Quick Overview
- 1#1: athenahealth - Provides comprehensive cloud-based medical billing, revenue cycle management, and practice management for healthcare providers.
- 2#2: Kareo - Offers user-friendly medical billing software with claims management, patient payments, and analytics for small to mid-sized practices.
- 3#3: AdvancedMD - Delivers robust EHR-integrated medical billing with automated claims processing, denial management, and reporting tools.
- 4#4: DrChrono - Mobile-first EHR and medical billing platform with real-time claims submission and eligibility verification.
- 5#5: Waystar - Specializes in revenue cycle management with AI-driven medical billing, claims scrubbing, and patient payment solutions.
- 6#6: eClinicalWorks - Integrated EHR and medical billing system featuring automated coding, claims tracking, and payer management.
- 7#7: NextGen Healthcare - Enterprise-grade practice management and medical billing software with advanced analytics and interoperability.
- 8#8: Epic Systems - Full-scale EHR platform with sophisticated medical billing, charge capture, and revenue integrity features for large organizations.
- 9#9: Oracle Health - Cloud-based health IT suite including medical billing, financial management, and revenue cycle optimization.
- 10#10: Veradigm - Provides EHR and revenue cycle management with medical billing, claims processing, and analytics capabilities.
We evaluated these tools based on core features (including claims management and denial handling), user experience, technical reliability, and overall value, ensuring they cater to diverse practice sizes and operational needs.
Comparison Table
Selecting the ideal medical billing software is vital for healthcare providers, with tools like athenahealth, Kareo, AdvancedMD, and DrChrono leading the market. This comparison table outlines key features, workflow integration, and practice suitability, equipping readers to make informed decisions that align with their needs.
| # | Tool | Category | Overall | Features | Ease of Use | Value |
|---|---|---|---|---|---|---|
| 1 | athenahealth Provides comprehensive cloud-based medical billing, revenue cycle management, and practice management for healthcare providers. | enterprise | 9.2/10 | 9.5/10 | 8.7/10 | 8.9/10 |
| 2 | Kareo Offers user-friendly medical billing software with claims management, patient payments, and analytics for small to mid-sized practices. | specialized | 9.1/10 | 9.4/10 | 8.7/10 | 8.9/10 |
| 3 | AdvancedMD Delivers robust EHR-integrated medical billing with automated claims processing, denial management, and reporting tools. | enterprise | 8.4/10 | 9.1/10 | 7.6/10 | 7.8/10 |
| 4 | DrChrono Mobile-first EHR and medical billing platform with real-time claims submission and eligibility verification. | specialized | 8.3/10 | 8.9/10 | 7.8/10 | 7.6/10 |
| 5 | Waystar Specializes in revenue cycle management with AI-driven medical billing, claims scrubbing, and patient payment solutions. | enterprise | 8.7/10 | 9.2/10 | 7.8/10 | 8.1/10 |
| 6 | eClinicalWorks Integrated EHR and medical billing system featuring automated coding, claims tracking, and payer management. | enterprise | 7.8/10 | 8.2/10 | 6.9/10 | 7.4/10 |
| 7 | NextGen Healthcare Enterprise-grade practice management and medical billing software with advanced analytics and interoperability. | enterprise | 7.8/10 | 8.5/10 | 7.2/10 | 7.5/10 |
| 8 | Epic Systems Full-scale EHR platform with sophisticated medical billing, charge capture, and revenue integrity features for large organizations. | enterprise | 8.7/10 | 9.4/10 | 6.8/10 | 7.9/10 |
| 9 | Oracle Health Cloud-based health IT suite including medical billing, financial management, and revenue cycle optimization. | enterprise | 8.2/10 | 9.1/10 | 6.8/10 | 7.9/10 |
| 10 | Veradigm Provides EHR and revenue cycle management with medical billing, claims processing, and analytics capabilities. | enterprise | 7.6/10 | 8.2/10 | 6.8/10 | 7.1/10 |
Provides comprehensive cloud-based medical billing, revenue cycle management, and practice management for healthcare providers.
Offers user-friendly medical billing software with claims management, patient payments, and analytics for small to mid-sized practices.
Delivers robust EHR-integrated medical billing with automated claims processing, denial management, and reporting tools.
