AdvancedMD Medical Billing Review
- AdvancedMD's medical billing service is our best pick for large practices.
- AdvancedMD can scrub claims, manage claim denials and follow up on outstanding balances.
- AdvancedMD does not manage charge entry or coding, so you will need to keep a biller on staff.
- This review is for medical practice owners who are thinking of outsourcing their medical billing to AdvancedMD.
AdvancedMD Editor's Score: 92/100
| Claim scrubbing | 100/100 |
| Medical software | 88/100 |
| Denied claim management | 100/100 |
| First-pass acceptance rate (FPAR) | 98/100 |
| Depth of RCM services | 75/100 |
Why AdvancedMD Is the Best for Large Practices
AdvancedMD offers a medical billing service that picks up medical claims after they've been coded by your practice. For large practices, this is no obstacle, and AdvancedMD's medical billing service is exceptional from there. Its 97.6% first-pass acceptance rate (FPAR) means you'll get your claims paid quickly. And when any claims are denied, AdvancedMD's certified medical billers follow up within 14 days. AdvancedMD can help large practices with high volumes of claims improve their medical billing.
AdvancedMD Medical Billing
The Verdict
AdvancedMD's medical billing service is useful for high-volume practices that have an in-house biller or coder to perform charge entry and coding. It is an efficient way for large practices and health systems to process a substantial number of claims.
Large practices also need a top medical software platform. AdvancedMD's medical billing services include access to the company's electronic medical record (EMR) system and medical practice management software (PMS).
Did you know?: We also named AdvancedMD our pick for the best medical software for large practices. Read our review of AdvancedMD's medical software to find out why.
Pros
- AdvancedMD has a high first-pass acceptance rate.
- The company follows up on any unpaid claims.
- It has an experienced billing staff.
Cons
- AdvancedMD doesn't offer charge entry or medical coding services.
- The setup customization is difficult.
Usability
AdvancedMD's PMS interface, which you'll need to use for updates on how your billing team is managing your revenue, is quite user-friendly. However, the large number of shortcuts may prove overwhelming for some users. To address this concern, AdvancedMD offers one-on-one training if needed. However, this training is expensive, and other RCM providers offer free training. The extensive library of online setup resources should also prove helpful.
One feature that simplifies AdvancedMD's usability is its dashboard. We particularly liked the inclusion of "task donuts," which provide a quick view of information that's relevant to each user. For instance, a provider could set up task donuts to include their patients' notes, prescriptions, and lab orders or results, and a front-office staff member might customize the screen to show patient appointments, unread messages and provider availability. [Related article: The Benefits of EFT and ERA in Medical Billing]
AdvancedMD Features
Here are some of AdvancedMD's most important medical billing features:
| Claim scrubbing | AdvancedMD will scrub all your claims for errors, resulting in a first-pass claim acceptance rate of 97.6%. |
| Denied-claim services | Although denied claims are rare with AdvancedMD, the company will handle the entire process of turning denials into approvals. |
| Focus on large practices | AdvancedMD works for healthcare organizations with 305,000 to 350,000 monthly patient encounters. |
| Highly experienced staff | All AdvancedMD billers have at least one year of experience, and many are certified medical coders. |
| Follow-up on outstanding balances | If either patients or payers are overdue on payments, AdvancedMD will follow up with them regularly until you're reimbursed. |
Claim Scrubbing
Your AdvancedMD medical billers will scrub all your claims for errors and file your scrubbed claims to payers. However – and this is especially important to note – your AdvancedMD billing team will pick up the slack only after your team has entered and coded your charges.
As such, you'll still need staff who are capable of entering and coding your charges. This distinction separates AdvancedMD from most other medical billing services that always enter and code your charges.
Did you know?: AdvancedMD will not manage your charge entry and coding, but the company will pick up the billing process after you've coded your medical claims.
Denied-Claim Services
If any claims that AdvancedMD's billing team files for you wind up denied, you won't be left to pick up the slack. Instead, AdvancedMD will put its full effort behind revising the claim and resubmitting it as many times as needed until the payer approves it.
However, denied claims are unlikely with AdvancedMD. The company's billing team boasts an outstanding 97.6% FPAR. That means that if your practice is large enough to see 10,000 patients per month, only 240 or so claims will be denied on the first pass. As such, AdvancedMD saves you immense headaches on delayed-claim payments that would otherwise hamper your practice's cash flow.
Focus on Large Practices
AdvancedMD handles billing for practices with 305,000 to 350,000 patient encounters per month. The company says its average number of monthly encounters among medical billing clients is 317,000. These metrics make it clear that AdvancedMD focuses on large practices. You can rest assured knowing that this provider has the capacity and knowledge to meet the needs of large and complex health systems.
Did you know?: The average AdvancedMD client practice has roughly 317,000 patient encounters per month, but the company works with a range of practices and has expertise in various specialties, including dermatology and mental health billing.
