In the USA and several other states (Australia, Canada, the UK), insurance billing software is used for the payments and claims, as well as all the related tasks. According to it, a hospital’s employee called a medical biller has to submit, process, and appeal claims with insurers. The entire billing cycle starts with an initial patent examination, diagnosing, and delivering claims to a client that can be an insurance team or a patient himself. Then, the payer processes these claims, approves or denies them.

Nowadays, healthcare facilities and insurance teams more often handle the billing cycle stages using digital tools. Medical billing and coding software provide for automated claims management, payments processing, data recording and verifying, analyzing, and reporting. With the dedicated software, all the parties can get rid of paperwork and increase the overall efficiency. With modern apps, industry experts can work faster and better.

By the way, did you know that the average salary of the biller in the USA is more than $36,000 per year or $15.6 per hour? Consider that this profession allows working from home so employees don’t have to spend on transport and hospitals can avoid office-related expenses. Hence, it looks quite profitable to hire someone who will work with the best medical billing software for home-based businesses. Let’s find out how to use such apps!

Insurance Billing Software Types and Categories

The first stop in our journey to perfect software for medical centers and insurers features the most basic things required for clear vision on the industry and the software. Long story short, there are some differences in applications designed for in-office teams and home workers. For example, web-based medical billing software is a good choice for remote employees that can access programs from any place. Simultaneously, products hosted on the hospital’s own servers are more reliable as managers get full control over them.

Apart from tech stuff, there are custom solutions that are unique for each company and off-the-shelf products that are the same for all customers. Our team designs custom applications for both healthcare and insurance brands so we will explain this category in details.

Insurance billing software: classification

Sounds complicated? Don’t worry, the next sections answer your questions.

Traditional Apps for Established Companies

Practices that work with in-house medical staff are free to choose between different software types. The most popular one includes apps hosted on own servers inside the hospital. In this case, all workers and managers can interact with programs directly and modify them if needed. Patients also can access their data freely.

On the other hand, maintenance and support, as well as all the related expenses, are the clinic’s duty, too. Complex solutions are often expensive because they require a lot of storage and energy. Moreover, some vendors refuse to add space for scalability and/or customization so employees have to use prepackaged tools only.

Best Medical Billing Software for Home-Based Business

On the contrary, remote billers have a wider choice. Firstly, they can use the same software as in-house hospital workers have but this approach requires proper access level management and remote control. Thus, external employees often get web-based medical billing software. Developers deliver apps via clouds, most often.

These programs are much less expensive because neither a client nor his/her managers have to pay for hosting, energy, maintenance, and updates. However, cloud-based software provides for a poorer level of control as end users barely can change code or preferences. Clinics may be afraid of entrusting the patients’ data to third-party providers.

Custom Solutions with Exclusive Features

To be precise, this type can be both hosted and web-based depending on the client’s requirements. Bespoke applications are designed from scratch and feature the best possible level of customization. Hospitals can specify any goal or wish and developers will do their best to create the software according to these specifications.

Custom apps provide for high market advantage because they are unique and aren’t available for other clinics or remote medical billers. Simultaneously, they feature lower costs as it’s enough to pay the initial price and then enjoy various features and services. With the custom program, you can request updates and changes at any time, also.

To learn a bit more about industry-specific custom approaches, check the article dedicated to outsource healthcare software development.

Major Business Tasks that Applications Should Solve

Well, as it’s clear which applications you can get from developers, let’s proceed to the main goals of the insurance billing software. Apps created for this industry focus on comprehensive management of the billing, including claims scrubbing, working with electronic health records, processing payments, and so on. The software is suitable for billers and coders, related managers, remote employees, etc. Plus, patients also can use these apps to get control over their data.

Nonetheless, we propose to look at insights revealed by the research by Kaufmann Hall in 2018. The company surveyed CFOs from 350+ healthcare companies, including 69% of the respondents from multihospital facilities, 19% from ordinary clinics, 4% from med groups, and 8% from other healthcare-related teams. Here are three key directions the participants wanted to prioritize in their financial processes. Note that even free medical billing software can help you to reach the described goals. Just look at them:

  1. Plan finance. More than 50% of the survey participants mentioned that they’d want to improve financial planning and forecasting, money management, and reports. Hospitals try to optimize organizational stuff but CFOs should focus on the revenue. For this, billing software can help by gathering data under one roof and analyzing it.
  2. Process budgets. Sadly, 69% of the respondents reported that their budget processes take at least 3 months. Moreover, 9% said that they face at least 6 months-long budgeting. With proper insurance billing software, finance-related tasks can be completed much quicker thanks to the high level of automation.
  3. Reduce costs. For 30% of CFOs, cost reduction goals are the most essential. Still, these initiatives aren’t successful due to inefficient data management, poor planning, lack of accuracy and transparency, etc. 70% of companies don’t use cost planning tools! Obviously, billing apps can help to manage at least one side of this approach.

Medical billing and coding software influence

Insurance billing software solving challenges

As you see, there’s enough room for improvements. Not only clinics don’t use the most elaborate custom digital tools, they often don’t use the software at all. Old-fashioned companies stick to paper-based claims management. In the modern world with really affordable applications for various need, it’s strange to refuse to implement new tech.

