Quick Overview
- 1#1: Athenahealth - Provides comprehensive revenue cycle management including automated claims submission, scrubbing, and payment posting for healthcare providers.
- 2#2: Kareo - Offers cloud-based medical billing software with claims processing, denial management, and patient payments for practices of all sizes.
- 3#3: AdvancedMD - Delivers integrated billing and revenue cycle management with real-time claims tracking, eligibility verification, and analytics.
- 4#4: Waystar - Specializes in healthcare payments and claims management with AI-driven denial prevention and streamlined revenue cycle workflows.
- 5#5: Change Healthcare - Facilitates claims processing, electronic remittance advice, and payer connectivity for efficient medical billing operations.
- 6#6: Availity - Enables secure claims submission, status checking, and payer-provider collaboration through its healthcare clearinghouse platform.
- 7#7: DrChrono - Integrates EHR with billing features for seamless claims filing, superbills, and payment processing in a mobile-friendly interface.
- 8#8: Office Ally - Provides a free claims clearinghouse service with submission, tracking, and ERA posting for small practices and providers.
- 9#9: SimplePractice - Offers practice management with built-in billing, superbills, and claims submission tailored for mental health and therapy providers.
- 10#10: CollaborateMD - Delivers web-based medical billing software focused on claims management, scheduling, and reporting for specialty practices.
These tools were evaluated based on features, usability, reliability, and value, prioritizing those that deliver robust functionality—such as automated claims processing, denial management, and integration with EHR systems—to meet the diverse needs of healthcare providers.
Comparison Table
Efficient claims billing software is vital for optimizing healthcare revenue cycles, and selecting the right tool requires key insights. This comparison table explores top options including Athenahealth, Kareo, AdvancedMD, Waystar, Change Healthcare, and more, analyzing features, usability, and cost factors. Readers will discover the best fit for their practice needs through side-by-side details.
| # | Tool | Category | Overall | Features | Ease of Use | Value |
|---|---|---|---|---|---|---|
| 1 | Athenahealth Provides comprehensive revenue cycle management including automated claims submission, scrubbing, and payment posting for healthcare providers. | enterprise | 9.5/10 | 9.7/10 | 8.7/10 | 9.0/10 |
| 2 | Kareo Offers cloud-based medical billing software with claims processing, denial management, and patient payments for practices of all sizes. | enterprise | 8.8/10 | 9.2/10 | 8.5/10 | 8.6/10 |
| 3 | AdvancedMD Delivers integrated billing and revenue cycle management with real-time claims tracking, eligibility verification, and analytics. | enterprise | 8.7/10 | 9.2/10 | 7.8/10 | 8.1/10 |
| 4 | Waystar Specializes in healthcare payments and claims management with AI-driven denial prevention and streamlined revenue cycle workflows. | enterprise | 8.7/10 | 9.2/10 | 8.0/10 | 8.3/10 |
| 5 | Change Healthcare Facilitates claims processing, electronic remittance advice, and payer connectivity for efficient medical billing operations. | enterprise | 8.6/10 | 9.2/10 | 7.8/10 | 8.4/10 |
| 6 | Availity Enables secure claims submission, status checking, and payer-provider collaboration through its healthcare clearinghouse platform. | enterprise | 8.2/10 | 9.1/10 | 7.4/10 | 8.0/10 |
| 7 | DrChrono Integrates EHR with billing features for seamless claims filing, superbills, and payment processing in a mobile-friendly interface. | specialized | 8.4/10 | 8.7/10 | 8.5/10 | 7.9/10 |
| 8 | Office Ally Provides a free claims clearinghouse service with submission, tracking, and ERA posting for small practices and providers. | specialized | 8.1/10 | 7.8/10 | 8.5/10 | 9.2/10 |
| 9 | SimplePractice Offers practice management with built-in billing, superbills, and claims submission tailored for mental health and therapy providers. | specialized | 8.6/10 | 8.8/10 | 9.2/10 | 8.1/10 |
| 10 | CollaborateMD Delivers web-based medical billing software focused on claims management, scheduling, and reporting for specialty practices. | specialized | 8.1/10 | 8.5/10 | 7.6/10 | 8.0/10 |
Provides comprehensive revenue cycle management including automated claims submission, scrubbing, and payment posting for healthcare providers.
Offers cloud-based medical billing software with claims processing, denial management, and patient payments for practices of all sizes.
