Selecting medical billing software is like hiring a financial strategist. With the right medical billing software features in place, you account for every dollar, mitigate risk, and seize billing opportunities to improve your financial health. 

All of this is critical as 60% of medical group leaders report an increase in their practices’ claim denial rates. This is valuable revenue lost and, in some cases, never recouped.

Unfortunately, like strategists, not all medical billing systems are created equally. What might work for one specialty or practice size might not be effective for another. And your healthcare business goals may also eliminate some vendors right out of the gate because they simply can’t give you what you need. 

However, aligning platform capabilities with practice needs is paramount. The right medical billing software features streamline your billing process, improve your patient data accuracy, enhance your billing workflows, and drive better financial performance. 

In this guide, we’ll walk you through essential medical billing software features that benefit all medical practices. Use this as a starting point as you dig deeper into available options that fit your unique practice needs.

While some medical billing software vendors tout “automation,” the reality is that the medical billing solutions they offer may still require manual interventions for scrubbing, tracking, or follow-up. 

The best medical billing software features:

Tip: Ask the vendor to walk you through how its system handles a claim from initial charge capture to final payment posting and denial resolution. This helps you evaluate billing workflows and how well the technology may or may not support efficiency, transparency, and revenue recovery.

When it comes to eligibility verification, not all medical billing software vendors can support complex coverage needs and scalability. 

The best medical billing software features:

Tip: Test real-time accuracy across multiple payers. Check whether the system automates batch verification and flags potential issues (e.g., inactive policies or plan mismatches) before the patient arrives.

Some medical billing software vendors simply don’t provide the level of data protection today’s vulnerable medical practices need. 

The best medical billing software features:

Tip: Verify that the vendor provides a signed Business Associate Agreement. Also, ask the vendor how it handles breach notification, incident response, and user role management to evaluate real-world readiness — not just checkboxes.

Many medical billing systems do not offer true real-time, bi-directional integration with electronic health records or EMRs. This means clinical and billing data may not sync automatically, and you may need to enter data manually or perform batch uploads — causing errors and inefficiencies. 

The best medical billing software features:

Tip: Ask whether the medical billing software allows clinical and billing data (e.g., demographics, insurance, charges, CPT/ICD-10-CM codes, documentation) to flow seamlessly and in real-time between the EHR and billing system in healthcare practices.

Subpar medical billing solutions may result in insufficient granularity or no access to real-time data. 

The best medical billing software features:

Tip: Ask the vendor how a front-office staff member, biller, and administrator would generate a report tailored to their needs. Also, test the ability to create ad hoc reports without needing IT support or advanced technical skills.

Limited payment options, inflexible user interfaces, and minimal financial assistance integration are just a few of the drawbacks associated with some medical billing software solutions. 

Alternatively, the best medical billing software features:

Tip: Test the patient experience from the user side — ease of login, mobile responsiveness, and clarity of billing statements are key indicators of usability and effectiveness.

Some medical billing software solutions tend to fall short in terms of being able to support medical practices as they grow. 

The best medical billing software features:

Tip: Ask whether the software can support increased patient volumes and expanded service lines without degrading performance. Ask for references from practices that have scaled their businesses using the same system.

While many medical billing platforms offer similar tools, the right medical billing software should support your unique workflows and specific needs, practice size, and compliance goals. Choosing a software solution is one of the most important decisions you’ll make, and your medical billing team should be involved in every step of the process. 

Finding the right fit to match practice needs is critical. Tebra’s practice management software adapts to the way you work and includes the medical billing software features you need — regardless of whether you’re a solo provider, a growing practice, or a billing company managing multiple clients.

Book a demo, take a tour, or get customized pricing to learn more about how the right medical billing software can elevate your billing and promote financial sustainability.