Kareo Medical Billing Review

• Kareo connects its clients with third-party affiliate medical billing services. These services are among the best available for small practices, especially those that want to outsource only part of their revenue cycle.
• Kareo's medical billing services include claim scrubbing, charge entry and coding, and follow-up on unpaid claims.
• Kareo's potential flaws include a lack of response to certain negative reviews and almost no experience working with larger practices.
• This review is for medical practice owners who are interested in outsourcing their revenue cycle management to Kareo.

Kareo Editor's Score: 86/100

Why Kareo Is the Best for Tracking Claims

Kareo outsources its medical billing services to third-party affiliate billers. At the same time, Kareo clients get access to the company's medical software platform, which includes an electronic medical record (EMR) system, medical practice management software (PMS) and medical billing software. Since these tools are incredibly easy to use and require minimal training for most users, Kareo makes it easy for users to track the performance of their outsourced medical billing. This real-time window into Kareo's billing operations makes it easy to hand off such a delicate financial process without losing insight into how your practice is performing.

Pros

• The software you'll use to track your claims is highly intuitive and requires minimal training.
• It's affordable for small practices on a budget.

Cons

• It's not a good fit for large health systems.
• The company has not responded to certain customer complaints online.

Usability

In our review of Kareo's medical software, which comes with Kareo's medical billing service, we found the system intuitive to navigate. As such, it should require minimal training for new users to get up to speed. That's important because, as a Kareo medical billing service client, you will have to use the medical PMS at a minimum. Most practices opt to use the EMR system as well because the two are integrated seamlessly, with no additional implementation effort required. 

Kareo's EMR dashboard is designed like a social media feed, so most users can move through it intuitively. You can also move among most programs in just a click or two, and the Kareo dashboard is home to all your EMR, PMS and medical billing tools. We liked that Kareo's medical billing software allows users to monitor Kareo's medical billers in real time as they prepare and submit medical claims.

Source: Kareo

Kareo Features

These are some of Kareo's key revenue cycle management (RCM) features:

Charge Entry and Coding

All third-party billing teams Kareo connects you to can manage your entire revenue cycle (although it is not required). That means you can outsource your charge entry and coding, which is the first step in the process. 

Not all of our best picks offer charge entry or medical coding; some require you to enter and code charges before they begin the claim scrubbing and submission process. With Kareo's service, you can be confident that your claims will be treated with care.

Source: Kareo

Claim Scrubbing

Kareo's built-in rules engine scrubs all your claims for errors before any payer submissions. This way, your chances of rejected or denied claims are substantially lower. Kareo powers its rules engine based on the experiences of its entire client network, thus helping the system catch common errors. If the engine sees these errors in your claims, Kareo will flag them for a medical biller to review. The biller will then revise the claims as needed and submit them, thereby improving the odds that the payer will accept them the first time.

Did you know?: Kareo uses its claim scrubber to flag common errors in your claims before submission, leading to a higher first-pass acceptance rate.

Denied-Claim Management

Kareo's website is full of content encouraging its clients to strive for a first-pass acceptance rate (FPAR) of 95% or greater. However, in our conversations with Kareo representatives, we were not given a concrete FPAR value for the company.

No matter how high Kareo's FPAR turns out to be, you'll still have some denied claims. For those cases, Kareo turns to its Organized Worklist (OWL) system, which automatically assigns denied claims to the Kareo billing team that is most qualified to address the issue. 

All Kareo billing teams address denied claims before working on unfulfilled ones. After your Kareo billing team resubmits your claims, it will follow up as needed to obtain payment.

EMR and PMS Access

As with most medical billing companies, Kareo requires you to use its PMS. Its billing teams will use the same software to code and scrub your claims. You can also view the status of submitted claims, as well as a queue of rejected and denied claims that Kareo's billers still need to work on. We liked the overall usability of Kareo's medical PMS as well; in fact, we found it to be the most intuitive medical software we reviewed.

Although Kareo doesn't require you to implement its EMR system, this software is always included with your RCM services, so you can use it if you want to. Doing so may streamline your billing, because when you add codes to a patient record in your EMR, Kareo's billing teams will receive it immediately. Alternatively, you can fax your codes to Kareo. Kareo's EMR and PMS platforms include numerous features that may make both platforms the right fit for your practice. 

Tip: To choose the right medical software, examine more than just cost. Your practice's care providers will be using this software every day during patient encounters, so usability and customizable workflows are imperative.

