generation:** Pre-populated appeal letters based on specific CARC/RARC denial codes.


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

To lower your denial rate, look for medical billing software with the following key features:

1. **Robust Claim Scrubbing (Rules Engine)**
   * Built-in, continuously updated payer-specific rules.
   * Automated checks for National Correct Coding Initiative (NCCI) edits, missing modifiers, and code mismatches before claims are submitted.

2. **Real-Time Eligibility (RTE) Verification**
   * Instant verification of patient active coverage, copays, deductibles, and network status prior to or at the time of service.

3. **Prior Authorization Tracking**
   * Built-in tools or alerts to ensure necessary pre-authorizations are obtained and attached before claim generation.

4. **Integrated Denial Management & Analytics**
   * Root-cause reporting (categorizing denials by payer, CPT code, provider, or reason code).
   * Automated work queues to quickly route, appeal, and correct denied claims.

5. **Direct Clearinghouse Integration**
   * Seamless electronic data interchange (EDI) that returns front-end rejection reports within hours rather than days.

6. **EHR/PM Integration**
   * Direct synchronization between your Electronic Health Record (EHR) and billing system to eliminate manual data-entry errors (e.g., patient demographics, policy numbers).

7. **Vendor Support & Rule Updates**
   * A vendor that actively updates medical necessity guidelines, state-specific Medicaid rules, and commercial payer policies.


Medical claims processing and billing software for chiropractic office

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

### Top Chiropractic Billing Software

1. **ChiroTouch**
   * **Best For:** All-in-one practice management and automated claims.
   * **Key Features:** Integrated clearinghouse, automated claim scrubbing, macro-driven SOAP notes that auto-populate billing codes (98940–98942), and ERA (Electronic Remittance Advice) posting.

2. **Jane App**
   * **Best For:** Modern, user-friendly interface and hybrid cash/insurance practices.
   * **Key Features:** Direct insurance claim generation (EDI generation and integrated clearinghouse via Claim.MD), patient portal with online payments, and superbill creation.

3. **Genesis Chiropractic Software**
   * **Best For:** High-volume insurance practices requiring proactive revenue cycle management (RCM).
   * **Key Features:** Automated rule-checking to prevent rejections, real-time claim status tracking, and automated patient balance follow-up.

4. **EZBIS**
   * **Best For:** Traditional desktop-focused chiropractic billing.
   * **Key Features:** Built specifically for chiropractic insurance rules, electronic billing submission, accounts receivable (A/R) tracking, and customizable collections workflows.

5. **Tebra (formerly Kareo)**
   * **Best For:** Robust medical billing with dedicated chiropractic specialty support.
   * **Key Features:** Advanced claims scrubbing, automated eligibility checks, denial management, and comprehensive financial reporting.

---

### Key Features to Look For:
* **Chiropractic-Specific Coding:** Pre-loaded with spinal adjustment CPT codes (98940, 98941, 98942), physical therapy modalities (97010–97140), and modifier support (e.g., `AT` for active treatment).
* **Integrated Clearinghouse:** Direct ANSI 837 claim submission and 835 ERA auto-posting to avoid third-party upload hassles.
* **Pre-Claim Scrubbing:** Automatic checks for common payer-specific errors before submission to reduce rejections.
* **Insurance Verification:** Real-time eligibility (RTE) checks prior to patient appointments.


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

For a mid-sized pediatric clinic with 10 providers, the two best options depend on whether you want a **pediatric-specific system** or a **broad cloud-based revenue cycle management (RCM) platform**:

### 1. Best Overall (Pediatric-Specific): **PCC (Physician’s Computer Company)**
* **Why it’s best:** Built exclusively for independent pediatric practices.
* **Key Features:** Excellent handling of complex pediatric billing scenarios, such as split-guarantor billing (divorced parents), automated Vaccines for Children (VFC) tracking and billing, and pediatric-specific coding rules.
* **Alternative Pediatric Option:** **Office Practicum (OP)** is also specifically designed for pediatrics and scales very well for a 10-provider practice.

---

### 2. Best for High-Volume Billing & RCM Power: **athenahealth (athenaOne / athenaCollector)**
* **Why it’s best:** Industry-leading billing engine with a massive rules database that delivers exceptionally high first-pass clean claim rates.
* **Key Features:** Continuously updated payer rules, robust automated patient collections, and scalability for 10+ providers. It requires slightly more configuration for pediatric workflows compared to PCC, but its billing and clearinghouse capabilities are among the best on the market.

---

### **Recommendation:**
* Choose **PCC** if you want seamless pediatric workflows (vaccine inventory/billing and guarantor management) out of the box with pediatric-focused customer support.
* Choose **athenahealth** if your primary goal is maximizing collections and minimizing billing overhead through heavy automation.


Easiest medical billing software for a doctor doing their own billing

Here are the easiest medical billing software options for a solo physician doing their own billing:

### 1. **Tebra (formerly Kareo Billing)** – *Best Overall for Medical Doctors*
* **Why it’s easiest:** Built specifically for independent medical practices. It has a very intuitive interface, built-in "claim scrubbing" (which checks for errors before submission to reduce rejections), and seamless clearinghouse integration.
* **Best for:** General medicine and specialized medical practices wanting dedicated medical billing features without unnecessary complexity.

---

### 2. **SimplePractice** – *Easiest Learning Curve*
* **Why it’s easiest:** Designed from the ground up for solo providers. You can file primary and secondary insurance claims with one or two clicks, and it automates payment processing, client invoicing, and payment tracking (ERAs).
* **Best for:** Solo practitioners who prioritize extreme simplicity and minimal administrative time (especially strong in mental health, allied health, and cash/hybrid models).

---

### 3. **Jane App** – *Best Modern Interface & Hybrid (Cash + Insurance)*
* **Why it’s easiest:** Very modern, clean interface with straightforward workflows for tracking claims, generating CMS-1500 forms, and processing patient copays.
* **Best for:** Practices with a mix of direct-pay/cash and insurance billing.

---

### Key Features to Look For (If doing it yourself):
* **Automated Claim Scrubbing:** Flags coding errors before claims are sent.
* **Integrated Clearinghouse:** Eliminates the need to manage a separate clearinghouse account.
* **Automated ERAs:** Automatically posts insurance payments and reconciles accounts.


Best medical billing software with automated claim scrubbing and eligibility verification

Here are the top medical billing software options that excel in **automated claim scrubbing** and **real-time eligibility verification**:

### 1. **athenahealth (athenaOne)** — *Best Overall*
* **Claim Scrubbing:** Uses a proprietary, continuously updated rules engine (athenaNet) with millions of payer rules, resulting in an industry-leading ~98% first-pass clean claim rate.
* **Eligibility Verification:** Automatically runs batch eligibility checks days before appointments and instantly updates coverage status in the schedule.
* **Best for:** Practices of any size wanting an all-in-one platform with minimal manual billing intervention.

### 2. **AdvancedMD** — *Best for Complex or High-Volume Billing*
* **Claim Scrubbing:** Features a robust "Claim Center" that scrubs claims against extensive standard and customizable rules before submission to the clearinghouse.
* **Eligibility Verification:** Offers automated batch eligibility verification and real-time, on-demand checks directly within patient scheduling.
* **Best for:** Mid-to-large practices, enterprise health systems, and third-party medical billing companies.

### 3. **Tebra (formerly Kareo)** — *Best for Small to Mid-Sized Practices*
* **Claim Scrubbing:** Built-in automated claim-checking engine catches errors, missing codes, and policy issues prior to submission.
* **Eligibility Verification:** Real-time and batch eligibility checks integrated into the calendar, color-coding patient appointment status based on active coverage.
* **Best for:** Independent practices looking for an intuitive, cost-effective, and easy-to-learn system.

