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 its automated billing rules help practices catch errors before claims are submitted, reducing the risk of denials and rework. 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 especially like that the rules engine is built directly into the billing workflow rather than requiring staff to check claims separately before submission.

CareCloud’s broader cloud-based platform brings together medical billing, revenue cycle management, practice management, EHR and patient engagement tools. Practices can also customize workflows and features to fit their particular needs. CareCloud supports more than 70 medical specialties and organizations ranging from solo practitioners to large healthcare groups, giving the platform considerable flexibility as a practice grows.

Another advantage is the visibility CareCloud provides into billing performance. Its analytics and reporting tools include claims and denial analytics, revenue and financial performance data, patient volume insights and clinical and quality metrics. Practices can use this information to identify billing problems and keep a closer eye on the health of their revenue cycle.

Ease of Use

CareCloud’s HIPAA-compliant cloud-based software is designed to simplify medical billing workflows by keeping billing and claims information in a centralized system. You’re not required to use CareCloud’s practice management solution or EHR — the medical billing software can integrate with an existing practice management system. But when CareCloud’s systems are fully integrated, billing, practice management, EHR and patient information can be managed within the same platform.

The billing module brings claims and relevant patient information together, giving billing staff a central place to manage the process. Your in-house billers and coders can prepare claims before CollectiveIQ applies automated billing rules to identify potential problems prior to submission. CareCloud also includes health insurance eligibility verification, denial resolution and claims management tools, helping staff catch problems before filing medical claims and handle multiple parts of the billing workflow without jumping between separate systems.

CareCloud Features

CareCloud handles much of the medical billing process in one platform. Claim scrubbing is a standout, but practices can also use it to manage and submit claims, resolve denials, verify insurance eligibility, post and reconcile payments and track billing performance through reports and analytics.

Claim Scrubbing

CareCloud’s billing rules engine, CollectiveIQ, scrubs claims for millions of potential errors. The engine draws on an extensive database of automated billing rules that is continuously updated to identify errors, missing information and inconsistencies before claims leave the practice. By catching issues early, CareCloud can help practices reduce rejections and denials, minimize rework and get claims right the first time.

The platform also includes advanced data analytics that give you insight into your practice’s performance and help you identify billing issues early. CareCloud says its real-time reporting can help practices spot trends and address problems that could otherwise affect collections.

CareCloud also offers an integrated clearinghouse that allows practices to submit claims electronically to payers without relying on a separate system. For practices that need coding assistance, CareCloud provides medical coding services staffed by certified professional coders.

Outsourced RCM

If you’d prefer to hand off most of your revenue cycle management tasks, CareCloud’s outsourced RCM service is a compelling option. The company provides end-to-end support that includes claims scrubbing and submission, denial management and appeals, payment posting, accounts receivable follow-up, patient billing and collections and reporting and analytics. Practices can also track key performance indicators (KPIs) to monitor their financial performance and identify areas for improvement.

CareCloud’s team handles claims throughout the billing cycle, from checking them for errors before submission to following up on unpaid claims and managing rejections and denials. The company says it processes more than 50,000 claims a day and reports a 90 percent collection rate, a 30 percent reduction in A/R and a claims turnaround time of seven to 14 days. CareCloud notes that these performance figures are based on national averages and that individual results can vary.

CareCloud All in One Medical Software

CareCloud All in One brings the vendor’s practice management, EHR and revenue cycle tools together in one cloud-based platform. For practices using CareCloud for medical billing, that means billing doesn’t have to operate separately from the clinical and administrative side of the practice. Patient information, insurance eligibility, claims and payments can all flow through the same system. Here’s what stood out to us:

• Billing and collections: The billing tools cover much of the revenue cycle, including eligibility and benefits verification, charge capture, rule-based claim scrubbing, claims submission, denial management and appeals, accounts receivable management, payment posting and reconciliation and patient billing and collections. We especially like that CareCloud combines these tools with its clinical and administrative software, which can cut down on the need to move information between separate systems.
• Analytics and reporting: CareCloud also gives practices tools for keeping tabs on financial and operational performance. You can track revenue and financial performance, claims and denials, patient volume and clinical metrics through customizable dashboards and reports. These tools give billing teams another way to spot trends and identify problems that could be affecting collections.
• Automation: CareCloud uses robotic process automation (RPA) to cut down on repetitive administrative work. Its microbots handle tasks related to claims management, insurance eligibility and payments. According to the company, its RPA software can automate up to 90 percent of repetitive tasks and reduce operational costs by 40 percent.

cirrusAI and stratusAI

CareCloud has expanded its AI capabilities considerably, with tools that now extend beyond clinical documentation into front-desk operations. The company’s cirrusAI suite focuses on documentation and clinical insights, while stratusAI uses AI to handle patient calls and other administrative tasks. We like that the two suites tackle very different sources of busywork in a medical practice.