Mobile-first EHR and medical billing platform with real-time claims submission and eligibility verification.
Specializes in revenue cycle management with AI-driven medical billing, claims scrubbing, and patient payment solutions.
Integrated EHR and medical billing system featuring automated coding, claims tracking, and payer management.
Enterprise-grade practice management and medical billing software with advanced analytics and interoperability.
Full-scale EHR platform with sophisticated medical billing, charge capture, and revenue integrity features for large organizations.
Cloud-based health IT suite including medical billing, financial management, and revenue cycle optimization.
Provides EHR and revenue cycle management with medical billing, claims processing, and analytics capabilities.
athenahealth
enterpriseProvides comprehensive cloud-based medical billing, revenue cycle management, and practice management for healthcare providers.
AI-driven Revenue Intelligence with predictive denial management and real-time claim optimization for maximum reimbursements
athenahealth's athenaOne platform is a comprehensive cloud-based solution for medical billing, integrated within its EHR and practice management system, automating claims submission, coding, scrubbing, and denial management to optimize revenue cycles. It leverages AI-driven analytics for predictive insights, eligibility verification, and payment posting, achieving industry-leading clean claim rates often exceeding 98%. Designed for scalability, it supports practices of all sizes with robust interoperability via FHIR standards and seamless data exchange with payers and clearinghouses.
Pros
- Exceptional revenue cycle management with AI-powered denial prevention and 98%+ clean claims rate
- Seamless EHR integration for end-to-end workflows and reduced errors
- Advanced analytics and reporting for revenue optimization and compliance
Cons
- High implementation costs and time for setup (often 3-6 months)
- Pricing can be prohibitive for very small practices
- Occasional customization limitations for niche specialties
Best For
Large and mid-sized medical practices seeking an integrated, scalable billing solution with top-tier automation and payer connectivity.
Pricing
Custom subscription starting at $400-$800 per provider/month (billed annually), plus one-time implementation fees of $10K+; revenue-based RCM services available.
Kareo
specializedOffers user-friendly medical billing software with claims management, patient payments, and analytics for small to mid-sized practices.
Intelligent Revenue Cycle Management with real-time eligibility checks and AI-driven denial prediction
Kareo is a cloud-based platform specializing in medical billing, revenue cycle management, and practice management for independent practices and small to mid-sized groups. It automates claims submission, eligibility verification, denial management, and patient payments to maximize reimbursements. Integrated with EHR and telehealth, it provides a unified solution to streamline administrative workflows and improve financial performance.
Pros
- Robust revenue cycle management with automated claims scrubbing and denial prevention
- Seamless integration with EHR, scheduling, and patient engagement tools
- Strong analytics and reporting for tracking financial KPIs
Cons
- Pricing can escalate with transaction fees for high-volume practices
- Some advanced customizations require additional setup or support
- Mobile app functionality is solid but lacks some desktop features
Best For
Small to mid-sized independent medical practices needing an integrated billing and practice management solution.
Pricing
Subscription starts at ~$140/provider/month for core billing, plus per-claim fees (4-7% of collections); bundled plans with EHR from $300+/month.
AdvancedMD
enterpriseDelivers robust EHR-integrated medical billing with automated claims processing, denial management, and reporting tools.
AI-powered revenue cycle analytics for predictive denial prevention and cash flow forecasting
AdvancedMD is a comprehensive cloud-based medical billing software integrated within its all-in-one EHR and practice management platform, designed to streamline revenue cycle management for healthcare providers. It automates claims submission, eligibility verification, payment posting, and denial management across multiple payers. The solution offers advanced reporting, analytics, and patient payment portals to optimize cash flow and reduce administrative burdens.
Pros
- Robust automation for claims processing and ERA posting
- Seamless integration with EHR and scheduling
- Advanced denial management and analytics tools
Cons
- Steep learning curve for new users
- High subscription costs with add-on fees
- Occasional customer support delays
Best For
Mid-sized to large medical practices needing an integrated billing solution within a full practice management suite.
Pricing
Custom subscription pricing starts at $400-$729 per provider/month, plus setup fees and per-user costs; enterprise quotes available.
DrChrono
specializedMobile-first EHR and medical billing platform with real-time claims submission and eligibility verification.