Delivers integrated billing and revenue cycle management with real-time claims tracking, eligibility verification, and analytics.
Specializes in healthcare payments and claims management with AI-driven denial prevention and streamlined revenue cycle workflows.
Facilitates claims processing, electronic remittance advice, and payer connectivity for efficient medical billing operations.
Enables secure claims submission, status checking, and payer-provider collaboration through its healthcare clearinghouse platform.
Integrates EHR with billing features for seamless claims filing, superbills, and payment processing in a mobile-friendly interface.
Provides a free claims clearinghouse service with submission, tracking, and ERA posting for small practices and providers.
Offers practice management with built-in billing, superbills, and claims submission tailored for mental health and therapy providers.
Delivers web-based medical billing software focused on claims management, scheduling, and reporting for specialty practices.
Athenahealth
enterpriseProvides comprehensive revenue cycle management including automated claims submission, scrubbing, and payment posting for healthcare providers.
AI-powered claims intelligence engine delivering 98%+ clean claims rate and predictive denial prevention
Athenahealth's athenaOne platform is a comprehensive cloud-based solution specializing in revenue cycle management, with advanced claims billing capabilities that automate submission, scrubbing, and tracking to payers. It integrates seamlessly with EHR for end-to-end workflows, achieving industry-leading clean claims rates above 98% to reduce denials and accelerate reimbursements. Real-time analytics and AI-driven insights help practices manage accounts receivable effectively across specialties.
Pros
- Exceptional claims scrubbing and automation for high first-pass acceptance rates
- Broad payer connectivity and real-time eligibility verification
- Integrated denial management with automated appeals and AR analytics
Cons
- High implementation costs and timeline for full setup
- Steep learning curve for non-technical users
- Pricing can be prohibitive for very small practices
Best For
Mid-sized to large medical practices or health systems needing integrated EHR and robust claims billing with minimal denials.
Pricing
Custom subscription pricing based on practice size and revenue volume; typically $400-$1,200 per provider/month plus setup fees, with optional RCM outsourcing.
Kareo
enterpriseOffers cloud-based medical billing software with claims processing, denial management, and patient payments for practices of all sizes.
Intelligent Denial Prevention engine that uses AI to predict and prevent claim denials before submission
Kareo is a cloud-based medical billing and revenue cycle management platform designed for independent healthcare practices, streamlining claims submission, eligibility verification, and payment processing. It offers end-to-end billing solutions including automated scrubbing, denial management, and analytics to maximize reimbursements. Integrated with its EHR and practice management tools, Kareo reduces administrative overhead and improves cash flow for providers.
Pros
- Automated claims scrubbing and direct submission to over 3,000 payers for high first-pass acceptance rates
- Robust denial management with analytics and workflows to recover lost revenue
- Real-time eligibility checks and payment posting to accelerate reimbursements
Cons
- Pricing can escalate with higher claim volumes or additional modules
- Customer support response times vary, with some users reporting delays
- Steeper learning curve for advanced reporting and customization
Best For
Small to mid-sized independent medical practices seeking integrated billing and revenue cycle management without in-house expertise.
Pricing
Starts at $110/provider/month for core billing, plus per-claim fees (around 4-7%) and tiered plans up to $300+/provider/month for full RCM services.
AdvancedMD
enterpriseDelivers integrated billing and revenue cycle management with real-time claims tracking, eligibility verification, and analytics.
Advanced Claim Scrubber that delivers industry-leading clean claim submission rates exceeding 98%
AdvancedMD is a comprehensive cloud-based platform offering robust claims billing capabilities as part of its integrated EHR and practice management suite, designed to streamline the revenue cycle for medical practices. It automates electronic claims submission, scrubbing, eligibility verification, payment posting, and denial management to improve cash flow and reduce errors. With support for over 3,000 payers and high clean claims rates, it helps providers maximize reimbursements efficiently.
Pros
- Exceptional claim scrubbing with 98%+ clean claims acceptance rates
- Integrated denial management and automated appeals workflow
- Seamless integration with EHR and major clearinghouses for end-to-end billing
Cons
- Steep learning curve and requires significant training
- High cost with custom pricing that can be prohibitive for small practices
- Occasional customer support delays reported by users
Best For
Mid-sized to large medical practices needing integrated EHR and advanced billing automation.