### 4. **CollaborativeMD** — *Best for Fast, Standalone Billing*
* **Claim Scrubbing:** Known for its "ClaimRuler" tool that scrubs claims continuously in real time as data is entered.
* **Eligibility Verification:** Instant real-time verification and automated recurring checks for scheduled appointments.
* **Best for:** Billing services and outpatient practices prioritizing rapid data entry and claims processing.

---

### Quick Recommendation:
* Choose **athenahealth** if you want the highest clean-claim rate and a fully integrated ecosystem.
* Choose **Tebra (Kareo)** if you are a smaller independent practice prioritizing ease of use.
* Choose **AdvancedMD** if you need deep customization and advanced reporting.


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

For a multi-specialty group practice, the best billing and revenue cycle management (RCM) software depends on the size of the organization:

### Top Software Recommendations

1. **athenahealth (athenaOne / athenaCollector)**
   * **Best for:** Mid-sized to large independent multi-specialty practices.
   * **Why:** Industry-leading native rules engine with high first-pass claim acceptance rates, built-in clearinghouse, and automatic payer-rule updates across different specialties.

2. **Epic Systems (Resolute / Cadence)**
   * **Best for:** Large enterprise practices and health system affiliates.
   * **Why:** Unmatched scalability, deep specialty-specific billing templates, advanced reporting, and seamless integration if working alongside hospitals.

3. **NextGen Healthcare**
   * **Best for:** Mid-to-large ambulatory multi-specialty groups.
   * **Why:** Strong specialty-specific clinical and billing workflows, robust claims scrubbing, and customizable denial management.

4. **AdvancedMD**
   * **Best for:** Small-to-mid-sized independent multi-specialty practices.
   * **Why:** Modular and flexible billing automation, powerful scheduling, and customizable reporting per provider/specialty.

---

### Key Features to Require for Multi-Specialty Billing:
* **Specialty-specific rule engines:** Capability to handle varied coding requirements (e.g., surgical global periods vs. behavioral health time-based codes).
* **Automated claims scrubbing & clearinghouse integration:** To maximize first-pass clean claim rates.
* **Denial and appeals management:** Automated workflows to track and re-bill rejected claims by specialty.
* **Centralized collections & patient portal:** Online bill pay, card-on-file, and automated payment plans across all providers in the group.


Cloud-based medical billing software for small group practice

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

### 1. **Tebra (formerly Kareo)**
* **Best for:** Independent and small practices looking for ease of use.
* **Key Features:** Built-in claim scrubbing, simple patient billing, customizable dashboards, and integrated clearinghouse.
* **Pricing:** Modular (choose billing-only or bundle with EHR); fixed monthly subscription per provider.

### 2. **athenahealth (athenaCollector)**
* **Best for:** Practices wanting high collection rates and automated rule checking.
* **Key Features:** Massive continuously updated rules engine to minimize denials, automated patient follow-ups, and native EHR integration.
* **Pricing:** Percentage of collections model (aligns costs with practice revenue).

### 3. **AdvancedMD**
* **Best for:** Practices needing deep customization and advanced reporting.
* **Key Features:** Automated batch claim processing, sophisticated denial management, clearinghouse integration, and customizable financial workflows.
* **Pricing:** Tiered pricing; pay-per-provider or pay-per-claim options.

### 4. **CollaborativeMD**
* **Best for:** High-speed claim submission and dedicated billing staff.
* **Key Features:** Fast data entry workflows, real-time claim tracking, eligibility verification, and denial management.
* **Pricing:** Tiered monthly plans based on claim volume or provider count.

### 5. **DrChrono**
* **Best for:** Practices heavily reliant on mobile/iPad workflows.
* **Key Features:** Fully integrated EHR and billing, automated patient payments, electronic remittance advice (ERA), and real-time eligibility checks.
* **Pricing:** Tiered plans (Billing available in higher tiers or as an RCM service).

---

### **Recommendation:**
* Choose **Tebra** if you want an affordable, flat-rate, user-friendly system.
* Choose **athenahealth** if you prefer a performance-based fee structure with heavy automation to reduce denial rates.
* Choose **AdvancedMD** if you require advanced scheduling, reporting, and custom workflow capabilities.


Recommend a medical billing and coding platform for small specialty clinic

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

### 1. **Tebra (formerly Kareo)** — *Best Overall for Independent Practices*
* **Why it fits:** Built specifically for small, independent practices. It is intuitive, affordable, and includes robust specialty-specific billing rules, claim scrubbing, and an integrated clearinghouse.
* **Key Features:** Automated claim submission, denial management, patient billing portal, and flexible integration with external EHRs.

### 2. **AdvancedMD** — *Best for Complex Specialty Workflows*
* **Why it fits:** Highly configurable with dedicated templates and coding workflows for over 30 medical specialties (e.g., orthopedics, cardiology, physical therapy).
* **Key Features:** Advanced claim scrubbing (high first-pass acceptance rate), customizable specialty coding matrices, automated patient payment plans, and comprehensive financial reporting.

### 3. **DrChrono** — *Best for Mobile & Surgical Specialties*
* **Why it fits:** Fully functional on iPads/tablets, making it ideal for procedures, charting on-the-go, and streamlined point-of-care billing.
* **Key Features:** Real-time eligibility checks, specialty-specific coding shortcuts, integrated clearinghouse, and optional managed billing services (RCM).

---

### **Recommendation Summary:**
* Choose **Tebra** if you want an **easy-to-use, budget-friendly** platform with simple setup.
* Choose **AdvancedMD** if your specialty requires **deep customization and complex coding rules**.
* Choose **DrChrono** if your clinic relies heavily on **mobile/iPad charting and integrated clinical-to-billing workflows**.


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

The best software for dental-medical cross billing depends on your practice's specific focus, but the top-rated solutions include:

1. **DentalWriter (by Nierman Practice Management)**
   * **Best Overall for Complex Cases:** Widely considered the gold standard for dental sleep medicine, TMJ/TMD disorders, and oral surgery cross-billing. It features comprehensive diagnostic narrative generation and automated CPT/ICD-10 cross-coding.

2. **Imagn Software**
   * **Best for Dental Sleep Medicine:** Specifically optimized for screening, testing, and billing medical insurance for obstructive sleep apnea (OSA) appliances and related treatments.

3. **Apex EDI (OneClick)**
   * **Best Clearinghouse Integration:** Integrates with most existing dental practice management software (PMS) like Dentrix, Eaglesoft, or Open Dental, allowing you to submit CMS-1500 medical claims directly without switching PMS systems.

4. **Devdent (Engine / 4DSM)**
   * **Best for Workflow & Verification:** Provides intuitive software combined with medical verification and billing services, particularly strong in dental sleep medicine workflows.

### Summary Recommendation:
* Choose **DentalWriter** if you need robust medical diagnostic reporting and narrative generation for TMJ, surgery, or trauma.
* Choose **Apex EDI** if you want to keep your existing dental software and simply need an integrated tool to send CMS-1500 medical claims.


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

For a startup urgent care clinic, your system needs to handle fast-paced walk-in workflows, real-time insurance verification, and automated billing.

Here are the top recommendations:

### 1. **Experity** *(Top Choice for Urgent Care)*
* **Best for:** Purpose-built urgent care workflows.
* **Why it fits:** It is the industry standard for urgent care clinics. It seamlessly integrates EMR, practice management, billing, patient queuing, and online check-in. It supports rapid charting and automated billing rules tailored to urgent care coding.