Native iPad-optimized apps for real-time billing and charge capture during patient encounters
DrChrono is a comprehensive cloud-based EHR and practice management platform with integrated medical billing tools designed for ambulatory practices. It streamlines revenue cycle management through features like electronic claims submission, automated ERA posting, denial management, and patient payment processing. The software supports specialty-specific billing rules, superbills, and clearinghouse integrations, making it suitable for efficient practice billing workflows.
Pros
- Seamless EHR-billing integration reduces data entry errors
- Mobile iOS apps enable on-the-go claims and payments
- Robust analytics and denial management tools improve collections
Cons
- Steep learning curve for non-tech-savvy users
- Premium pricing may strain small practices' budgets
- Occasional delays in claims scrubbing and support response
Best For
Mid-sized specialty practices needing an all-in-one platform with strong mobile billing capabilities.
Pricing
Starts at $199/provider/month plus $39/user/month; includes billing but adds fees for clearinghouse ($0.09-$0.25/claim) and custom setups.
Waystar
enterpriseSpecializes in revenue cycle management with AI-driven medical billing, claims scrubbing, and patient payment solutions.
RevView AI analytics engine that delivers predictive insights for proactive denial prevention and revenue optimization
Waystar is a leading revenue cycle management (RCM) platform specializing in medical billing software for healthcare providers. It automates claims processing, denial management, patient payments, and eligibility verification to streamline financial operations and accelerate reimbursements. The platform leverages AI and analytics to provide actionable insights, helping organizations reduce errors and improve cash flow across hospitals, physician practices, and health systems.
Pros
- Exceptional claims acceptance rates (often 98%+ first-pass)
- Comprehensive AI-driven analytics and denial prevention tools
- Seamless integration with EHRs and robust patient payment options
Cons
- Steep learning curve and lengthy implementation for complex setups
- Pricing lacks transparency and is geared toward enterprise-scale users
- Overkill for very small practices with basic billing needs
Best For
Mid-to-large healthcare providers and health systems needing scalable, end-to-end RCM automation.
Pricing
Custom enterprise pricing based on claims volume and modules; typically starts at $50K+ annually for mid-sized users—contact sales for quotes.
eClinicalWorks
enterpriseIntegrated EHR and medical billing system featuring automated coding, claims tracking, and payer management.
Prism Revenue Cycle Management with AI-driven denial prevention and predictive analytics for optimizing reimbursements
eClinicalWorks is a comprehensive electronic health record (EHR) and practice management platform with robust medical billing features as part of its revenue cycle management (RCM) suite. It automates claims submission, eligibility verification, denial management, and payment posting, integrating seamlessly with clinical workflows for efficient charge capture. The software supports electronic remittance advice (ERA) processing and provides analytics for AR aging and financial performance, making it suitable for multi-specialty practices.
Pros
- Seamless integration with EHR for accurate charge capture and reduced errors
- Advanced RCM tools including automated denial management and AR analytics
- Scalable for small to large practices with support for multiple locations
Cons
- Steep learning curve and complex interface requiring extensive training
- Customer support often criticized for slow response times
- High implementation costs and lengthy onboarding process
Best For
Large multi-specialty practices or hospitals needing an integrated EHR and billing solution with strong RCM capabilities.
Pricing
Custom quoted pricing; typically starts at $449 per provider per month, plus implementation fees and add-ons for advanced RCM features.
NextGen Healthcare
enterpriseEnterprise-grade practice management and medical billing software with advanced analytics and interoperability.
AI-driven predictive denial management to proactively identify and resolve claim issues
NextGen Healthcare provides an integrated EHR and revenue cycle management (RCM) platform tailored for medical practices, with strong medical billing features including automated claims processing, eligibility verification, and denial management. It supports end-to-end billing workflows, from charge capture to payment reconciliation, while integrating seamlessly with clinical documentation. Designed for ambulatory and specialty practices, it leverages analytics to improve financial outcomes and reduce revenue leakage.
Pros
- Comprehensive RCM with automated claims scrubbing and denial prevention
- Deep integration with EHR for accurate charge capture
- Advanced analytics and reporting for revenue optimization
Cons
- Steep learning curve and complex interface
- High implementation and customization costs
- Customer support can be inconsistent
Best For
Mid-sized to large ambulatory practices needing robust, integrated EHR and billing with analytics.
