Medical billing is a payment practice within the United States healthcare system. The process involves a healthcare provider obtaining insurance information from a patient and filing, following up on and appealing claims with health insurance companies in order to receive payment for services rendered, such as testing, treatments, and procedures. The same process is used for most insurance companies, whether they are private companies or government sponsored programs. Medical coding reports what the diagnosis and treatment were and prices are applied accordingly. Medical billers are encouraged, but not required by law, to become certified by taking an exam such as the CMRS Exam, RHIA Exam, CPB Exam and others. Certification schools are intended to provide a theoretical grounding for students entering the medical billing field. Some community colleges in the United States offer certificates, or even associate degrees, in the field. Those seeking advancement may be cross-trained in medical coding or transcription or auditing, and may earn a bachelor's or graduate degree in medical information science and technology.
An electronic health record (EHR) is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care settings. Records are shared through network-connected, enterprise-wide information systems or other information networks and exchanges. EHRs may include a range of data, including demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information.
IDX Systems Corporation (IDX) was a healthcare software technology company that formerly had headquarters in South Burlington, Vermont, United States. It was founded in 1969 by Robert Hoehl, Richard Tarrant, and Paul Egerman. IDX was acquired by General Electric and incorporated into its GE Healthcare business unit in 2006. A portion of the former IDX business were sold by GE to private equity firm Veritas Capital in 2018. The resulting company was named Virence. In 2019, Virence was merged into athenahealth.
IMS Health was an American company that provided information, services and technology for the healthcare industry. IMS stood for Intercontinental Medical Statistics. It was the largest vendor of U.S. physician prescribing data. IMS Health was founded in 1954 by Bill Frohlich and David Dubow with Arthur Sackler having a hidden ownership stake. In 2010, IMS Health was taken private by TPG Capital, CPP Investment Board and Leonard Green & Partners. The company went public on April 4, 2014 and began trading on the NYSE under the symbol IMS. IMS Health was headquartered in Danbury, Connecticut.
IQVIA, formerly Quintiles and IMS Health, Inc., is an American multinational company serving the combined industries of health information technology and clinical research. IQVIA is a provider of biopharmaceutical development and commercial outsourcing services, focused primarily on Phase I-IV clinical trials and associated laboratory and analytical services, including consulting services. It has a network of more than 88,000 employees in more than 100 countries and a market capitalization of $49 Billion as of August 2021. As of 2017, IQVIA was reported to be one of the world's largest contract research organizations.
Hyland Software is the developer of the enterprise content management (ECM) and process management software suite called OnBase. Applications of the suite are used in healthcare, financial institutions, insurance, government, higher education and manufacturing. The firm has its headquarters in Westlake, Ohio, and offices in Lincoln, Nebraska; Irvine, California; Charlotte, North Carolina; São Paulo, Brazil; London, England; Tokyo, Japan; Andover, Massachusetts; Melbourne, Australia; Kolkata, India; Sydney, Australia; Berlin, Germany; Olathe, Kansas; Bloomington, Minnesota; Salt Lake City, Utah; Phoenix, Arizona; and Tampa, Florida.
Athenahealth is a private American company that provides network-enabled services for healthcare and point-of-care mobile apps in the United States.
DrChrono is an American digital health technology company providing a software and billing service platform consisting of Web- and cloud-based apps for doctors and patients. It makes electronic health records (EHR), practice management software and medical billing software available digitally and provides medical revenue cycle management (RCM) services. The company is based in Sunnyvale, California
Practice Fusion is a web-based electronic health record (EHR) company based in San Francisco, CA. The company was founded in 2005 by Ryan Howard and acquired by Allscripts in 2018.
NextGen Healthcare, Inc. is an American software and services company headquartered in Atlanta, Georgia. The company develops and sells electronic health record (EHR) software and practice management systems to the healthcare industry. NextGen Healthcare also provides population health, financial management, and clinical solutions for medical and dental practices. On September 7, 2018, Quality Systems, Inc. changed its name to NextGen Healthcare, Inc. and on September 10, their stock ticker symbol changed to NASDAQ: NXGN.
Allscripts Healthcare Solutions, Inc. is a publicly traded American company that provides physician practices, hospitals, and other healthcare providers with practice management and electronic health record technology. Allscripts also provides products for patient engagement and care coordination, as well as financial and analytics technology. The company has more than 180,000 physician users and has products in 2,700 hospitals and 13,000 extended care organizations.
CareCloud, Inc. is a publicly traded American healthcare information technology company that provides services, to healthcare providers and hospitals throughout the United States. The Company maintains its headquarters in Somerset, New Jersey and employs approximately 4,000 workers worldwide.
Inovalon is an American technology company that provides cloud-based tools for healthcare.
Healthcare CRM, also known as Healthcare Relationship Management, is a broadly used term for a Customer relationship management system, or CRM, used in healthcare.
Amwell, formerly known as American Well, is a telemedicine company based in Boston, Massachusetts, that connects patients with doctors over secure video. Amwell sells its platform as a subscription service to healthcare providers to put their medical professionals online and its proprietary software development kits, APIs, and system integrations enable clients to embed telehealth into existing workflows utilized by providers and patients.
Change Healthcare is a provider of revenue and payment cycle management that connects payers, providers, and patients in the U.S. healthcare system. The name also refers to a company founded in 2007 which subsequently became part of the current conglomerate. The company operates the largest financial and administrative information exchange in the United States.
Netsmart Technologies is an American company that develops and sells health information technology, including for electronic health records and health information exchanges, for organizations and entities in the behavioral health, human services, and post-acute care markets.
Greenway Health, LLC is a privately-owned vendor of health information technology (HIT) including integrated electronic health record (EHR), practice management, and revenue cycle management solutions. Intergy, Greenway’s cloud-based EHR and practice management solution, serves ambulatory healthcare practices. The company has offices in Tampa, Florida; Carrollton, Georgia; and Bangalore, India.
Teladoc Health, Inc. is a multinational telemedicine and virtual healthcare company headquartered in the United States. Primary services include telehealth, medical opinions, AI and analytics, telehealth devices and licensable platform services. In particular, Teladoc Health uses telephone and videoconferencing software as well as mobile apps to provide on-demand remote medical care. Billed as the first and largest telemedicine company in the United States, Teladoc Health was launched in 2002 and has acquired companies such as BetterHelp in 2015, Best Doctors in 2017, and Advance Medical in 2018. It trades on the NYSE and in 2019 was active in 130 countries and served around 40 million members in 2021.
CollaborateMD is a private company that provides cloud-based medical billing and practice management software services for independent medical practices and hospitals. The company's software uses real-time claim submission and built-in edits and integrates with various electronic health records (EHRs).
