PCG Software: Next Generation Provider Tool with Coding Accuracy

Top 10 Medical Billing and Coding Pioneers - 2019

The global medical billing and coding market is poised to expand for years to come owing to factors such as increasing healthcare expenditure, the need for risk and compliance management, and the proliferation of sophisticated technology. However, in an effort to reduce recruitment and infrastructural cost and thereby increase revenue, providers resort to third party vendors to outsource the job.

There is no denying that medical billing comes with various technical challenges such as unintentional billings, billing code errors, incorrect filings, and duplication of processes. With increasing adoption of technologies such as AI, ML, and automation, manual-intensive tasks including duplicate billing, incorrect modifiers, and inaccurate patient information can be digitized. This ensures more efficiency and quality while delivering the services to the patients. It is also important to bridge the gap between patients, healthcare service providers, and insurance companies for delivering seamless healthcare services. Healthcare providers are pushing the envelope to combine digital and telecommunication technology to find a viable solution for the same. Using natural language processing (NLP) to interpret the text on clinical documents, processes that require more human labor can be automated. As poor record keeping can lead to a variety of problems during the reimbursement process, providers are increasingly moving to platforms that integrate Electronic Health Records (EHR) with medical billing software. This allows providers to automatically populate the patient demographic data into a bill, instead of wasting time on re-entering it.

Providers are also experimenting virtual health care models for enhancing patient care more effectively. Virtual healthcare can bring significant return on investment as this service evolves to a value-based care and compensation model. The challenge here is that the rules for billing telemedicine varies among government and private third party insurance companies. Adding to that, billing a virtual patient visit and billing an in-person visit are not the same. For most smart providers, the year 2019 is all about integrations. Providers are looking for effective and efficient ways to seamlessly integrate medical billing software, CAC, and EHR, in order to make a variety of processes smarter. Blockchain technology has also found its way in the healthcare sector. As it is as a way to improve the standardization and security of health data, solutions that leverage blockchain technology will gain immense popularity. To assist industry leaders navigate their business in the right direction while adopting medical billing and coding solutions, the editorial panel of MD Tech Review magazine has analyzed emerging trends and filtered out solutions that genuinely address the existing challenges in this space.

This edition of MD Tech Review magazine lists top 10 medical billing and coding solution providers who are leading the world market in providing the best quality solutions and systems. This list gives you some of the prominent companies in the industry that have proved its expertise with their service portfolio in medical billing and coding landscape. Through this we aim to bring businesses and solution providers closer and transform various processes as to deliver seamless and error-free services.

    Top Medical Billing and Coding Pioneers

  • ClaimCare is focused on one mission: “To collect the maximum revenue for a client as fast as possible while helping to alleviate costs and hassle for the client’s organization.” In business for 30 years and 100% USA-based, ClaimCare provides its clients with guaranteed results. Its proven track record of increasing collections from 10 to 20 percent while lowering clients’ billing costs as compared to either in-house or other billing services astonishes clients. With a complete medical billing solution, ClaimCare does not ask a client’s staff to perform data entry, correct claims or engage in patient collections. ClaimCare promises extraordinary processes and technology, along with complete transparency performed by an incredible team of experienced professionals


  • The company is focused on revenue cycle management and collection of old Accounts Receivable (A/R) through analysis and formulation of effective plans of action for A/R clean-up. With an expert team that specializes in revenue cycle management and collection of accounts receivable(A/R), the company prides itself on operating a very client-centric customer service-oriented practice. A 100 percent US-based company,mr2 focuses on “one-percenters” that billing companies rarely target. What usually haunts decision-makers is not being informed by their current billers about the status of their collections. The company’s differentiator is its “WOW report” which provides initial, no-cost, detailed sample analysis of aged accounts receivable


  • The company is dedicated to creating product solutions that reduce the cost of healthcare for national and regional health insurance plans, independent physician associations and third-party administrators. PCG Software also partners closely with leading value-added resellers, software developers and other market influencers by integrating their software with other best-in-class solutions to confront healthcare’s greatest challenges. The company’s flagship product, Virtual Examiner®, monitors the internal claims process of an organization to trend provider data for wasteful, fraudulent and abusive billing patterns, while maximizing financial recoveries