Pricing
Custom enterprise pricing; typically $300-$600 per provider/month plus implementation fees starting at $50K+.
Epic Systems
enterpriseFull-scale EHR platform with sophisticated medical billing, charge capture, and revenue integrity features for large organizations.
Fully embedded revenue cycle management within the EHR, enabling real-time clinical-financial data synchronization
Epic Systems is a leading electronic health record (EHR) platform with integrated medical billing capabilities through its Resolute modules, handling everything from patient registration and charge capture to claims submission, denial management, and revenue cycle analytics. Designed primarily for large hospitals and health systems, it ensures seamless data flow between clinical and financial workflows while maintaining strict HIPAA compliance. Its scalability supports high-volume billing operations with advanced automation and interoperability standards like FHIR.
Pros
- Seamless integration with comprehensive EHR for accurate charge capture and reduced errors
- Advanced revenue cycle management tools including AI-driven denial prediction and analytics
- Robust compliance features and support for complex payer contracts and coding standards
Cons
- Prohibitively expensive with massive upfront implementation costs often exceeding millions
- Steep learning curve requiring extensive training and customization
- Prolonged deployment timelines typically spanning 1-3 years
Best For
Large hospitals, health systems, and academic medical centers needing an enterprise-grade, fully integrated EHR and billing solution.
Pricing
Custom enterprise pricing; implementation often costs $50M+ for large organizations, with annual subscriptions in the millions.
Oracle Health
enterpriseCloud-based health IT suite including medical billing, financial management, and revenue cycle optimization.
AI-powered Revenue Cycle Intelligence for proactive denial management and reimbursement forecasting
Oracle Health, formerly Cerner, offers a comprehensive electronic health record (EHR) platform with integrated Revenue Cycle Management (RCM) tools tailored for medical billing in large-scale healthcare environments. It streamlines claims submission, denial management, coding accuracy, patient payments, and payer reimbursements through automation and analytics. The solution ensures HIPAA compliance and scalability for hospitals and health systems, optimizing revenue capture while reducing administrative burdens.
Pros
- Seamless integration with EHR for accurate charge capture and reduced errors
- Advanced AI-driven analytics for denial prediction and revenue optimization
- Robust compliance tools and scalability for enterprise-level operations
Cons
- High implementation costs and long deployment timelines
- Steep learning curve for non-technical users
- Less ideal for small practices due to overkill features and pricing
Best For
Large hospitals, health systems, and multi-facility providers seeking an integrated EHR and billing platform.
Pricing
Custom enterprise licensing with annual subscriptions starting at $1M+ depending on modules, users, and deployment scale; no public SMB pricing.
Veradigm
enterpriseProvides EHR and revenue cycle management with medical billing, claims processing, and analytics capabilities.
AI-powered predictive analytics for denial management and revenue optimization
Veradigm offers a robust revenue cycle management (RCM) platform designed for healthcare providers, automating medical billing, claims processing, denial management, and payment posting. Integrated with its electronic health records (EHR) system, it enables seamless data flow from patient encounters to revenue capture. The solution leverages analytics and automation to improve financial performance and reduce administrative burdens in medical practices.
Pros
- Strong integration with EHR for streamlined workflows
- Advanced analytics and denial prevention tools
- Scalable for various practice sizes with compliance features
Cons
- Steep learning curve for new users
- Occasional customer support delays
- Higher cost compared to standalone billing software
Best For
Mid-sized to large medical practices seeking an integrated EHR and billing solution for complex revenue cycles.
Pricing
Custom enterprise pricing, typically $500–$5,000+ per month based on practice size and modules, with implementation fees.
Conclusion
When evaluating top medical billing software, athenahealth emerges as the standout choice, providing comprehensive cloud-based tools for healthcare providers. Kareo and AdvancedMD also excel, with Kareo offering user-friendly design for small to mid-sized practices and AdvancedMD impressing with robust EHR integration. Each solution caters to distinct needs, ensuring optimal fit for various healthcare settings.
To experience the leading capabilities firsthand, start with athenahealth—its integrated features can transform your practice’s efficiency and revenue cycle management.
Tools Reviewed
All tools were independently evaluated for this comparison