Flexible Services

Although Kareo's third-party affiliate billers can enter and code your charges, this service is optional. That's because you can choose which parts of the revenue cycle you want Kareo to handle. Kareo is also flexible in that it works with practices in virtually all medical specialties. 

Tip: If you prefer to abide by a value-based care model instead of a fee-for-service model, ask any medical billing service you're considering if it offers that program.

No Clearinghouse Fees

Although Kareo doesn't include an integrated clearinghouse, you won't be charged any fees when Kareo uses a clearinghouse. Kareo builds all clearinghouse fees into your monthly rates, whereas some medical billing services charge monthly fees before adding clearinghouse costs. Typically, Kareo processes your claims through the Waystar clearinghouse, but it also works with TriZetto. [Related article: The Benefits of EFT and ERA in Medical Billing]

Follow-Up on Unpaid Claims

Kareo will follow up on all unpaid claims on your behalf to make sure you get your money on time. This goes for payers and patients alike, helping to reduce your practice's average days in accounts receivable and support healthy cash flow management. Once Kareo gets you the money you're owed, it will deposit your money straight into your practice's bank account. In this way, Kareo acts as an especially seamless accounts receivable partner.

Kareo Cost

Kareo's medical service rates are fairly competitive. As with the vast majority of RCM services, Kareo charges a percentage of your monthly collections instead of a flat fee. You pay based on variables such as your specialty, practice size and claim volume. No matter how much you pay, however, you get full access to Kareo's EMR and PMS platforms.

When you sign up for Kareo's medical billing services, you'll be locked into a year with the company, which is standard for RCM. You'll also have to agree to a $1,000 minimum monthly payment. This number may sound high, but it's often what small practices pay given the above collection percentages. It's also lower than the monthly minimum for competitors such as DrChrono. However, if you're looking for small-practice billing, read our DrChrono review to see why it's our top pick on that front.

Setup

On top of your monthly fees, Kareo charges $500 per provider for billing service setup. Training, though, is free. When you start with Kareo, you'll notice that its website has a wealth of educational videos and downloadable materials. If these materials don't answer your questions, you can contact your dedicated customer success coach for additional help.

Customer Service

Kareo customer service is included in the monthly cost. Kareo's customer support team is available via phone from 8 a.m. to 7 p.m. ET on weekdays, though your customer success coach should be your first point of contact. 

Kareo's medical billing services also include monthly consultations with your customer success coach, who will go over your practice's metrics and suggest how you can improve your medical billing workflows to help you hit your KPIs.

Drawbacks

Kareo's medical billing services don't really have any serious drawbacks. However, one downside involves previous customer complaints. As part of our research, we looked at the Better Business Bureau pages of all the medical billing services we evaluated. Kareo had more customer complaints about EMR and payment processing than other services we reviewed, and the company has not publicly responded to many of these comments.

Another downside is that this service may not be a good fit for large practices. Kareo's focus on working with small practices means that it lacks experience managing the revenue cycles of larger practices. As such, larger practices that choose Kareo may quickly find themselves disappointed in the services they're receiving. 

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. When looking for the easiest service to use, we compared the ease of navigation and general user-friendliness of the software provided by billing services. Ultimately, we found that Kareo goes the extra mile in ease of use and ability to track claims, so we designated it our best pick.

Kareo Medical Billing FAQs

How much does Kareo's medical billing service cost?

The cost of Kareo's medical billing service ranges from 4% to 7% 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 Kareo's medical software to use the billing service?

Kareo's medical billing clients must use the company's medical practice management software, which includes the medical billing tools that Kareo's team uses. You can monitor Kareo's third-party billing teams in real time as if they were other users of your medical software. Use of Kareo's EMR system is not required, but it is recommended for practices that adopt the PMS.

Does Kareo's medical billing service include medical coding?

Yes. Kareo's third-party affiliate medical coders handle charge entry and medical coding before handing off claims to billers for scrubbing and submission. Not all of our medical billing service best picks offer medical coding, making this a valuable service for Kareo clients.

Overall Value

We recommend Kareo Medical Billing for …

• Small or low-volume practices.
• Practices that need supremely user-friendly medical software and outsourced billing.
• Practices that want a medical billing service that includes medical coding.

We do not recommend Kareo Medical Billing for …

• Large practices.
• Practices that want extensive reporting.