Back to Menu
Connecting You To Opportunity
What can we help you find?
| Login|Sign Up
Back to Menu
Hello
  • Login
  • Sign Up

CareCloud Review

By
Adam C. Uzialko
,
business.com writer
| Updated
Jul 24, 2019
Home
> Technology
SHARE THIS

CareCloud's outsourced medical billing, called Concierge, offers three different tiers of service, which include limited billing work as well as full revenue cycle management. This model allows practices to select the tier best suited to their needs – whether they want to augment their in-house billing or fully outsource their billing department. Either way, the cost is affordable and competitive with other top medical billing services we researched during our review.

CareCloud

CareCloud

The Best Medical Billing Service Providers of 2019

The Verdict

With three tiers of service, CareCloud can offer a low-cost limited approach or full revenue cycle management at a competitive rate.

CareCloud takes a percentage of collections, and that percentage varies depending on the tier selected, the size and specialty of the practice, and the complexity of its billing operations. CareCloud Concierge is available to practices of varying sizes and specialties, and the company offers a solid organization-wide first-pass claims rate of 94%. For these reasons, CareCloud is our pick for the best flexible medical billing service.

View all our recommendations for medical billing services on our best picks page.

Billing Process

CareCloud's billing process depends on which tier of service your practice selects. Clients at the lowest tier outsource a small portion of their billing, which includes the submission of practice-generated claims and denial management in the event any of those claims are rejected. At this level, practices are responsible for charge entry and coding of claims.

The next level, Concierge Plus, adds claims scrubbing services through the company's CollectiveIQ billing rules engine to reduce denial; however, practices are still responsible for generating their own claims at this level.

The third tier of service, Concierge Pro, is a full revenue cycle management outsourcing solution, in which CareCloud generates and codes the claims from superbills or other clinical documentation gathered by the practice during the patient encounter. CareCloud then scrubs the claims it has generated, submits them to the appropriate payers, follows up on unpaid claims, and manages rejections and denials. 

CareCloud's billing rules engine, CollectiveIQ, scrubs claims for more than 120 million errors. The engine is regularly updated with new errors encountered by any of CareCloud's clients, which reduces common rejections or denials. Currently, CareCloud reports an organization-wide first-pass claims rate of 94%.

In addition to working on claims for payers like insurance companies, CareCloud's billing process includes work on patient statements. In the same way that CareCloud billers follow up on unpaid claims with payers, staff will follow up with patients. When funds are collected, CareCloud takes its percentage and deposits the money directly in the practice's accounts.

At all levels, CareCloud helps ensure practices are enrolled in Electronic Data Interchange (EDI) with payers, which allows practices or third parties acting on their behalf to submit claims and receive payments electronically. CareCloud's billing team includes coders with certifications from organizations such as the AAPC and AHIMA. CareCloud works with several clearinghouses, including Change Healthcare, TriZetto, Availity and Optum. The company also works directly with Medicare-associated payers.

CareCloud Pricing

CareCloud's pricing is largely dependent on the same criteria other medical billing services use to determine their percentage of collections: practice size, specialty, claims volume and complexity of billing operations. In addition, pricing is significantly impacted by which of the three service tiers your practice selects. CareCloud's average costs range from 3% of net collections to 7% of net collections, which is lower than many of the other medical billing services in our review.

However, CareCloud also charges additional setup, implementation and training fees beyond this percentage of collections. These fees include a $5,000 setup fee for each of the first three providers and $2,750 per provider after that. Those are among the highest fees in our review.

CareCloud requires a minimum contract commitment of one year, though many of its clients are contracted for as long as three years. The company cites its implementation and training period requirements as a primary reason for signing a longer contract, though it is not required. It also includes a minimum payment amount each month that is calculated based on the expected monthly collections of a practice. Minimum monthly payments were not uncommon in our review, though not every company includes monthly minimums in their contracts.

Software

CareCloud maintains its own electronic medical records (EMR) software and practice management software. Medical billing service clients are not required to use CareCloud's EMR, but they must be on the practice management software through which CareCloud billers conduct all revenue cycle management operations. Because CareCloud billers work directly within the practice management system, clients can monitor the billers' activities in real time, just as they would any in-house staff member using the software. The practice management software also includes claim error alerts, an audit log and a reporting tool for analyzing practice data.

CareCloud offers practices several ways to gain insights from their financial data. The first level includes scheduled reports, along with on-demand reporting that can be pulled from the system on an ad hoc basis. The next level down features a command center dashboard that displays practice KPIs, such as revenue goals, expenses, collections and denials. The system includes more than 150 templates for generating reports on demand, but for practices that want to take an even deeper dive, CareCloud offers an advanced analytics tool – essentially a massive spreadsheet that contains all the data stored on the system. Providers can sort and filter that data in any way they'd like, creating custom tables that can be turned into daily, weekly or monthly reports. All data gleaned from the advanced analytics tool can be exported to Microsoft Excel.

CareCloud Support

With CareCloud, you're assigned a dedicated account manager who offers both support and advice. The company maintains a U.S.-based support team that is available Monday through Friday from 8 a.m. to 9 p.m. EST. The company also offers a ticket system when technical issues arise, as well as a tool that lets you check the status of existing support tickets. In addition, CareCloud clients have access to a community forum for discussing issues, offering tips, asking questions or finding answers to frequently asked questions.

When a practice signs up with CareCloud, part of the implementation costs are applied to EDI enrollment and ensuring that providers are properly credentialed with the appropriate payers. CareCloud also offers training to in-house staff on how to properly use its systems.

Limitations

CareCloud's biggest limitation is its significant setup fees, which can run a small practice into five-figure expenses very quickly. While these are one-time costs (unless you add more providers after signing up), they do represent a hefty expenditure when signing up for the service. CareCloud's limited billing outsourcing is a great option for practices that want to keep costs low over the long term, but any practices considering working with CareCloud should be aware that startup costs will likely be higher than average and could prove cost-prohibitive to a small practice on a budget. However, the total cost (including setup fees) for medical billing services should be calculated against the cost of maintaining in-house employees to fulfill the roles an outsourced biller will be conducting. Despite the high setup fees, CareCloud remains our best pick for flexible medical billing services because of its versatile offerings and ability to adapt to a wide range of billing operations and workflows.

SHARE THIS
CareCloud

CareCloud

The Best Medical Billing Service Providers of 2019

The Verdict

With three tiers of service, CareCloud can offer a low-cost limited approach or full revenue cycle management at a competitive rate.

Adam C. Uzialko
Adam C. Uzialko
Adam C. Uzialko, a New Jersey native, graduated from Rutgers University in 2014 with a degree in political science and journalism and media studies. He reviews healthcare information technology, call centers, document management software and employee monitoring software. In addition to his full-time position at Business News Daily and Business.com, Adam freelances for several outlets. An indispensable ally of the feline race, Adam is owned by four lovely cats.