Pricing
Custom quote-based pricing; typically $400-$800 per provider/month depending on modules and practice size.
Waystar
enterpriseSpecializes in healthcare payments and claims management with AI-driven denial prevention and streamlined revenue cycle workflows.
AI-powered Claims Guarantee, which proactively scrubs claims to achieve near-99% first-pass acceptance rates
Waystar is a comprehensive revenue cycle management (RCM) platform specializing in healthcare claims billing, offering tools for electronic claims submission, scrubbing, denial management, and payment posting. It leverages AI and automation to achieve high first-pass acceptance rates (up to 99%) and accelerate reimbursements across hospitals, health systems, and physician groups. The software integrates with major EHRs like Epic and Cerner, providing analytics for optimizing billing workflows and reducing A/R days.
Pros
- Exceptional claims scrubbing and denial prevention with AI-driven intelligence
- Seamless integrations with EHRs and PMS systems
- Advanced analytics for revenue cycle performance insights
Cons
- Complex implementation process for new users
- Pricing lacks transparency and can be costly for smaller practices
- Steep learning curve for non-technical staff
Best For
Mid-to-large healthcare organizations such as hospitals and health systems needing scalable, enterprise-grade claims billing automation.
Pricing
Custom quote-based pricing; typically starts at $50,000+ annually for mid-sized practices, scaling with volume and modules.
Change Healthcare
enterpriseFacilitates claims processing, electronic remittance advice, and payer connectivity for efficient medical billing operations.
Largest healthcare EDI network for unmatched claims routing and acceptance rates
Change Healthcare offers a comprehensive claims billing platform focused on revenue cycle management, including electronic claims submission, scrubbing, eligibility verification, and denial management. As a leading clearinghouse, it processes billions of transactions annually through its extensive EDI network, integrating seamlessly with EHRs and practice management systems. The software provides advanced analytics for performance insights and compliance with evolving healthcare regulations.
Pros
- Massive scale with processing over 15 billion claims annually
- Robust compliance and denial prevention tools
- Strong interoperability with major EHR systems
Cons
- Complex interface with steep learning curve for new users
- Enterprise pricing often too high for small practices
- Customer support can be slow during peak issues
Best For
Large hospitals, health systems, and high-volume providers needing scalable claims processing.
Pricing
Custom enterprise pricing based on transaction volume; typically subscription or per-claim fees starting at thousands per month—contact sales for quote.
Availity
enterpriseEnables secure claims submission, status checking, and payer-provider collaboration through its healthcare clearinghouse platform.
Industry-leading payer network with direct connectivity to thousands of payers for seamless, high-accuracy claims processing and reduced rejections.
Availity is a leading healthcare interoperability platform that enables providers, payers, and vendors to securely exchange administrative and clinical data. As a claims billing solution, it supports electronic claims submission (EDI 837), real-time eligibility verification, electronic remittance advice (ERA 835), denial management, and patient payment collection. Its vast network covers over 90% of insured lives in the US, making it a cornerstone for revenue cycle management in healthcare billing.
Pros
- Extensive payer connectivity to over 4,000 payers covering 90%+ of US insured lives
- Comprehensive RCM tools including claims scrubbing, ERA auto-posting, and denial workflows
- Strong compliance with HIPAA and robust API integrations for EHR/PM systems
Cons
- Steep learning curve and dated interface for new users
- Transaction-based fees can add up for low-volume practices
- Customer support response times vary, especially for smaller clients
Best For
Mid-to-large healthcare providers, hospitals, and billing companies managing high-volume claims across multiple payers.
Pricing
Transaction-based pricing with free basic eligibility checks; premium features via subscription tiers starting at $100/month, scaling to enterprise custom quotes.
DrChrono
specializedIntegrates EHR with billing features for seamless claims filing, superbills, and payment processing in a mobile-friendly interface.
AI-driven claims scrubbing and denial prediction for higher first-pass acceptance rates
DrChrono is a cloud-based EHR and practice management platform with integrated claims billing capabilities, designed to streamline revenue cycle management for healthcare providers. It supports electronic claims submission to major clearinghouses, real-time patient eligibility verification, and denial management tools. The software automates billing workflows, payment posting, and ERA processing, making it suitable for practices handling complex medical billing.
