Find the Right Medical Billing Software or Service for Your Practice

Start with how claims move through your practice today. Look at your clean claim rate, denial rate and days in accounts receivable, and note where staff spend the most time: entering charges, checking eligibility, chasing denials or posting payments. Most practices want to get paid faster, cut denials and reduce manual work, while keeping patient billing simple and accurate.

The right fit depends on your specialty, size and how much of the billing work you want to keep in-house. Some practices want software their own staff can run; others prefer to outsource billing to a service that handles claims and follow-up for them.

Think about the following questions:

• How many providers and locations does your practice have?
• Which specialties do you bill for, and do they have specific coding requirements?
• Which insurance payers make up most of your claims?
• Do you want to keep billing in-house, outsource it, or use a mix of both?
• Does the solution need to integrate with your current EHR or practice management system?
• Do you need patient-facing features such as online statements and payments?
• What reporting do you need to track collections and denials?

Make a shortlist of medical billing software vendors and billing services, and compare them on features, integrations, support and pricing. Pricing models vary: software is often billed per provider per month, while outsourced billing services commonly charge a percentage of collections. Ask each vendor exactly what is included so you can compare total cost.

Read independent reviews and user ratings, and ask colleagues at similar practices what they use. Track your findings in a spreadsheet so you can compare options side by side.

Once you’ve narrowed your list, request demos and written quotes. Include the billing staff and office managers who will use the system day to day, and walk through real workflows such as submitting a claim, working a denial and posting a payment. Ask about implementation, training, data migration from your current system, and how the vendor handles support.