Here’s what stood out to us about cirrusAI:

• cirrusAI Notes: Notes captures patient encounters in real time and generates SOAP notes that flow directly into the EHR, with support for more than 50 specialties. CareCloud says providers spend up to 70 percent less time on documentation and cut after-hours charting by 49 percent. Those figures come from CareCloud’s own internal studies, however, so we’d treat them as vendor-reported results rather than guarantees.
• cirrusAI Assist: Assist pulls a patient’s medical history, past visits, medications, labs and other information into a single clinical snapshot. We like that providers can get the information they need without repeatedly digging through tabs and screens.
• cirrusAI Summary: Summary turns patient chart data into concise encounter summaries, making lengthy clinical records easier for providers to review quickly.

stratusAI takes that automation to the front desk. Here are the two tools that caught our attention:

• stratusAI Desk Agent: This 24/7 AI virtual receptionist can answer patient calls and handle tasks such as scheduling, prescription refills, follow-up reminders and callbacks. It also syncs directly with the EHR, which makes it more useful than a standalone answering service. One CareCloud customer featured on the company’s website says stratusAI now handles nearly 80 percent of his practice’s inbound calls.
• stratusAI Voice Audit: Voice Audit uses AI to review 100 percent of inbound patient calls rather than relying on random samples or manual reviews. It scores calls against customizable criteria and surfaces trends in call quality and agent performance, giving practices a much broader view of what’s happening on their phone lines.

We especially like that CareCloud isn’t limiting AI to clinical documentation. Automating routine phone calls and front-desk work could take a meaningful burden off practice staff while giving patients another way to get help outside normal office hours. 

CareCloud Pricing

We were disappointed to see that CareCloud doesn’t publish standard pricing for its medical billing services. Instead, the company uses flexible pricing that may be based on the number of providers or users or the practice itself. You’ll need to contact CareCloud for a customized quote based on your practice and the services you need.

The lack of upfront pricing makes comparison shopping harder, especially if you’re considering several medical billing providers. We recommend asking for a detailed breakdown of what’s included in your quote and whether there are additional fees for implementation, training or optional services. If you’re interested in CareCloud’s newer AI tools, be sure to ask whether they’re included or priced separately.

Implementation/Onboarding

CareCloud provides a guided implementation process rather than leaving practices to configure the system on their own. You’ll work with a dedicated implementation manager who helps configure your practice, coordinate EDI and ERA approvals, handle data imports or integrations with an existing system when necessary and prepare your team for the transition.

CareCloud says the implementation process takes place over the next few weeks, although it doesn’t provide a more specific timeline. Practices also have some homework to do along the way, including completing setup forms and making sure their technology meets CareCloud’s system requirements.

Training is built into the process as well. CareCloud provides recorded training webinars, and practices implementing its Charts EHR can receive training through webinars, videos and one-on-one sessions.

Customer Support

CareCloud provides a dedicated, U.S.-based support team that customers can reach by phone, email and live chat. Phone support is available Monday through Friday from 8 a.m. to 9 p.m. ET. You can also open and track support cases online.

Clients using CareCloud Concierge, the company’s outsourced revenue cycle management service, also have a dedicated account manager who can help with billing and reimbursement questions.

CareCloud offers additional self-service support through its online Community and a library of resources, including FAQs, webinars, e-books, research and other educational materials. We like that customers have several ways to find answers on their own or reach a person when they need more help.

Limitations

We identified the following limitations with CareCloud:

• Lack of transparent pricing: We were disappointed to see that CareCloud doesn’t publish pricing for its medical billing services, making it difficult to estimate costs or compare the service with competitors before contacting the company. If upfront pricing is important to you, consider AdvancedMD, which publishes starting price ranges for its medical billing and RCM services. Learn more in our AdvancedMD review.
• Unclear implementation timeline: CareCloud provides implementation resources and a dedicated implementation manager, but its onboarding materials don’t give practices a firm timeline for going live. The process also requires clients to complete several setup forms and make sure their technology meets CareCloud’s system requirements. Practices that prefer a more defined onboarding process may want to consider DrChrono, which typically completes implementation in 30 to 60 days. Learn more in our DrChrono review.
• No weekend customer support: CareCloud offers generous weekday support hours, with phone assistance available from 8 a.m. to 9 p.m. ET Monday through Friday. However, practices that need help outside those hours may want more around-the-clock options. Tebra, for example, offers a virtual support agent 24/7 for immediate assistance, although its live customer care team is also limited to weekdays. Learn more in our Tebra Medical Billing Services 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 reviews across third-party review platforms.

When choosing our best pick for practices focused on claim scrubbing, we examined criteria such as billing engines, claims management tools, automation capabilities, reporting and ease of use. We chose CareCloud because its CollectiveIQ rules engine automatically checks claims for errors before submission, helping practices catch issues that could otherwise lead to denials or delayed payments.

Bottom Line

We recommend CareCloud’s medical billing service for …

• Practices that prioritize claim scrubbing and want to catch potential errors before claims are submitted.
• Healthcare organizations that want to outsource much of the revenue cycle while still having visibility into billing and financial performance.
• Practices that want medical billing, practice management and EHR tools from the same provider.

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

• Practices that want transparent pricing and the ability to compare costs before speaking with a sales representative.
• Healthcare organizations that need customer support on weekends or around the clock.
• Practices looking for a more hands-off implementation process with minimal setup work required from their own staff.