CareCloud Medical Billing Review

Why CareCloud Is Best for Flexible Medical Billing

CareCloud is a medical billing service that can manage part or all of your revenue cycle. You can also opt in to CareCloud’s medical software and consulting services when you hire the company for revenue cycle management. Even better, CareCloud is unlike most medical billing services in that, as of its 2020 acquisition by MTBC, it doesn’t require its RCM clients to use its PMS. This PMS-agnostic structure is exceedingly rare among medical billing services. These are the main reasons we’ve named CareCloud our top pick for flexible medical billing.

Usability

If you use CareCloud’s electronic medical record (EMR) system or PMS alongside its medical billing services, you’re likely to have a user-friendly experience. In previous years, when we were granted access to test the company’s software, we found it to be quite intuitive and user-friendly. All key features were within quick reach.

We were especially impressed with the extent of customization options, both on a practice-wide level and for individual users. This customization goes hand in hand with CareCloud’s flexible medical billing services. As you get started with CareCloud’s medical software, dedicated training is available as well, though at a steep cost. Other RCM services charge no such fees.

Because CareCloud doesn’t require you to use its PMS (like most services, CareCloud doesn’t mandate that you use its EMR), CareCloud’s medical billing usability may depend primarily on your choice of EMR vendor. Our top pick for the easiest-to-use EMR and PMS is Kareo. Read our full Kareo medical software review to find out why.

CareCloud Features

Account Management Team

All CareCloud RCM clients get quick access to the company’s dedicated account management team to ask any questions and hear back almost instantly. CareCloud’s ethos is that no question is too small or too big, so you should feel free to fire away. And while this sort of hands-on customer service is par for the course with medical billing, it’s especially important if you’re looking for the sort of flexible solutions CareCloud offers.

Benefits Verification and Prior Authorization

Before any patient encounters, CareCloud will verify that the patient’s insurance covers any medical procedures you expect to perform. CareCloud will also obtain prior payer authorization as necessary so you can be properly reimbursed for nonemergency procedures. This service is available by phone, fax and email. We like that flexibility; not all RCM providers work via all of these communication channels.

Credentialing

CareCloud can get your practice set up with government payers, commercial payers and managed care plans. It can also do all the legwork to secure your quarterly re-attestations for Council for Affordable Quality Healthcare (CAQH). CareCloud is one of the few medical billing services we reviewed to offer this level of credentialing support.

Charge Entry and Coding

Billing starts with charge entry and coding, but not all medical billing companies offer these services. We like that CareCloud does offer charge entry and coding, further adding to its flexibility as a revenue cycle management provider.

If you want to outsource just the very start of your medical billing process, you can do that with CareCloud. That’s not quite the case with other providers, such as AdvancedMD, which doesn’t offer charge entry or coding. However, we do highly recommend AdvancedMD for large-practice medical billing. Read our full AdvancedMD medical billing review to see why.

Claims Management and Submission

CareCloud quickly sends your claims to payers electronically or via paper. Before that, the company scrubs your claims for accuracy to minimize your chances of denials or rejections. These features are standard with revenue cycle management, and we like that CareCloud offers them. This is yet another way CareCloud can empower you to hand off as many parts of the billing process as you’d like.

EMR/PMS Flexibility

Unlike nearly all other RCM providers, CareCloud does not require you to use its PMS. You can use any other vendor’s PMS while CareCloud oversees part or all of your revenue cycle. The flexibility to choose between CareCloud’s PMS or another vendor’s platform is a standout feature that we were quite happy to see.

Source: CareCloud

Similarly, CareCloud does not require you to implement its electronic health records (EHR) system to use its RCM services, though you can if you’d like. Admittedly, EHR-binding provisions are relatively rare among medical billing services, though prominent brand DrChrono requires this of its RCM clients. However, we still highly recommend DrChrono, especially for new practices. Read our full DrChrono medical billing review to learn why.

Out-of-Network Billing

Working with out-of-network payers to get your reimbursements can be a drain and a hassle. CareCloud can handle the entire process for you, giving you the option to offload this challenging medical billing task. From sending claims, to posting payments, to negotiating payment amounts, CareCloud covers you from start to finish when your patients use out-of-network insurers.

Patient Call Center

Your front-office staff is presumably busy scheduling patients and handling check-in. That means your staff might not always have the time to walk customers through their billing and payment questions. CareCloud can handle that for you, adding to its flexibility. You can use CareCloud’s RCM services as your own billing call center to field these patient questions. CareCloud can also collect payments from your patients over the phone, adding more flexibility to their payment options.

Patient Statements

The more time your front-office staff can spend with your patients, the more your patients typically enjoy the experience of visiting your practice. Printing and mailing patient statements can take your front-office staff away from patients, thus lessening their interaction time. CareCloud can step in to print and mail your patient statements instead. Notably, the company isn’t quite clear on whether it can email statements to your patients, but we were still impressed with this feature.

Payer Contract Negotiation

Another standout CareCloud feature is that it can negotiate your contracts with payers. This feature is rare and another way CareCloud adds flexibility. With CareCloud, you can manage the amounts of money your practice can earn from payers. This was one of the features that impressed us the most.