That said, AdvancedMD is likely an imperfect fit for small practices. A single-doctor practice with a small front-office staff might prefer a medical billing service such as DrChrono, which sees the process through from charge entry and coding all the way to payer approval and payment. You can learn more in our review of DrChrono's medical billing service.
Highly Experienced Staff
Many practices seek medical billing services because even the most robust PMS isn't saving their front-office staff quite enough time to handle patient-facing work. If that's the case for your practice, you'll want to make sure the medical billers you choose won't find practice management systems tough to use. With AdvancedMD, that's not an issue.
All of AdvancedMD's billers have at least one year of medical billing experience. This certification means you can trust the AdvancedMD team to adequately scrub your claims; after all, the company does have a 97.6% FPAR.
Follow-Up on Outstanding Balances
AdvancedMD won't let the money you're owed go unpaid. If a payer approves a claim and doesn't pay within a reasonable time frame, AdvancedMD will follow up until you get paid. It will do the same with patients who owe you money.
The result is that your front-office employees don't have to pester patients and payers and can instead focus on the patient experience. It also means you'll be less likely to have to send patients or payers to collections.
AdvancedMD Cost
For RCM services, AdvancedMD typically charges 4% to 6% of your monthly collections. These rates are competitive in the medical billing space. Your exact rate will depend on your practice's size, claim volume, medical specialty, billing complexity and other factors.
AdvancedMD Setup
As you get started with AdvancedMD's RCM platform, you'll be offered all kinds of webinars, training videos and ICD-10 coding resources. You'll also notice that the software for connecting with your AdvancedMD billers includes support for clinical modification codes and hospital procedure codes. This inclusion makes AdvancedMD compatible with a wide variety of medical specialties and clinical settings.
AdvancedMD's RCM setup also lets you customize several billing-related reports. You can configure these reports in the way that best serves your practice's specialty, but doing so isn't exactly easy; AdvancedMD's reporting suite setup is known to be lengthy and full of unpleasant obstacles.
The challenges with AdvancedMD's medical billing setup stem mostly from the company's vast number of features. Though the abundance of features makes AdvancedMD exceptionally flexible, it presents a learning curve you might not experience with other RCM interfaces.
Key takeaway: Although AdvancedMD offers a wide range of custom reports, setting up your customized suite is often quite challenging.
AdvancedMD Drawbacks
One downside of outsourcing medical billing to AdvancedMD is that the company doesn't offer charge entry or coding management. If outsourced charge entry and coding management are crucial to your billing services, you'll need to handle them in-house. This setup may make AdvancedMD the wrong choice for tiny practices.
Another challenge relates to the setup: If you want to customize your managed billing and reporting portal, you might be in for a tough time. We found AdvancedMD's setup for these features to be more difficult than with other medical billing services. However, once you do set up your custom system, you'll be using one of the most powerful RCM platforms available.
Methodology
We spent hours researching medical billing services. That research included software demonstrations, phone interviews and customer service calls, as well as analysis of customer service reviews available online, including those listed on the Better Business Bureau website. We spent several months browsing company websites, reading customer reviews and speaking with company representatives. To find the best for large practices, we compared the services' experience with large practices and health systems, as well as its associated medical software's ability to handle multiple providers and locations. Based on these factors, we chose AdvancedMD as the best medical biller for large practices.
AdvancedMD Medical Billing FAQs
How much does AdvancedMD's medical billing service cost?
AdvancedMD's medical billing service ranges from 4% to 6% of your monthly collections. The pricing varies based on factors such as practice size, specialty, claim volume and billing complexity. These rates are competitive with those of the other medical billing services we reviewed.
Do I have to use AdvancedMD's medical software to use the billing service?
Yes, to outsource medical billing to AdvancedMD, clients also must use the company's medical practice management software. Because AdvancedMD's medical billers use the same software, you can monitor their activity in real time. Use of AdvancedMD's EMR system is not required, but it is recommended for practices that adopt the PMS.
Does AdvancedMD's medical billing service include medical coding?
No, AdvancedMD does not handle charge entry or medical coding as part of its revenue cycle management services. You will need to have a medical coder on staff or outsource this task to another company.
Overall Value
We recommend AdvancedMD Medical Billing for ...
- Large practices with multiple locations and high volumes of claims.
- Practices with in-house medical coding capabilities.
- Practices that need extensive coding resources.
We don't recommend AdvancedMD Medical Billing for ...
- Newly opened medical practices that need simple software.
- Practices looking to avoid steep learning curves with reporting interfaces.
- Practices that want to outsource all of their RCM, including medical coding.
AdvancedMD Medical Billing
The Verdict
AdvancedMD's medical billing service is useful for high-volume practices that have an in-house biller or coder to perform charge entry and coding. It is an efficient way for large practices and health systems to process a substantial number of claims.