CareCloud Medical Billing Review and Pricing

Why We Chose CareCloud for Claim Scrubbing

We chose CareCloud as the best medical billing service for claim scrubbing because it eliminates billing cycle inefficiencies, making RCM as smooth and seamless as possible. In addition to robust claim scrubbing and submission tools, CareCloud offers denial resolution, centralized billing, advanced analytics, payment processing and more.

The platform’s standout feature, CollectiveIQ, impressed us. CollectiveIQ is a set of advanced, automated billing rules embedded in the claims workflow. It helps practices avoid medical billing and coding errors and get paid faster. We also appreciated CareCloud’s dedicated training resources, which help users get the most out of the platform.

CareCloud’s billing service integrates with CareCloud Central, the vendor’s practice management solution and Charts-EHR, its electronic health records (EHR) platform. These integrations make it easy and convenient to check patient records, insurance eligibility and demographic details in a central location. CareCloud also offers a robust analytics and reporting hub that provides helpful, actionable insights to help improve your practice’s overall performance. In addition, CareCloud’s standalone patient portal, Breeze, helps practices track and manage patient payments.

For those who want to fully outsource their medical billing process, CareCloud’s Concierge service is a smart choice. This package includes end-to-end revenue cycle support, from claims submission to accounts receivable (AR)  follow-ups. The company claims to achieve a denial rate under 3 percent, reduce time in AR by approximately 33 percent and deliver a first-pass claims rate of 94 percent.

CareCloud’s cloud-based software is accessible across devices, including desktop, tablet and mobile, giving practices real-time access to appointments, billing and patient records. Source: CareCloud

Ease of Use

CareCloud’s cloud-based software is exceptionally user-friendly, especially for billing. A single screen houses all billing information so that you don’t lose what you’re working on. You’re not required to use CareCloud’s practice management solution or EHR — you can integrate it with your existing EHR software. But when these systems are fully integrated, you get a holistic medical software suite that functions logically and intuitively. Meanwhile, if you use CareCloud’s billing service with another vendor’s practice management tools, the experience may not be quite as smooth.

The billing module breaks down visits and bills alongside the relevant patient information. Your in-house billers and coders can charge and code claims before they’re scrubbed by CollectiveIQ. It’s easy to find flagged errors in claims. CollectiveIQ also presents helpful visuals for key data points like insurance eligibility and patient payments, while offering insights into denied claims so you can prevent them when filing medical claims in the future.

CareCloud’s software gives you real-time updates on your practice’s appointments and billing.
Source: CareCloud

CareCloud Features

Even if you don’t opt for CareCloud’s fully outsourced revenue cycle management, the provider’s medical billing service still makes a splash, largely thanks to its claim scrubbing abilities.

Claim Scrubbing

CareCloud’s billing rules engine, CollectiveIQ, scrubs claims for millions of potential errors. The engine is regularly updated based on real-world issues encountered by CareCloud’s clients, reducing the likelihood of rejections and denials. The platform also includes advanced data analytics that give you insight into your practice’s performance and help you catch billing issues early.

All CareCloud packages include support for electronic data interchange and electronic remittance advice enrollment, enabling practices to send claims and receive payments electronically. CareCloud’s billing team includes certified coders from professional organizations such as the AAPC and the American Health Information Management Association. The platform integrates with multiple clearinghouses, including Change Healthcare, TriZetto and Availity and connects directly with more than a million Medicare and commercial payers.

Outsourced RCM

If you’d prefer to hand off most of your revenue cycle management tasks, CareCloud’s Concierge service is a compelling option. Each plan includes key performance indicators (KPIs) to help you monitor and optimize your RCM processes, valuable insights to improve collections and hands-on guidance to ease the administrative burden that medical billing often creates.

CareCloud not only generates claims but also scrubs them, submits them to insurers, follows up on unpaid claims and manages rejections and denials. The company reports a first-pass claims rate of 94 percent across all clients.

Doctors can use CareCloud Charts during patient appointments. Source: CareCloud

Medical Software

You can choose to use CareCloud Central, the practice management component of the vendor’s medical software or upgrade to CareCloud Complete to add EHR functionality through CareCloud Charts. Both setups support full medical billing capabilities as CareCloud includes all the necessary features. Patient data is available in real time and includes clinical documentation, task management, predefined templates, eprescribing and evaluation and management coding to help maximize revenue.

CareCloud also gives you flexible tools for assessing and improving practice performance. Its analytics module includes a command center dashboard with KPIs covering revenue goals, expenses, collections and denials. Providers can also use PrecisionBI, CareCloud’s healthcare business intelligence software, to make data-driven decisions. PrecisionBI offers advanced analytics via a highly customizable dashboard that consolidates system-wide data to improve financial visibility and track clinical performance.