Pros
- Seamless integration with EHR for one-click claims submission
- Real-time eligibility checks and automated scrubbing to reduce denials
- Mobile app support for on-the-go billing and payment tracking
Cons
- Pricing can be steep for very small practices
- Customer support response times vary
- Advanced customization for billing rules requires setup time
Best For
Small to mid-sized specialty practices needing integrated EHR and claims billing without standalone software.
Pricing
Custom subscription starting at $199/provider/month, plus per-user fees and add-ons for advanced billing features.
Office Ally
specializedProvides a free claims clearinghouse service with submission, tracking, and ERA posting for small practices and providers.
Completely free electronic claims submission to Medicare and 4,000+ payers
Office Ally is a cloud-based clearinghouse platform designed for medical claims billing, offering free electronic submission to Medicare and over 4,000 payers, along with eligibility verification and ERA auto-posting. It streamlines the revenue cycle for healthcare providers by handling professional and institutional claims processing efficiently. The software integrates with various practice management systems and emphasizes HIPAA compliance for secure data handling.
Pros
- Free core claims clearinghouse services including submission to thousands of payers
- Intuitive web-based interface with quick setup and no software installation required
- Reliable eligibility checks and ERA processing to reduce denials
Cons
- Advanced reporting and analytics require paid upgrades
- Limited integrations compared to full-suite PM/EHR systems
- Customer support can be slower for free-tier users
Best For
Small to mid-sized medical practices and solo providers needing cost-effective claims submission without complex setups.
Pricing
Free for basic claims submission and eligibility; paid plans start at $0.14 per claim or $19/month for premium features like advanced reporting.
SimplePractice
specializedOffers practice management with built-in billing, superbills, and claims submission tailored for mental health and therapy providers.
Built-in claims scrubber with one-click submission to 1,000+ payers and real-time eligibility verification
SimplePractice is an all-in-one practice management platform with robust claims billing features designed primarily for mental health and wellness professionals. It enables electronic claims submission to over 1,000 insurance payers, automated ERA posting, eligibility verification, and superbills generation. The software integrates billing seamlessly with EHR documentation, scheduling, and client portals for efficient revenue cycle management.
Pros
- Intuitive interface for quick claims submission and tracking
- Automated eligibility checks and ERA auto-posting to reduce errors
- Strong integration with EHR and scheduling for streamlined workflows
Cons
- Higher costs for full billing features and add-ons like telehealth
- Limited advanced analytics and custom reporting for complex claims
- Occasional payer-specific issues requiring manual adjustments
Best For
Solo and small mental health practices seeking user-friendly, integrated claims billing without needing enterprise-level customization.
Pricing
Starts at $69/month per provider for Enhanced plan with billing; $99 for Pro with telehealth; additional per-claim fees may apply for some payers.
CollaborateMD
specializedDelivers web-based medical billing software focused on claims management, scheduling, and reporting for specialty practices.
Proprietary Smart Scrubber technology that automatically validates claims against payer rules before submission
CollaborateMD is a cloud-based medical billing and practice management software designed to streamline claims processing, revenue cycle management, and EHR integration for healthcare providers. It automates electronic claims submission to major payers, includes robust claims scrubbing to minimize denials, and offers tools for patient billing and collections. Ideal for practices seeking an all-in-one solution for efficient claims billing workflows.
Pros
- Advanced claims scrubbing engine that significantly reduces claim rejections and denials
- Seamless EDI integration with major clearinghouses and payers for fast electronic submissions
- Comprehensive reporting and analytics for revenue cycle insights
Cons
- User interface feels somewhat dated and less intuitive compared to modern competitors
- Limited customization options for complex workflows
- Customer support response times can be inconsistent during peak periods
Best For
Small to mid-sized medical practices needing reliable claims billing with integrated EHR functionality.
Pricing
Starts at $399/month for single provider (billed annually), scales up with additional providers/users; custom enterprise pricing available.
Conclusion
The reviewed claims billing software each bring unique strengths to healthcare revenue management, from automated processing to integrated EHR tools. Athenahealth leads as the top choice, offering comprehensive revenue cycle management that streamlines core operations. Kareo and AdvancedMD follow closely, with cloud-based flexibility and real-time tracking, making them standout alternatives for diverse practice needs.
Start optimizing your billing workflow today by trying Athenahealth— its robust features can transform how your practice handles claims and payments.
Tools Reviewed
All tools were independently evaluated for this comparison