If you realize that your business requires efficient medical billing software (free or proprietary), let’s continue and check major advantages and drawbacks of it. Spoiler: benefits outweigh issues.

Hosted and Web-Based Medical Billing Software Pros and Cons

We revealed some strengths and drawbacks of applications in the first section. Now, let’s talk about them again. Still, as we covered differences between web-based/hosted and cloud-based types, further info will be about general advantages and drawbacks of insurance billing software.


The benefits of billing applications are as follows:

  • Engaging for patients. Not only medical billers should be able to access functions but end users also get their accounts. Thus, patients can check claims and benefits, find core insurance data, and explore medical records.
  • Full management. Digital tools provide all the core features, including claims processing and tracking, payments, invoices, and so on. Employees also can set schedules, appointments, and check records.
  • HIPAA complaint. According to this law, all health-related information must be protected and unavailable for third-party groups. Additionally, it sets new insurance standards. Top medical billing apps are HIPAA complaint.
  • Simple and efficient. Apps have to be easy-to-use enough so employees will choose them instead of the traditional paper-based approach. Interfaces should be convenient for all users, including home-based workers and patients.

If you want to find more info about HIPAA and ways to make the software HIPAA complaint, check the related guide.

Note that these advantages are valid only if the chosen app meets your requirements. For example, programs with real-time accounting only will not be useful for large practices because of database overloads. Thus, be sure to choose suitable systems only.


As well, there are some limitations and drawbacks in billing apps:

  • Company-specific. You should choose the software for your company carefully. Big hospitals can’t be happy with plain tools that come with basic functions only. Vice versa, local clinics simply don’t need vast functionality.
  • Require training. Despite simple and user-friendly interfaces, digital tools still aren’t extremely easy for employees. Be sure to hold some training courses to familiarize your workers with new applications.

Medical Billing Software Prices

According to the development and distribution type, applications feature different costs. For example, cloud-based billing tools are delivered on a subscription basis where the total cost depends on time and number of employees. An app with basic functions only will cost somewhat $30 per user per month while powerful all-in-one solutions can go up to $250. Plus, you can start with free medical billing software to check out how it works.

Hosted products that you have to deploy on your own server often feature one-time payments for the software itself. The cheapest examples start from $3,000 per user. The average sum is around $10,000 but the most complex solutions cost even more than $50,000. In this case, you also should remember about indirect costs related to tech maintenance, team training, and potential upgrades. And if you opt for custom apps, this stuff is included already!

Medical billing software prices

Oh, to compare prices, set up a budget, and maintenance expenses, you want to check out our accounting software for insurance brokers!

Choosing the Best Development Team

To avoid misconceptions and further usage problems, you want to work with professional tech partners. To choose the best team, it’s important to explore options carefully, talk with representatives, discuss your needs and their capabilities, and finally find the company with exact skills your project requires. Don’t neglect to consult with devs as these first meetings are almost always free. They can help to understand partners better.

In Diceus, we have a team of skilled developers that finished more than 150 projects for clients from over 20 countries. We adhere to the Agile principles, focus on timely delivery, comprehensive QA, and precise conditions without unexpected changes. Our employees do everything, from initial business research to post-launch project support and user training. We don’t work on an hourly basis because each project is unique; every single customer gets an individual estimation according to project requirements and specifications. Pay once – and get 360-degree service.

We handle all types of development and can deliver tools for different needs, e.g. medical insurance verification software, billing apps, accounting programs, etc.


To summarize things, you can move through the next four questions and answers. They reflect the key points of the article so it should be easier to remember only important info. If you still want to know more about insurance billing software, feel free to ask our experts.

What Does Insurance Billing/Medical Billing Software Mean?

Digital tools that cover claims processing, scrubbing, and tracking. This software simplifies and automates the process that involves payments of healthcare facilities’, insurance companies, and patients. As well, apps can include management and scheduling tools.

What Are the Main Strengths and Weaknesses of Billing Apps?

The programs allow to speed up all parts of the billing, manage interactions with insurers and patients better, and get more control over cash flow. As for drawbacks, these apps require some user training and have to be carefully customized under your needs.

How to Create a Custom Insurance Billing Software?

The best option for healthcare managers is to cooperate with custom teams. Dedicated developers can create almost everything, from the simplest apps with only one feature to all-in-one enterprise platforms for the biggest clinics.

How Much Does It Cost to Develop a Medical Billing Solution?

Cloud-based programs range between $30 and $250 per user per month but you also can find medical billing software for free. Custom products feature quote-based pricing that starts from $3,000 and may go up to $50,000.

Final Tips

Nowadays, medical practices tend to outsource their billing processes. External teams take care of invoicing, verification, tracking, and other things related to claims and payments. Managers do this to reduce paperwork and increase the efficiency but this approach isn’t the most effective one. Why not use simple and convenient software instead?

Both the industry professional in a hospital of national importance and interns in small towns can benefit from insurance billing software. It also simplifies and enhances all stages of the billing process between enterprises, patients, and insurers. Moreover, it comes at a lower cost and leaves room for expansion. Think about it. We’re ready to create your own app!