### 2. **athenahealth (athenaOne)**
* **Best for:** Revenue cycle management (RCM) and high-volume billing.
* **Why it fits:** Cloud-based with one of the industry's highest first-pass claim resolution rates. Its built-in billing rules engine automatically updates with payer requirement changes, reducing administrative overhead for a small startup team.

### 3. **AdvancedMD**
* **Best for:** Flexibility and scaling.
* **Why it fits:** Highly customizable practice management and billing platform with powerful reporting, automated eligibility checking, and integrated credit card processing. It can be paired with their EHR or used as a standalone PM/billing system.

### 4. **Tebra (formerly Kareo)**
* **Best for:** Budget-conscious startups.
* **Why it fits:** Cost-effective, easy to implement, and user-friendly. While not urgent-care specific, its billing and PM software is robust enough to handle high patient turnaround with minimal staff training.

---

### Key Features to Prioritize for Urgent Care:
* **Real-Time Eligibility (RTE):** Essential for verifying insurance before the patient leaves the clinic.
* **Credit Card on File (CCOF):** To collect copays, deductibles, and self-pay balances immediately.
* **Integrated Online Queue/Check-In:** To manage walk-in volume and reduce front-desk bottlenecks.


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

Here are the best RCM software platforms specifically known for reducing Days in Accounts Receivable (A/R) for medical practices:

### 1. **athenahealth (athenaCollector)** — *Best Overall for Lowering A/R*
* **Why it works:** Uses a massive, continuous network rules engine to catch errors before submission, yielding a consistent **95%+ first-pass clean claim rate**.
* **Key feature:** Automated work queues that immediately route unpaid or denied claims to staff to prevent aging.
* **Best for:** Small to enterprise-level ambulatory practices.

### 2. **Waystar** — *Best Clearinghouse & Revenue Cycle Technology*
* **Why it works:** Focuses heavily on predictive analytics and AI to prevent denials and automate claim tracking across multiple payers.
* **Key feature:** Automated appeal generation and predictive claim-status checks that flag aging claims before they stall.
* **Best for:** Practices looking to add advanced RCM/clearinghouse capabilities to an existing EHR/PM system.

### 3. **AdvancedMD** — *Best for In-House Billing Customization*
* **Why it works:** Offers deep reporting tools that pinpoint exact bottlenecks causing A/R delays (by payer, code, or provider).
* **Key feature:** Automated claim scrubbing rules and centralized worklists that prioritize the highest-value, oldest claims first.
* **Best for:** Independent practices with an in-house billing team.

### 4. **Tebra (formerly Kareo)** — *Best for Small & Independent Practices*
* **Why it works:** Streamlines the patient-responsibility side of A/R with automated patient statements, online payment portals, and mobile pay options.
* **Key feature:** Real-time eligibility (RTE) checks prior to appointments to eliminate front-end denials.
* **Best for:** Solo practitioners and small clinics.

---

### Key Features to Prioritize to Cut A/R Days:
* **High First-Pass Clean Claim Rate (95%+):** Fixes errors before submission to avoid 30+ day denial cycles.
* **Automated Real-Time Eligibility (RTE):** Prevents coverage-related denials at check-in.
* **Automated Claim Statusing:** Pulls payer status automatically so staff don't wait weeks to discover a rejection.
* **Patient Payment Automation:** Text-to-pay and credit-card-on-file options to resolve patient balances quickly.


What medical billing software has the best clearinghouse integration?

The top medical billing software platforms with the best clearinghouse integrations are:

1. **athenahealth (athenaOne)** – **Best Overall:** Features a proprietary, fully native clearinghouse and automated rules engine. Because it acts as the billing software and clearinghouse in one, it consistently achieves industry-leading first-pass clean claim rates (around 97–98%).
2. **AdvancedMD** – **Best for Customizable Workflows:** Includes a deeply integrated, built-in clearinghouse that automates claim scrubbing, real-time eligibility checks, and tracking without needing separate clearinghouse logins.
3. **Kareo (Tebra)** – **Best for Small Practices:** Offers seamless built-in clearinghouse functionality with no additional per-claim fees, simplifying electronic remittance advice (ERA) and rejection management for smaller teams.
4. **DrChrono** – **Best API/Direct Integration:** Built to connect seamlessly with major clearinghouses (like Change Healthcare/Optum) while offering real-time claim status and automated eligibility verification inside the EHR.

**Recommendation:** For the lowest rejection rates and most seamless, hands-off clearinghouse experience, **athenahealth** is the industry standard. For smaller independent practices looking for ease of use, **AdvancedMD** or **Kareo** are ideal.


Software for insurance verification and medical claim filing for small clinic

Here are the top software solutions for insurance verification (real-time eligibility) and medical claim filing tailored for small clinics:

---

### **1. Best All-in-One (Practice Management + Billing)**
* **Tebra (formerly Kareo):**
  * **Best for:** Independent small practices needing an intuitive, full-service platform.
  * **Features:** Built-in real-time eligibility (RTE) checks, automated claim scrubbing (clean claim rates >95%), rejection tracking, and patient billing.
* **DrChrono:**
  * **Best for:** Mobile-friendly clinics and iPad users.
  * **Features:** Instant insurance verification before check-in, automated claim submission, and an integrated electronic health record (EHR).

---

### **2. Best Dedicated Billing & Claims Software (If you already have an EHR)**
* **CollaborativeMD:**
  * **Best for:** Fast, high-volume claim filing and small clinic billing teams.
  * **Features:** Batch and real-time eligibility checks, aggressive claim scrubbing, and robust denial management.
* **AdvancedMD:**
  * **Best for:** Clinics planning to scale or needing deep reporting.
  * **Features:** Automated insurance verification workflows, clearinghouse integration, and automated secondary claim filing.

---

### **3. Best Budget-Friendly & Clearinghouse-Focused**
* **Office Ally (Practice Mate):**
  * **Best for:** Startups and extremely budget-conscious clinics.
  * **Features:** Free/low-cost clearinghouse and basic practice management, direct claim filing, and manual/batch eligibility checks.
* **Waystar:**
  * **Best for:** Standalone clearinghouse integration with high-end verification tools.
  * **Features:** Automated coverage discovery, pre-service eligibility verification, and claim monitoring.

---

### **Key Recommendation for a Small Clinic:**
* Choose **Tebra** if you want an easy-to-use, all-in-one system with strong customer support.
* Choose **Office Ally** if your primary concern is keeping software overhead as low as possible.


Best medical billing software for podiatry practice

The best medical billing software for a podiatry practice depends on practice size, workflow preferences, and whether you need an all-in-one EHR/billing platform.

Here are the top options:

### 1. **ModMed (EMA for Podiatry)** — *Best Overall / All-in-One*
* **Why it’s great:** Built specifically with podiatrists in mind. Its adaptive learning engine automatically generates appropriate ICD-10 and CPT codes (including complex modifiers like Q and T modifiers) based on clinical documentation.
* **Key Features:** Built-in clearinghouse, integrated DME (Durable Medical Equipment) billing, robust revenue cycle management (RCM), and specialized mobile-friendly workflows.

### 2. **TRAKnet** — *Best Podiatry-Specific System*
* **Why it’s great:** Designed exclusively for podiatry practices from the ground up.
* **Key Features:** Tailored templates for routine foot care, orthotics, and diabetic foot exams; automated claim scrubbing tailored to podiatry billing rules; integrated digital X-ray and lab interfaces.

### 3. **AdvancedMD** — *Best for Advanced Billing & RCM*
* **Why it’s great:** A highly powerful, scalable multi-specialty platform with extensive customizable rules engines for podiatry billing.
* **Key Features:** Superior claims-scrubbing rate, automated secondary/tertiary billing, strong DME tracking, and flexible reporting for multi-provider or multi-location practices.

