After conducting our 2018 research and analysis of medical billing services, we recommend AdvancedMD as the best medical billing service for large practices.
We chose AdvancedMD from a pool of dozens of medical billing services. To learn more about our full methodology and for a more comprehensive list of medical billing companies, see Business News Daily’s best picks.
Medical billing is difficult for any practice, but especially large ones. After scaling, medical practices have to keep track of a lot of outstanding claims and patient statements, all while keeping day to day operations running smoothly. Given the complexities of revenue cycle management (RCM) in the healthcare industry, running billing in-house can be quite an expensive challenge. Luckily, there are outsourced medical billing services that can take the burden of RCM off your hands and allow your staff to focus on patients instead of billing.
Our best pick for medical billing services for large practices is AdvancedMD. Pricing varies depending on the size of your practice, the amount of monthly collections, number of providers and number of patient encounters. Pricing is a percentage of monthly collections and includes any implementation or training fees. Advanced MD also includes free access to their electronic health record (EHR) system. AdvancedMD’s medical billing service offers a thorough billing and scrubbing process designed to capture a higher than industry average amount of errors prior to submission.
Billing process
AdvancedMD offers a thorough billing process aimed at capturing as much revenue as possible on each claim the first time it is submitted. AdvancedMD guarantees a first pass claim rate of 95 percent in their annual contract. The company has certified coders on staff and uses Optum as a claims scrubber, which is the same software their preferred clearinghouse partner, RelayHelp uses to check for errors. That helps ensure that any mistakes the clearinghouse would catch are captured by AdvancedMD’s team before claims are submitted. As a result, all rejections or denials come from the payers directly. The billing team at AdvancedMD will follow up on unpaid or rejected claims, resolving any possible issues standing between your practice and its money.
Software
AdvancedMD maintains a full suite of healthcare IT products, including an EHR system and integrated practice management software. It is our best overall pick for electronic medical record software, and you can read a full review of AdvancedMD’s EHR software here.
Full access to the EHR and practice management software adds a great deal of value to AdvancedMD’s RCM service. At normal cost, the system is more than $700 per month plus thousands in implementation and training fees; however, with AdvancedMD’s medical billing service, the software is included in the negotiated percentage of collections.
Highlights of AdvancedMD’s EHR and practice management software include:
- 3 tiers of implementation and training plans to suit different levels of experience
- 8 to 11-week implementation period
- Extensive integrations with labs, pharmacies, and hospitals nationwide
- 24/7 customer support help desk
Pricing
AdvancedMD’s pricing, like most medical billing services, is based on your practice’s details and specific needs. The criteria AdvancedMD uses to determine pricing includes:
- Monthly collections: The ultimate price will be the higher of a monthly minimum (set during contract negotiation) or a percentage of your monthly collections, so to offer a precise quote AdvancedMD needs to know how much your practice brings in per month.
- Patient encounters: Pricing will also vary depending on the number of total patients seen by physicians.
- Specialty: Because the billing process and specific rules can vary so much from specialty to specialty, AdvancedMD incorporates the complexity of your specialty into their final percentage.
- Number of providers: Finally, your total number of providers can also influence the quote.
AdvancedMD requires practices to sign a one-year contract, which can be renewed annually or canceled at the end of the contracted term.
Reporting
AdvancedMD offers detailed financial reporting through its Advanced Insight module. Advanced Insight offers a complete view of your practices financials. It also includes useful planning tools. Some of the features in Advanced Insight include:
Practice benchmarking: Benchmarking is essential to understanding how your practice fits in within the larger industry. AdvancedMD’s benchmarking tool allows you to compare your numbers to other practices based on geographic region, specialty, or size to see how you stack up. Benchmarking helps show you where your practice is performing strongly, and where it needs improvement. When outsourcing your medical billing, it could be considered a way to see how the RCM team you’ve partnered with is delivering.
Financial dashboard: AdvancedMD’s financial dashboard brings your practice’s most critical financial information to one central location. The data is displayed in visualizations, like charts and graphs, which can be filtered in a number of ways to help you better understand your cash flow and the sources from which your money comes.
Data analytics: The data analytics tool takes the financial dashboard a step farther and allows you to examine historical data and make projections to help guide your business strategy. The data analytics tool shows recent trends in accounts receivable, practice productivity, and reimbursements. It also allows you to examine your referral network and see which relationships are paying off the most.
The tools in Advanced Insight are easy to use, and users are helped with on-screen advice that makes navigation easier when you’re still learning the program. Overall, it adds a strong element of visibility into the effectiveness of your managed billing.
Customer service
Our customer service experience with AdvancedMD was mostly positive, as representatives spent a great deal of time with us to explain the ins and outs of the medical billing service. We threw a lot of questions at them about the clearinghouse they use and how they achieve their purported first pass claim rate of 95 percent. We received thorough answers to each of our questions and earnest follow-ups to ensure we had all the information we needed.
The only downside of our experience is that we were not given a quote – not even ballpark pricing – but the representative did break down the considerations that go into pricing and explained what factors would contribute to the final costs. We also felt as though representatives were somewhat aggressive in trying to land the sale.
Limitations
The biggest limitation in our experience with AdvancedMD is that they weren’t able to give us a range of numbers for pricing. We explained that we were a soon to open practice of about five providers, but because AdvancedMD’s pricing is so practice-dependent, our lack of specifics about number of patient encounters, gross monthly claims and payers required meant they would not give us an estimate. A real practice, however, would have this information available, so we didn’t hold it against AdvancedMD that they wouldn’t offer a quote. However, we did request a ballpark range of typical prices multiple times and weren’t given any numbers.
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