CareCloud’s medical software also supports robotic process automation (RPA) to streamline administrative workflows. The platform automates up to 90 percent of repetitive tasks and helps reduce operational costs by 40 percent. You can minimize manual work related to insurance eligibility, denial management and payment processing, while syncing patient data during health and wellness checks.

CareCloud’s business intelligence tools give you the analytics you need to track your practice’s financial performance. Source: CareCloud

cirrusAI

CareCloud gives you access to generative AI tools designed to optimize and streamline clinical, financial and operational outcomes. The cirrusAI suite includes four tools: 

1. cirrusAI Appeals: cirrusAI Appeals analyzes patient claim data, the reason for the appeal and the specific payer involved to generate customized appeal letters you can review and send.
2. cirrusAI Guide: cirrusAI Guide automates clinical data entry and workflow tasks, while offering real-time, evidence-based recommendations using Vertex AI technology.
3. cirrusAI Chat: cirrusAI Chat streamlines training, reduces response times and assists in navigating EHR workflows, all the while using natural language for conversations.
4. cirrusAI Notes: You can use cirrusAI Notes to assist in any clinical notetaking for documentation. It supports multiple languages and claims to save 20 percent of your time each day.

CareCloud Pricing

CareCloud offers three service options: Central, Complete and Concierge. While you’ll need to request a custom quote, here are estimated starting prices for each tier:

CareCloud’s pricing is based on common factors used by other medical billing vendors, including practice size, specialty, claims volume and the complexity of billing operations. Its 3 percent to 7 percent collections-based fee is lower than many of the services we evaluated.

CareCloud requires a three-year contract commitment. However, in the past, we’ve found some providers were able to negotiate a one-year contract. The company cites its implementation and training period requirements as a primary reason for signing a longer contract.

Implementation/Onboarding

CareCloud charges a one-time implementation fee that depends on your practice size and the services you choose. Although pricing isn’t listed on the company’s website, we’ve seen reports suggesting the cost can be high, especially for larger practices or more involved setups. It’s a good idea to request a quote so you know exactly what you’re getting and how it aligns with your onboarding needs.

For smaller organizations, the implementation cycle — including system implementation and staff training — typically takes about 45 to 60 days. However, larger practices likely face a longer process because of the added complexity and moving parts common in these high-volume environments. 

On the plus side, you’ll get access to a dedicated Implementation Manager, enrollment videos and other training resources to support onboarding.

CareCloud offers three implementation plans at different price points:

• Essential: A rapid implementation option focused on the basics.
• Rich Patient Summaries: A professionally guided setup that incorporates best practices.
• Enterprise: A consultative approach for larger or more complex organizations.

Healthcare organizations can monitor billing tasks and key metrics via color-coded graphs. Source: CareCloud

CareCloud Support

Like some other medical billing vendors we reviewed, CareCloud assigns each client a dedicated account manager to provide support and guidance. The company’s United States-based customer service team is available by phone, email and live chat. You can also submit a support ticket when technical issues arise or use CareCloud’s online form, which typically receives a response within 24 hours.

In addition, users have access to CareCloud Community, a secure communication platform where clients can ask questions, share medical billing tips, troubleshoot issues and browse frequently asked questions (FAQs).

Limitations

We identified the following limitations with CareCloud: 

• Potentially expensive: CareCloud is cost-effective, with three medical billing tiers that let you choose a package that fits your budget. However, startup costs and potential add-on fees may be a barrier for smaller practices with tight margins. That said, the Concierge plan’s strong performance, including a 94 percent first-pass claims rate, may justify the investment for many practices.
• Contract requirement: Some practices may not be comfortable committing to a three-year contract. If flexibility is a priority, athenahealth’s billing service, athenaCollector, may be worth exploring. This vendor allows clients to cancel with 90 days’ notice. Learn more in our detailed athenaCollector review.

Methodology

Our investigation of the top medical billing services included hours of research and analysis encompassing software demonstrations, phone interviews and customer service calls. We also tracked down customer service reviews, including those on the Better Business Bureau website. 

When choosing our best pick for practices focused on claim scrubbing, we examined criteria such as billing engines, the billing process, billing staff and ease of use. We chose CareCloud because of its breadth of versatile billing options and its outstanding end-to-end outsourcing RCM hub.

Bottom Line

We recommend CareCloud’s medical billing service for …

• Multispecialty practices that could benefit from CareCloud’s high first-pass claims rate and specialized billing team.
• Small practices that are short-staffed, need RCM support and want to stay focused on patient care.
• Independent physicians who want to avoid hiring an in-house biller and need reliable, comprehensive RCM assistance.

We don’t recommend CareCloud’s medical billing service for …

• Practices looking to minimize costs and avoid upfront implementation fees.
• Healthcare organizations that are uncomfortable committing to multi-year contracts.
• Medical offices that prefer to keep billing fully in-house.

Amanda Hoffman contributed to this review.