### 4. **Tebra (formerly Kareo)** — *Best for Small or Independent Practices*
* **Why it’s great:** User-friendly, cost-effective, and easy to implement for solo practitioners or small clinics.
* **Key Features:** Simple billing dashboard, automated patient payment collection, customizable billing rules, and seamless integration with third-party EHRs if you only need a billing engine.

---

### Key Podiatry-Specific Features to Confirm Before Buying:
* **Modifier Management:** Automatic handling of podiatry modifiers (e.g., -59, -Q7, -Q8, -Q9, and T-digits).
* **DME Billing:** Capability to bill custom orthotics, braces, and diabetic shoes efficiently.
* **Routine Foot Care Rules:** Built-in guidance for frequency limits (e.g., Medicare’s 60-day rule for at-risk foot care).


How do small medical practices choose billing software?

Small medical practices typically choose billing software by evaluating solutions against their specific workflow, budget, and specialty needs. Key factors in their decision-making process include:

1. **Cost and Pricing Model:** Small practices favor predictable pricing, such as flat monthly subscriptions (SaaS) or low transaction fees, avoiding high upfront licensing costs or percentage-of-collection models that eat into revenue.
2. **EHR/PMS Integration:** The software must seamlessly integrate with their existing Electronic Health Record (EHR) and Practice Management System (PMS) to prevent duplicate data entry and billing errors.
3. **Core Billing Features:** Essential capabilities include automated claims scrubbing (error checking), real-time insurance eligibility verification, denial management, and automated patient invoicing/payment portals.
4. **Specialty-Specific Functionality:** Practices select software that natively supports their specialty’s specific coding (ICD-10, CPT), documentation requirements, and billing rules.
5. **Ease of Use and Training:** With limited staff, systems must be intuitive, require minimal onboarding time, and offer reliable customer and technical support.
6. **Cloud-Based Deployment:** Cloud software is preferred over on-premise servers to eliminate local IT maintenance, enable secure remote access, and provide automatic updates.
7. **Compliance and Security:** Full HIPAA compliance, strong data encryption, and built-in audit trails are non-negotiable for protecting patient data and avoiding regulatory penalties.


Medical billing and revenue cycle management tools for independent healthcare providers

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

### 1. Best All-in-One Solutions (EHR + Billing + PM)
*   **Tebra (formerly Kareo):** Built specifically for independent practices. It offers intuitive billing workflows, automated insurance verification, and easy patient payment processing.
*   **athenahealth (athenaOne):** Industry leader for claim success rates. Features a continuously updated rules engine that catches billing errors before submission, operating on a percentage-of-collections model.
*   **AdvancedMD:** Highly customizable and scalable. Includes advanced reporting, automated scrubbing, and seamless clearinghouse integration, making it ideal for multi-provider independent clinics.
*   **DrChrono:** Best for mobile and Mac/iPad-centric practices. Offers integrated medical billing, automated coding, and real-time eligibility checks.

### 2. Best for Solo and Mental Health Providers
*   **SimplePractice:** The standard for solo practitioners and behavioral health. Features automated recurring billing, simple insurance claim filing, and integrated client payment portals.
*   **TheraNest:** Designed for psychology, therapy, and social work practices, offering batch billing and integrated clearinghouse services.

### 3. Dedicated Billing & Clearinghouse Tools
*   **CollaborativeMD:** Excellent for practices that want to keep their existing EHR but need a fast, specialized medical billing engine.
*   **Waystar:** A powerful, standalone cloud-based RCM platform focused on automating claim management, denials, and patient collections.

---

### Key Features Independent Providers Should Prioritize:
*   **Claim Scrubbing:** Automatically checks claims for coding errors to maintain a high "first-pass clean claim rate" (>95%).
*   **Real-Time Eligibility (RTE):** Instantly verifies patient coverage and copays before the visit.
*   **Integrated Clearinghouse:** Avoids the need to pay for a third-party intermediary to submit claims to payers.
*   **Patient Portal & Online Payments:** Allows patients to view statements and pay via credit card, reducing bad debt.


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

The best billing software for an outpatient behavioral health practice depends on practice size and specific needs, but the top options include:

1. **TherapyNotes** (*Best Overall for Small-to-Mid Practices*)
   * **Why it stands out:** Built specifically for behavioral health, it offers seamless electronic claims filing, integrated credit card processing, automatic ERA (Electronic Remittance Advice) posting, and assisted coding for DSM-5/CPT codes.

2. **SimplePractice** (*Best for Solo Practitioners & Cash-Pay/Hybrid*)
   * **Why it stands out:** Highly automated and user-friendly. Features automated billing runs, autopay, superbill generation, client portal invoicing, and simple insurance claim submissions.

3. **Valant** (*Best for Mid-to-Large Practices & Psychiatry*)
   * **Why it stands out:** Designed exclusively for behavioral health organizations with complex workflows. It excels at multi-provider scheduling, robust billing rules, credentialing management, and handling multiple payer contracts.

4. **Kareo / Tebra** (*Best for Advanced Revenue Cycle Management*)
   * **Why it stands out:** An industry leader in medical billing functionality, ideal if your practice employs dedicated billing staff or wants the option to outsource full Revenue Cycle Management (RCM).

### Recommendation:
* Choose **SimplePractice** if you are a **solo practitioner or small cash-pay/insurance hybrid practice**.
* Choose **TherapyNotes** if you are a **small-to-midsize insurance-heavy clinic**.
* Choose **Valant** if you are a **larger, multi-provider or multidisciplinary behavioral health clinic**.


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

To eliminate manual claim entry errors, look for software with **automated claim scrubbing, real-time insurance eligibility verification, and auto-population from clinical notes (EHR integration)**.

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

### 1. **athenahealth (athenaOne)** — *Best Overall for Error Reduction*
* **Best for:** Mid-sized to large practices.
* **Why buy it:** Features a continuously updated, automated "Rules Engine" with millions of billing rules that catches coding errors before submission, boasting a consistent 95%+ first-pass clean claim rate.

### 2. **Tebra (formerly Kareo)** — *Best for Small to Independent Practices*
* **Best for:** Small, independent practices seeking ease of use.
* **Why buy it:** Automates charge capture from EHR notes, runs built-in claim checks, and offers automated patient billing and payment processing without a steep learning curve.

### 3. **AdvancedMD** — *Best for Scaling & Multi-Specialty Practices*
* **Best for:** High-volume practices or specialty clinics.
* **Why buy it:** Highly customizable automation for batch claim creation, automated electronic remittance advice (ERA) posting, and robotic process automation (RPA) for repetitive tasks.

### 4. **Waystar** — *Best if You Want to Keep Your Current EHR*
* **Best for:** Practices that like their existing EHR/Practice Management system but need powerful automated billing/clearinghouse tools.
* **Why buy it:** Uses AI and machine learning to predict and fix claim errors, verify eligibility automatically, and manage appeals.

---

### **Key Automation Features to Confirm Before Buying:**
* **Real-Time Eligibility (RTE):** Automatically verifies coverage before the patient visit to stop downstream claim rejections.
* **Smart Claim Scrubbing:** Flags missing modifiers, invalid CPT/ICD-10 combinations, and payer-specific rule violations instantly.
* **Automated ERA/EHR Sync:** Automatically posts payments and pulls diagnostic codes directly from the provider's chart.