  • AdvancedMD


    AdvancedMD, based in South Jordan, Utah, is a healthcare technology company that employs more than 680 team members. The company offers cloud medical office software to ambulatory medical practices. The company supports independent physicians and their staff with a comprehensive suite of solutions including practice management, electronic health records, telemedicine, patient relationship management, business analytics reporting, and physician-performance benchmarking. AdvancedMD offers a flexible outsourced billing option for practices looking to use a third-party billing company. AdvancedMD serves an expansive national footprint of more than 26,000 practitioners across 8,600 practices and 600 medical billing companies. Nearly 3.5M insurance claims are processed monthly on the AdvancedMD billing platform

  • APS Medical Billing

    APS Medical Billing

    APS Medical Billing has been providing physician billing services since 1960. APS delivers superior billing and revenue cycle management results to over 190 practices nationwide and continues to grow its client base. They offer : Customizing charge capture processes to ensure 100% of work is billed.Proprietary contract management system that verifies all payers remit at contracted rates, to the penny, and ensures all fees are higher than your best payment rate. Regular CPT coding audits with follow-up feedback and education for compliance and revenue maximization. Dedicated programmers with experience interfacing with almost all LIS and HIS systems. Expertise in billing for the Professional Component of Clinical Pathology and more

  • athenahealth


    athenaOne—their suite of integrated, network-enabled services—works to deliver measurable financial and clinical results for providers. Their top-performing clients are beating industry benchmarks across the board.Their promise is clinical Efficiency Their EHR systems continously learn from their network of over 160,000 providers and delivers patient information. Coordinate Carewhich let's the end users share patient's data with other care sites. And faster documentation, they attach patients paper record to the right electronic and save time by securely uploading photos. Also easy attestation ,Success under any reimbursement model

  • Coronis Health

    Coronis Health

    Coronis Health is a group of revenue cycle companies strategically brought together each with their own unique specialty expertise and experience. The company started with the idea that no multi-specialty RCM company is an expert in every specialty. It became Coronis Health’s mission to seek out companies with deep experience and success in a specific specialty to join the Coronis family. The result – a new kind of RCM company with teams of experts in over 16 specialties. Coronis Health is built on the foundation of pure performance, transparency and specialization. The company has over 30 years of experience in healthcare. Coronis takes on the administrative and staffing burden of managing their client's revenue cycle in house,their clients often see an increase in collections and a decrease in the amount of time it takes to get paid

  • DR Medical Billing and Consulting

    DR Medical Billing and Consulting

    DRMBC is well known for providing consulting and complete office set-up to new and established individual physicians, Medical Groups, Ambulatory Surgical Centers and hospitals. They specialize in customizing services and increasing revenue by assisting the providers and support staff with training on front desk operations and provider coding and documentation using CMS guidelines increasing revenue by a proven 18% in some cases. DRMBC promises their clients will receive every penny that they have worked hard to receive. They maintain their personnel approach to maximize your billing and collections ensuring that your practice runs efficiently. Every EOB is precisely and accurately scrutinized and appeals are handled in a timely manner. Documentation and coding practice are audited routinely for any missed billing to ensure that their client's are being compensated for everything they do

  • ezDI


    ezDI, Inc. was founded in 2009 with a mission to empower people to deliver innovative solutions that enhance human life. They empower healthcare professionals across the globe with the ability to organize, store and analyze medical data in real time, and embed the results of the analytics directly into the hospital clinical workflow. The company's leverage cutting-edge technologies such as Natural Language Processing (NLP), Machine Learning, Semantic Web, and High-Performance Computing to put actionable data in the hands of healthcare professionals to help them proactively identify patients at risk, patterns in disease and treatment outcomes. They provide a variety of solutions ranging from CDI, CAC, compliance audit, predictive and prescriptive analytics, population health, disease management, quality and performance measures, clinical registries and more

  • Global Healthcare Resource

    Global Healthcare Resource

    Global Healthcare Resource is a full service healthcare solutions firm focused on maximizing return on investment, increasing revenues and improving productivity for their valued clients. They provide cost-effective business solutions for U.S. healthcare providers and billing companies. The company strives to deliver personalized, flexible solutions based on each of our clients'​ unique needs. They claim to achieve this by investing in our employees training and ongoing career development. They maintain a 98% coding accuracy rate. Their U.s clients have direct access to a productivity dashboard, Globex. This homegrown technology provides their partners with instant access to their project's status at the click of a button. The company is also HIPAA and SOC2 compliant