Payer Follow-Up

As is par for the course with medical billing services, CareCloud follows up with payers that owe your practice money. This follow-up takes two forms. First, if payers deny your claims, CareCloud will follow up to find out why. Second, if approved claims go unpaid, CareCloud will keep following up until you get paid. Although these features are standard for medical billing services, we like that CareCloud won’t rest until you get the money you deserve.

Payment Posting

Posting paper remittances is a notoriously tedious process, and CareCloud will handle it on your behalf. This service is flexible for your practice in that you get back all the time you’d spend manually entering payments into your PMS. You can choose to use that extra time however you please – the very definition of flexibility.

Robust Consulting and Reporting

Alongside your revenue cycle management, you can add CareCloud consulting and reporting services. CareCloud’s professional consultants can keep you aware of industry changes so your practice remains ahead of potentially revenue-boosting shifts. The consulting team can also keep you compliant with regulations such as MACRA and ICD-10.

You can also use CareCloud to obtain reports and analytics that keep your RCM accountable and efficient – and your data accurate. Although many other RCM services offer reporting and consulting, we like that CareCloud’s approach is comprehensive, covering both your practice and the world beyond it.

Source: CareCloud

CareCloud Cost

Although CareCloud, like many medical billing companies, doesn’t explicitly list its prices on its website, we’ve previously spoken with company representatives who have given us some insight. In previous years that we’ve reported on medical billing services, CareCloud reps have told us that the company keeps a percentage of your monthly collections as payment for its RCM services. This model is standard for outsourced medical billing.

CareCloud’s monthly collections percentage ranges from 3% to 7%, which is competitive on the low end and standard on the high end. CareCloud will calculate your rate based on the same factors as other RCM providers. These factors include billing complexity, average claim value, average claim volume, practice specialty and practice size. As with most RCM providers, a free CareCloud trial is not available, but you can request a demo, as is common with most RCM providers.

There may be implementation fees associated with starting your CareCloud RCM subscription. In our previous reporting, we learned that CareCloud charges a flat fee of at least $1,000 to set up its EMR and PMS. It is unclear if this rate applies to RCM setup too, and how the parts of the EMR and PMS process you outsource to CareCloud affect your monthly costs.

We have also previously reported that CareCloud may require you to sign a three-year contract (though sometimes just a one-year contract). We were unable to determine whether these contract terms have changed. Assuming they remain true, this part of CareCloud’s cost structure is among its drawbacks. If you wind up unhappy with CareCloud’s services, you can’t easily back out of your arrangement – and that’s the opposite of flexibility.

CareCloud Setup

On the EMR and PMS side, CareCloud has previously told us that customers often need 90 days for full setup. The company also told us that customers can request hands-on EMR and PMS training if they choose to use the proprietary CareCloud platform. For clients using a different platform, CareCloud will need access to the medical practice management software in order to conduct billing transparently. The setup fee of at least $1,000 may also apply. This is a major CareCloud drawback, as many other medical billing vendors don’t charge setup fees.

CareCloud Customer Service

CareCloud prides itself on keeping its medical billing account management team accessible via phone at no extra cost. However, we were not able to obtain the hours of operation for CareCloud’s customer service phone line. Live chat and a ticket-based help desk system are also available.

When we reached out to CareCloud via all of its channels, we were pleased to hear back quickly with detailed, helpful responses to our questions. The overall experience, minus the lack of transparency about CareCloud’s phone availability, was roughly par for the course among the medical billing services we reviewed.

CareCloud Drawbacks

CareCloud’s most obvious drawback is its high setup costs. It costs $1,000 to get started with the company, whereas many other medical billing services don’t charge at all for setup.

Additionally, we were disappointed that CareCloud binds its customers to long-term contracts. This provision seems to go against CareCloud’s flexible RCM model; it’s perhaps the only rigid thing about using the company’s medical billing services. If this condition is a dealbreaker for you and you’re looking for another consultation-heavy medical billing partner, read our full athenahealth review. At no point in our research on athenahealth did we encounter rigid contracts.

Methodology

We spent hours researching medical billing services, starting with, when made available to us, live software demonstrations. We also maintained contact with company representatives from the medical billing vendors that sat us down for guided demonstrations. Beyond that, we reached out to the companies’ customer service teams to test their support options, and we also read customer reviews such as those on the Better Business Bureau website. We supplemented this research with everything available on the companies’ websites.

When looking for our best pick for flexibility, we considered the extent to which the medical billing services we reviewed could cover a practice’s revenue cycle. We also considered the services that practices could add or subtract from their list. Because CareCloud can manage your revenue cycle end to end and you can pick from its offerings, we’ve named it our top pick for flexibility.

Overall Value

We recommend CareCloud for …

• Practices looking to outsource some or all of their medical billing processes.
• Practices that need extra assistance in negotiating payer contracts.
• Practices already dedicated to another vendor’s EMR and/or PMS.

We don’t recommend CareCloud for …

• Practices looking to avoid costly setup fees.
• Practices that want flexible contracts.