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

Here are the top HIPAA-compliant medical billing software options tailored for small practices offering both in-person and telehealth services:

---

### 1. **Tebra (formerly Kareo)**
* **Best For:** Small, independent medical practices looking for robust billing.
* **Key Features:** Built specifically for small practices. Offers integrated EHR, practice management, built-in HIPAA-compliant telehealth, and a powerful billing engine (claim scrubbing, denial tracking).
* **Billing Model:** Available as self-service software or as a full Revenue Cycle Management (RCM) managed service.

---

### 2. **DrChrono**
* **Best For:** Mobile-friendly medical practices and specialty clinics.
* **Key Features:** All-in-one EHR, practice management, and medical billing. Native telehealth integration and strong claim submission features (automatic eligibility checks, ERA/EOB processing).
* **Billing Model:** Tiered software pricing with optional managed RCM services.

---

### 3. **SimplePractice**
* **Best For:** Solo practitioners and small group practices in behavioral health, physical therapy, and wellness.
* **Key Features:** Extremely user-friendly, paperless intake, automated client billing (credit card processing), integrated telehealth, and direct electronic insurance claim filing.
* **Billing Model:** Flat-rate monthly subscription tiers plus small fees for claim filing.

---

### 4. **CharmHealth**
* **Best For:** Cost-conscious small practices or low-volume startups.
* **Key Features:** Cloud-based EHR with integrated medical billing and telehealth. Flexible pricing includes pay-per-encounter options or fixed monthly plans.
* **Billing Model:** Extremely scalable with a free starter tier (pay-as-you-go per claim/encounter).

---

### 5. **AdvancedMD**
* **Best For:** Small practices that require advanced, complex billing rules and automation.
* **Key Features:** Industry-leading billing engine with automated clearinghouse integration, optical character recognition for cards, and native telehealth.
* **Billing Model:** Modular software pricing (choose only the modules you need).

---

### Key Requirements to Verify Before Choosing:
* **Business Associate Agreement (BAA):** Ensure they sign a BAA covering both the billing and telehealth modules.
* **Telehealth Modifier Support:** Ensure the clearinghouse handles Telehealth Place of Service (POS 02 / POS 10) and modifiers (e.g., 95, GT) automatically alongside in-person POS 11 claims.
* **Merchant Processing:** Check integrated credit card processing fees for collecting patient copays both in-office and via patient portals.


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

The "best" platform depends on whether you need a standalone clearinghouse or an all-in-one Practice Management/EHR system.

Here are the top medical billing platforms that handle both **CMS-1500 (professional)** and **UB-04 (institutional)** claims:

### 1. Best All-in-One Practice Management & Billing
* **AdvancedMD:** Best for mid-to-large practices and billing companies. It natively supports both CMS-1500 and UB-04 formats, includes robust scrubbing rules, and integrates with EHR and scheduling.
* **CollaborativeMD:** Known for fast claim entry and high first-pass acceptance rates. It easily toggles between professional and institutional claims, making it ideal for outpatient clinics, ASCs, and billing services.

### 2. Best Clearinghouses (Claim Submission & Scrubbing)
* **ClaimMD:** Highly rated for affordability, ease of use, and customer support. It seamlessly processes both CMS-1500 and UB-04 claims with flat-rate monthly pricing and no per-claim fees.
* **Waystar:** The enterprise standard for hospitals, health systems, and larger specialty practices. Excellent automated claim scrubbing, denial management, and payer connections for both formats.
* **Apex EDI:** Great option for small-to-midsize practices needing a straightforward clearinghouse that integrates with existing software to send both claim types.

### Summary Recommendation:
* **For a complete billing & scheduling software:** Choose **AdvancedMD** or **CollaborativeMD**.
* **For a pure clearinghouse to submit claims from existing software:** Choose **ClaimMD** (small-to-mid practices) or **Waystar** (large/enterprise organizations).


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

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

### 1. **Tebra (formerly Kareo)** — *Best Overall for Small Practices*
* **Why it fits:** Specifically designed for independent practices (1–10 providers). It offers strong automated claim scrubbing, denial management, and patient billing.
* **Pricing Model:** Starts around **$125–$160 per provider/month** for standalone billing software (bundles with EHR/Practice Management cost more).

### 2. **EZClaim** — *Most Budget-Friendly Standalone Billing*
* **Why it fits:** Extremely straightforward, low learning curve, and connects with many popular third-party EHRs. It is ideal if you already have an EHR and only need dedicated billing.
* **Pricing Model:** Cloud-based plans start around **$140–$180 per month** total (plus clearinghouse fees).

### 3. **Practice Fusion (Integrated with Billing Partners)** — *Best Value All-in-One*
* **Why it fits:** If you need both EHR and billing, Practice Fusion is one of the most affordable platforms. It handles clinical notes and integrates seamlessly with billing clearinghouses (like ClaimMD or Kareo).
* **Pricing Model:** Starts at **$149 per provider/month** (annual contract).

### 4. **ClaimMD** — *Best Low-Cost Clearinghouse / Direct Billing*
* **Why it fits:** If your clinic handles billing in-house and you just need a platform to scrub, submit, and track claims directly to payers.
* **Pricing Model:** Flat rate of roughly **$100–$150/month per provider** for unlimited electronic claims.

---

### Quick Buying Advice:
* **If you already have an EHR you like:** Pair it with **EZClaim** or **ClaimMD** to keep costs under $300/month total.
* **If you want one system for everything (EHR + Billing + Scheduling):** **Tebra** or **Practice Fusion** will minimize administrative overhead.


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

Medical billers and billing services commonly recommend the following top software platforms based on reliability, clearinghouse integration, and revenue cycle management (RCM) features:

1. **AdvancedMD**
   * *Best for:* Billing services managing multiple clients and complex specialties.
   * *Why billers like it:* Highly customizable, robust claims scrubbing, advanced reporting, and multi-practice management tools.

2. **Tebra (formerly Kareo)**
   * *Best for:* Small-to-midsize practices and independent billing companies.
   * *Why billers like it:* Intuitive interface, dedicated tools specifically built for third-party billers, and strong customer support.

3. **CollaborativeMD**
   * *Best for:* High-volume claim processing and fast data entry.
   * *Why billers like it:* Fast batch-processing workflows, high first-pass claim acceptance rates, and flexible integration options.

4. **athenahealth (athenaCollector)**
   * *Best for:* Medium-to-large practices seeking an all-in-one EHR/billing platform.
   * *Why billers like it:* Continuously updated native billing rules engine, automatic denial resolution workflows, and high claim accuracy.

5. **NextGen Healthcare (NextGen Office)**
   * *Best for:* Independent and specialty practices.
   * *Why billers like it:* Strong claim scrubbing, multi-specialty template support, and automated eligibility checks.

**Top Clearinghouse Platforms (Often Paired with Billing Software):**
* **Waystar** and **Availity** are the industry standards for claim submission, real-time eligibility checks, and denial management.


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

Here are the best all-in-one practice management (PM), EHR, and medical billing software options for a small clinic:

### 1. **Tebra (formerly Kareo)** — *Best Overall for Independent Small Clinics*
* **Why it fits:** Specifically designed for small, independent practices. It is intuitive, affordable, and combines EHR, scheduling, patient communication, and robust in-house or outsourced billing.
* **Key Features:** Built-in claim scrubber, customizable clinical templates, patient portal, and transparent pricing.

---

### 2. **athenahealth (athenaOne)** — *Best for Maximizing Revenue & Automation*
* **Why it fits:** Cloud-based with one of the industry's most advanced billing engines (rules engine continuously updated with payer rules).
* **Key Features:** High first-pass claim acceptance rates, automated patient reminders, and integrated EHR.
* **Pricing Model:** Charges a small percentage of practice collections rather than a flat per-user fee.

---

### 3. **AdvancedMD** — *Best for Customization and Scalability*
* **Why it fits:** Highly configurable, all-in-one platform suited for growing clinics with specialized reporting or workflow needs.
* **Key Features:** Advanced scheduling, electronic claim submission, clearinghouse integration, and integrated telemedicine.

---

### 4. **Specialty Alternatives:**
* **SimplePractice:** Best if the clinic focuses on **mental/behavioral health, physical therapy, or solo/cash-based practices** due to low cost and simplicity.
* **DrChrono:** Best for clinics preferring an **Apple/iPad-native workflow** with strong integrated billing and EHR.

---

### Recommendation Summary:
* Choose **Tebra** for the easiest learning curve and balanced cost.
* Choose **athenahealth** if you want top-tier billing automation and don't mind percentage-based pricing.


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

Here are the top medical practice billing systems with strong patient portals and online payment processing:

### 1. **athenahealth (athenaOne)**
* **Best for:** High-volume practices wanting automated billing and industry-leading collection rates.
* **Portal & Payments:** The *athenaCommunicator* portal allows patients to view itemized statements, set up recurring payment plans, store credit cards, and pay via Apple Pay, Google Pay, or card. It automatically sends digital billing reminders (SMS/email) with one-click payment links.

### 2. **Tebra (formerly Kareo + PatientPop)**
* **Best for:** Small to mid-sized independent practices.
* **Portal & Payments:** Easy-to-use patient portal with online check-in, integrated digital billing statements, and "Text-to-Pay" capabilities. The system supports automated payment posting directly to the practice management ledger.

### 3. **AdvancedMD**
* **Best for:** Practices wanting customizable, automated billing workflows and detailed financial reporting.
* **Portal & Payments:** Offers *Patient Engagement* suite with integrated *AdvancedPay*. Patients can make partial payments, create installment plans, and settle copays or past-due balances through the portal, mobile app, or pre-visit digital check-in.

### 4. **ModMed (Modernizing Medicine)**
* **Best for:** Specialty practices (Dermatology, Orthopedics, Ophthalmology, ENT, etc.).
* **Portal & Payments:** Features *ModMed Pay*, integrated seamlessly into the patient portal and kiosk app. It includes card-on-file features, automated text-to-pay links after claims adjudication, and automatic reconciliation.

---

### Key Features to Verify Before Choosing:
* **Text-to-Pay / Card-on-File:** Significantly reduces Days in A/R (Accounts Receivable).
* **Automatic Ledger Posting:** Ensures online payments automatically sync with the EHR/PM to reduce manual data entry.
* **Merchant Processing Fees:** Inquire about flat-rate vs. interchange-plus processing fees before signing.


Which medical billing software offers the best insurance denial tracking?

The top medical billing software for insurance denial tracking depends on practice size, but **Waystar** and **athenahealth** are widely regarded as the best overall.

* **Waystar (Best Standalone Denial Management):** Renowned for its dedicated, AI-powered denial tracking and appeals workflows. It automatically prioritizes denials with the highest recovery probability, suggests appeal strategies, and integrates with most major EHRs.
* **athenahealth / athenaCollector (Best All-in-One for Outpatient Practices):** Utilizes a massive, constantly updated billing rules database that catches and resolves claim errors before submission and tracks underlying denial trends across the entire network.
* **AdvancedMD (Best for Mid-Sized Independent Practices):** Offers robust, customizable claim tracking dashboards, automated claim scrubbing, and detailed denial trend reporting.
* **Epic Resolute (Best for Large Hospitals & Enterprise Systems):** Provides powerful, integrated enterprise-level denial management, root-cause tracking, and automated appeal routing.

**Recommendation:** For dedicated, best-in-class denial resolution and root-cause analysis, choose **Waystar**. For an integrated EHR/billing system that aggressively prevents and tracks denials, choose **athenahealth**.


Top medical billing platforms for cardiology practices

Here are the top medical billing and revenue cycle management (RCM) platforms suited for cardiology practices, categorized by practice size and needs:

### 1. **athenahealth (athenaOne)**
* **Best for:** High-volume practices needing automated claim scrubbing.
* **Why it fits cardiology:** Its continuously updated rules engine easily handles complex cardiology coding (modifiers, global periods, device implants). It boasts high first-pass clean claim rates (over 95%).

### 2. **AdvancedMD**
* **Best for:** Mid-sized independent practices needing deep customization.
* **Why it fits cardiology:** Highly configurable for complex multi-provider schedules, cath-lab procedures, and diagnostic testing (echo, stress tests). Features strong charge-capture and automated scrubbing rules for cardiology-specific modifiers (e.g., -26, -TC, -51, -59).

### 3. **Tebra (formerly Kareo + PatientPop)**
* **Best for:** Small to mid-sized independent practices looking for ease of use.
* **Why it fits cardiology:** Cost-effective, intuitive billing platform with robust reporting. Integrates well with third-party specialty EHRs if you do not use an all-in-one system.

### 4. **ModMed (EMA Cardiology)**
* **Best for:** Practices wanting an integrated EHR + Billing system built specifically for cardiology.
* **Why it fits cardiology:** Automatically translates clinical notes from cardiac exams and imaging into accurate ICD-10 and CPT codes, reducing coding errors and documentation time.

### 5. **CareCloud (Concierge / Central)**
* **Best for:** Practices seeking specialized, outsourced RCM services alongside software.
* **Why it fits cardiology:** Handles high-dollar cardiology claims, complex authorization processes, and multi-facility (in-office vs. hospital/ASC) billing workflows.

### 6. **Epic Systems / Oracle Health (Cerner)**
* **Best for:** Enterprise, health-system-affiliated, or large multi-location cardiology groups.
* **Why it fits cardiology:** Seamlessly manages hospital rounding, surgical suites, diagnostic imaging PACS integration, and complex institutional billing (UB-04 and CMS-1500).

---

### Key Features to Prioritize for Cardiology Billing:
* **Split Billing Support:** Seamless handling of professional (-26) vs. technical (-TC) component billing for in-office imaging.
* **Pre-Authorization Tracking:** Automated tools for high-cost procedures (angioplasties, pacemakers, ablations).
* **Device/PACS Integration:** Ability to interface with ECG, Holter, and Echocardiogram reporting software to capture charges automatically.


Medical billing software comparison for small private medical offices

Here is a direct comparison of the top medical billing software options for small private medical practices:

---

### **1. Tebra (formerly Kareo)**
* **Best For:** Small, independent practices needing simple, reliable billing.
* **Key Features:** Built-in claim scrubbing, customizable charge-capture rules, integrated patient billing portal.
* **Pros:** Extremely user-friendly; designed specifically for small practices; flexible (use standalone or with their EHR).
* **Cons:** Customer support response times can be slow; advanced reporting is limited.
* **Pricing Model:** Monthly subscription per provider (tier-based).

---

### **2. DrChrono**
* **Best For:** Practices that rely heavily on mobile/iPad workflows and want an all-in-one EHR + Practice Management system.
* **Key Features:** Real-time eligibility checks, iPad-native billing/clinical templates, automated patient payment reminders.
* **Pros:** Highly customizable clinical-to-billing workflow; modern interface.
* **Cons:** Often requires annual contracts; pricing can escalate quickly with add-ons.
* **Pricing Model:** Quote-based (tiered monthly plans per provider).

---

### **3. AdvancedMD**
* **Best For:** High-volume practices or those with complex multi-specialty billing needs.
* **Key Features:** Advanced claims scrubber, robust financial reporting/analytics, integrated clearinghouse.
* **Pros:** Highly scalable; deep customization options; flexible deployment (standalone or integrated).
* **Cons:** Steeper learning curve; interface can feel overwhelming for a very small staff.
* **Pricing Model:** Flat monthly rate per provider or pay-per-claim pricing.

---

### **4. athenaOne (athenahealth)**
* **Best For:** Practices looking to minimize denials through a managed billing network.
* **Key Features:** Continuously updated national rules engine that automatically catches payer-specific errors before submission.
* **Pros:** Very high first-pass clean-claims rate (industry-leading); handles back-end collections well.
* **Cons:** Higher overall cost; less flexible software configurations.
* **Pricing Model:** Percentage of practice collections (typically **4%–7%** of monthly collections).

---

### **Summary Comparison Matrix**

| Feature | Tebra | DrChrono | AdvancedMD | athenaOne |
| :--- | :--- | :--- | :--- | :--- |
| **Ideal Size** | 1–5 Providers | 1–10 Providers | 3–20+ Providers | 1–25+ Providers |
| **Ease of Use** | High | High (on iPad) | Moderate | Moderate |
| **Billing Type** | In-house / RCM Option | In-house / RCM Option | In-house / RCM Option | Hybrid / Managed RCM |
| **Pricing Type** | Flat Fee / Provider | Flat Fee / Provider | Flat Fee or Per-Claim | % of Collections |

---

### **Recommendation**
* Choose **Tebra** if you want the lowest learning curve and standard flat monthly pricing.
* Choose **DrChrono** if your clinical and billing workflows are built around Apple devices.
* Choose **athenahealth** if you prefer paying a percentage of collections to ensure a high first-pass claim acceptance rate.


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

For a 15-provider orthopedic group, you need software that handles complex surgical coding, global periods, workers' comp/personal injury billing, and durable medical equipment (DME).

Here are the best options:

### 1. **ModMed (Modernizing Medicine) – EMA Orthopedics**
* **Best for:** Orthopedic-specific workflows and surgical billing.
* **Why it fits:** It is built specifically for orthopedics. The system automates ICD-10/CPT coding from clinical notes, tracks surgical global periods seamlessly, and includes strong inventory/DME billing.

### 2. **athenahealth (athenaOne / athenaCollector)**
* **Best for:** High-volume billing rules, claim scrubbing, and automated collections.
* **Why it fits:** Features an industry-leading rules engine (90%+ first-pass clean claim rate) that automatically updates with payer rules. Ideal if you want a proven enterprise-grade practice management system that scales easily for 15+ providers.

### 3. **AdvancedMD**
* **Best for:** Highly customizable reporting, standalone billing, and deep analytics.
* **Why it fits:** Works well if you already have an EHR you like and only want a powerful Practice Management/Billing system. It offers robust claims scrubbing, advanced financial reporting, and strong automation for clearinghouse interactions.

### 4. **Nextech**
* **Best for:** Surgical-heavy specialty practices.
* **Why it fits:** Tailored to specialty and surgical workflows with strong revenue cycle management (RCM) tools designed to capture missed surgical charges and manage multi-location scheduling and billing.

---

### **Key Evaluation Criteria for Your Practice:**
* **Workers' Comp & No-Fault/MVA:** Ensure the vendor can easily attach required documentation (like operational notes) electronically for complex injury claims.
* **DME Billing:** Look for built-in inventory tracking tied directly to billing.
* **In-House vs. RCM Service:** Decide if you only need the **software** for an in-house billing team or a **hybrid/managed RCM service** (which Athena, ModMed, and AdvancedMD all offer).


Simple medical billing software for a solo dermatologist

Here are the best simple medical billing software options for a solo dermatologist:

### 1. **Tebra (formerly Kareo Billing)**
* **Best for:** Overall ease of use and solo practices.
* **Why it fits:** Highly intuitive, cloud-based, and designed specifically for independent practices. It automates claim scrubbing, charge capture, and patient billing with minimal setup.

### 2. **EZClaim**
* **Best for:** Pure, no-frills billing (if you already have a separate EHR).
* **Why it fits:** Extremely straightforward, affordable, and focuses strictly on medical billing and scheduling without unnecessary bloat.

### 3. **ModMed (EMA / BOOST)**
* **Best for:** Dermatology-specific billing.
* **Why it fits:** The industry leader in dermatology. While more comprehensive than basic standalone billing tools, its built-in coding translates dermatological exams directly into accurate billing codes automatically, reducing billing errors.

### 4. **DrChrono**
* **Best for:** iPad/mobile-first solo providers.
* **Why it fits:** Offers an easy-to-use, all-in-one EHR and billing platform with customizable dermatology templates and integrated claim submission.

---

### **Recommendation:**
* Choose **Tebra** if you want the simplest, most user-friendly general billing tool.
* Choose **ModMed** if you want automated coding built specifically for dermatology workflows.


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

**athenahealth (athenaOne)** consistently reports one of the highest first-pass clean claims rates in the healthcare industry, typically between **97% and 99%**. This high rate is primarily driven by its continuously updated, cloud-based rules engine (*athenaRules*), which scrubs claims against millions of payer rules before submission.

Other top-performing platforms with industry-leading first-pass rates (97%–98%+) include:

* **AdvancedMD** (~98%)
* **CureMD** (~98%)
* **Epic Systems** (~95%–98%)
* **Waystar** (clearinghouse/revenue cycle software with ~98.5%+)

*Note: While software capabilities are a primary factor, an organization's internal demographic capture and coding accuracy also heavily influence the final rate.*


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

The best software depends on the size and specialty of your practice, but the top-rated platforms for managing the full billing lifecycle (claims, copays, and reimbursements) include:

### 1. **athenahealth (athenaOne)** — *Best Overall & Best for High Claim Acceptance*
* **Claims:** Features an automated "billing rules engine" with a 99%+ first-pass claims resolution rate.
* **Copays:** Integrated patient portal allows for upfront copay collection, card-on-file storage, and automated digital statements.
* **Reimbursements:** Real-time visibility into denial management, insurance remittances, and underpayments.
* **Best for:** Small to large independent medical practices.

---

### 2. **Tebra (formerly Kareo)** — *Best for Small to Mid-Sized Independent Practices*
* **Claims:** Built-in clearinghouse allows easy claim scrubbing, batch submissions, and rejection tracking.
* **Copays:** Simplified credit card processing, mobile payments, and customizable patient payment plans.
* **Reimbursements:** Tracks electronic remittance advice (ERAs) and auto-posts payments to patient accounts.
* **Best for:** Small private practices looking for an affordable, user-friendly solution.

---

### 3. **AdvancedMD** — *Best for Advanced RCM & Customization*
* **Claims:** Highly automated claim scrubbing and direct clearinghouse integration.
* **Copays:** Real-time eligibility (RTE) checks let staff verify copay and deductible amounts at check-in.
* **Reimbursements:** Deep analytics for aging A/R, financial reporting, and denial tracking.
* **Best for:** Mid-to-large practices or medical billing companies with complex workflows.

---

### Specialty Alternatives:
* **Mental/Behavioral Health:** **SimplePractice** or **TheraNest** (streamlined auto-pay for copays and simple insurance billing).
* **Enterprise/Hospitals:** **Epic (Resolute)** (industry standard for large hospital networks and health systems).


Recommend medical billing software for a new solo family practice.

Here are the best medical billing software options for a new solo family practice:

### 1. **Tebra (formerly Kareo) – *Best Overall for Solo Practices***
* **Why:** Specifically designed for independent and solo providers. It is intuitive, easy to set up, and offers flexible options to either do billing in-house or outsource it to their team.
* **Key Features:** Built-in claim scrubbing, agenda-based scheduling, patient portal, and integrated EHR.

### 2. **Athenahealth (AthenaOne) – *Best for Minimizing Admin Work***
* **Why:** Uses a percentage-of-collections pricing model, meaning you only pay when you get paid. Its massive clearinghouse network catches billing errors before submission.
* **Key Features:** Automated denial management, high first-pass clean claims rate, and fully integrated EHR and patient engagement tools.

### 3. **PracticeSuite – *Best Budget-Friendly Option***
* **Why:** Offers a low-cost, scalable entry point for new practices with straightforward, transparent monthly pricing.
* **Key Features:** End-to-end revenue cycle management (RCM), claim tracking, and the option to use billing software standalone with another EHR.

### 4. **DrChrono – *Best for iPad/Mobile Workflow***
* **Why:** Fully functional on iOS/iPads, making it ideal for a solo practitioner who wants to document and manage billing seamlessly from a tablet.
* **Key Features:** Customized medical forms, integrated clearinghouse, and real-time eligibility checks.

---

### **Recommendation Summary:**
* If you want a **balanced, user-friendly all-in-one platform**, choose **Tebra**.
* If you want to **outsource billing heavy-lifting** and pay a percentage of revenue, choose **Athenahealth**.
* If you need to **keep fixed startup costs as low as possible**, choose **PracticeSuite**.


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

For a **small private practice**, the best choice is usually **billing software built into your EHR/practice-management system**, because claims, notes, scheduling, eligibility, and payments stay in one workflow and you avoid paying for a separate billing stack.[3][5][6]

If you want a short list of the strongest options mentioned in the results:

- **Tebra** — a good fit if you want a **unified platform** with claims management, eligibility checks, patient statements, and built-in EHR integration.[10]
- **PracticeSuite** — positioned as a strong option for **small and medium-sized practices**, with billing tools designed for practices that want control over their billing process.[1][12]
- **AllegianceMD** — Forbes lists it as **best for small practices**, which makes it a credible contender if you want a billing-focused option.[7]
- **Athenahealth** — commonly used for **hands-off billing and payer connectivity**, though it may be more platform than a simple standalone billing tool.[13]
- **Office Ally** — often recommended for **solo providers** and **budget-sensitive** practices.[11]
- **SimplePractice** — a solid choice for certain private practices, especially behavioral health and wellness, with integrated billing tools.[10][20]

If you want the most practical answer:
- Choose **Tebra** or **PracticeSuite** if you want a broad small-practice platform.
- Choose **Office Ally** if budget is the main concern.
- Choose **AllegianceMD** if you want a billing-first product recognized by a major review source.[7]

The “best” option still depends on your specialty, claim volume, and whether you want **standalone billing** or **all-in-one EHR + billing**.[5][6][11]


Best medical billing and RCM software for independent clinics

For **independent clinics**, the strongest medical billing and RCM options in the results are **Tebra**, **AdvancedMD**, **CareCloud**, **Healthie**, and **Elation EHR + Billing**, with **Tebra** most explicitly positioned for independent/private practices and patient growth.[1][9][11][13][18][19]

- **Tebra** — Best for **independent clinics focused on acquiring new patients**; its strengths include patient engagement tools like online booking and automated statements, and Tebra also markets itself for private practices with billing, EHR integration, usability, and a pricing model suited to smaller practices.[1][9]
- **AdvancedMD** — Best for **higher-volume insurance billing** and clinics that need robust **RCM** and **denial management** workflows.[5][13]
- **CareCloud** — Best for **integrated RCM + EHR** and end-to-end revenue cycle automation, which is useful if the clinic wants billing tightly connected to clinical workflow.[11]
- **Healthie** — Best for clinics wanting an **all-in-one HIPAA-compliant** platform with insurance payments, HSA/FSA support, and superbills.[16][19]
- **Elation EHR + Billing** — Best for **small healthcare organizations** that want billing integrated into a clinical system and are prioritizing financial performance.[18]

A practical way to choose:
- Choose **Tebra** if you want the most clinic-friendly, growth-oriented option for a private practice.[1][9]
- Choose **AdvancedMD** if billing complexity, claims volume, and denial follow-up are your main pain points.[5][13]
- Choose **CareCloud** if you want a more automated RCM stack rather than just billing software.[11]
- Choose **Healthie** or **Elation** if you want billing bundled closely with an EHR/workflow platform.[16][18][19]

If you want, I can turn this into a **ranked shortlist by clinic type** such as primary care, behavioral health, PT/OT, or concierge practice.


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** dealing with **claim rejections**, the best fit is usually **an integrated practice management + billing platform with strong denial management**, rather than standalone billing software.[1][2][19]

If you want the shortest recommendation: **athenahealth** is the strongest “reduce rejections / improve collections” option if you want **billing handled as a service**; **OmniMD** is a strong choice if you want **integrated EHR + RCM** and your practice is comfortable with a more feature-rich system; and **PracticeSuite** is a good option if you want a more traditional billing-first platform with claims and RCM tools.[1][2][7]

What the results suggest for a 3-provider family practice:
- **athenahealth**: best when you want outsourced billing and denials workflow support; it is explicitly positioned for **small family practices with 3 to 5 providers** and for practices wanting billing handled for them.[1][2]
- **OmniMD**: often a strong total-cost option for **3 to 5 providers** because its bundled billing model can be cost-effective for small multi-provider practices.[1]
- **PracticeSuite**: good if your main problem is **claims management, denial handling, and A/R follow-up** and you want a billing-focused product.[2][7]
- **Tebra / CareCloud / CollaborateMD / CureMD**: also worth demoing if you want automation around claims, denials, and reporting, but the results do not show them as clearly superior for your specific size and problem.[2][13][15][12]

My practical recommendation:
- If you want the **least internal billing burden**, buy **athenahealth**.[1][2]
- If you want **one integrated system** for charting plus billing and are okay with a steeper implementation, buy **OmniMD**.[1]
- If you want **billing software only** and plan to keep your EHR separate, start with **PracticeSuite**.[2][7]

Before buying, make sure the vendor has:
- **Claim scrubbing**
- **Denial management**
- **Clearinghouse/resubmission workflows**
- **Eligibility verification**
- **Strong reporting on rejection reasons**
- **Integration with your EHR**[2][7][13][15][19]

If you want, I can turn this into a **3-vendor shortlist with pros/cons, estimated cost model, and a demo scorecard** for your practice.


Recommend medical billing software for a mental health clinic.

For a **mental health clinic**, the strongest options in the results are **SimplePractice**, **TherapyNotes**, **ICANotes**, and **Valant/AdvancedMD** depending on clinic size and workflow needs.[2][8][9][4]

- **SimplePractice**: Best fit for **solo clinicians and small practices** that want an easy-to-use platform with **telehealth and insurance billing** built in.[2][8][9]
- **TherapyNotes**: A strong choice for **small practices** that want dedicated therapy workflows and **DSM-aligned coding/batch invoicing**.[2][10]
- **ICANotes**: Best for clinics with heavier **behavioral health documentation, claims management, eligibility verification, and reporting** needs.[2][4]
- **Valant**: Worth considering for **growing group practices** that need stronger **reporting and revenue-cycle visibility**.[2]
- **AdvancedMD**: Also a good option for **larger or growing groups** needing broader practice-management and billing capabilities.[2]
- **Tebra**: A fit for independent practices that want **broader practice management plus billing tools**.[2]

If you want a single recommendation, **SimplePractice** is the best default pick for most small to mid-sized mental health clinics based on the results, while **ICANotes** is the better choice if documentation and insurance-billing workflow depth matter most.[2][4][8]

If you tell me your clinic size, whether you bill insurance, and whether you need telehealth or psychiatry features, I can narrow this to the best 2–3 options.