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Kareo Medical Billing: How it Works, Pros and Cons, and Pricing

Who is Kareo?

Source: Kareo

Kareo is a top-rated medical billing company based in California that specializes in the Revenue Cycle Management (RCM) process. They provide medical billing software and/or services to medical practices of all different kinds. Most practices that work with Kareo will either outsource their medical billing needs to Kareo or utilize Kareo’s medical billing software in-house.

Kareo prides themself on meeting the unique needs of independent practices. They work to save practices time and money managing medical billing on their own, as well as efficiently and promptly collect patient balances.

Kareo’s Medical Billing Process

As far as the services Kareo offers to medical practices, there are several different options available. Kareo can:

  • Take over your entire medical billing process, from start to finish
  • Manage certain elements of your medical billing process (such as coding entries)

Kareo typically works with small, independent practices and offers solutions catered to particular needs. They can work with you to find a customized solution that makes sense for your practice. If you are looking into Kareo as a Revenue Cycle Management solution, here’s what Kareo’s medical billing process looks like:

  1. Process patient charges and enter them as claims using billing software.
  2. Code these claims using expert, certified coders on staff.
  3. Submit claims through a clearinghouse (usually, Waystar or TriZetto) to the correct payers (Note: any clearinghouse fees are not charged to your practice on top of your monthly charges).
  4. Follow-up on any unpaid claims promptly.
  5. Resubmit any denied claims to make sure it gets paid.
  6. Receive money for claims, and deposit it directly into your practice’s account. 

How does Kareo make sure claims are paid?

Kareo uses a comprehensive strategy to make sure claims are paid promptly. In fact, they take pride in a 95% clean claims rate. They use a system that “scrubs” every claim before it is submitted to catch any “red flags” that may result in denial, and get the maximum reimbursement. If any issues are found, Kareo assigns the issue to a professional biller on their staff to review the claim before submission. If any claims are denied, Kareo’s Organized Worklist (OWL) automatically assigns the denied claim to an appropriate staff member to resubmit ASAP. Denied claims get moved to the top of Kareo’s queue to make sure they are resubmitted as quickly as possible. 

Software

When working with Kareo, they will help you integrate your practice’s billing process with Kareo’s Electronic Health Records (EHR) system. This is very convenient for practices who want to enter codes for medical procedures on their own, then send them directly to Kareo to finalize billing. Kareo’s EHR system is web-based, so it can be accessed by your staff via desktop computer, laptop, iPad, and other devices.

Kareo also offers Practice Management Software when they help you with Revenue Cycle Management (RCM). This is a more robust software meant to help practices with billing plus managing everyday tasks for their practice. This software helps practices with appointment setting, insurance verification, financial reporting, check-ins, and more. You can either use their Practice Management Software to manage your practice on your own, or log in to check Kareo’s process as they manage revenue for you. Either way, Kareo offers transparency with their software solutions, so you’re always in the know of your practice’s revenue management. 

Pricing

Kareo offers competitive pricing for the medical billing industry, as well as different options and plans for practices. Typically, Kareo’s pricing structure is based on a percentage of net collections that they secure for your practice through their service. This is a quite common pricing structure for medical billing companies. Kareo will charge its clients around 4%-7% of net collections. The exact percentage will be determined by specific factors, such as:

  • Your practice’s size
  • Speciality
  • Approximate number of claims submitted monthly
  • Complexity of your billing process 

To get a custom quote from Kareo, visit their quote page here. Keep in mind that their fees also include access to Kareo’s medical billing software. 

There are some additional fees to keep in mind when considering whether Kareo’s solution fits with your budget. They often charge an initial start-up fee of $500 per provider, as well as have a $1,000 monthly minimum payment structure. We recommend asking Kareo about additional fees when they generate a custom quote for your practice.

Customer Support

Kareo provides several customer support tools for their clients. Take a look at their customer support options when signing up for their services:

  • Real time phone, email, and live chat support
  • Online “help center”
  • Free training when signing up
  • One-on-one customer success coach

Overall: Pros and Cons

All in all, Kareo provides a robust, cost-effective digital healthcare solution for both practice management and medical billing. However, before getting started, you will likely want to review commonly reported pros and cons from Kareo’s customers. After considering many different customer reviews, take a look at some pros and cons to Kareo’s services.

Pros

  • Value for the cost. Customers say they are satisfied overall with the value of Kareo’s solutions. Their Practice Management Software includes tons of valuable benefits for practices to oversee more than just billing processes, which makes them feel that their money is well-spent.
  • Transparency. Kareo allows its clients to oversee the entire billing process by giving them access to software at all times. Clients can follow Kareo’s billing process from start to finish from their own computer.
  • Eliminates error. Kareo’s customers report that they enjoy using the software because it helps them to catch errors and fix them before submitting. Overall, this helps practices receive the highest returns for their services and maximize their reven\ue.

Cons

  • Customer service support. Many customer reviews report slow or incomprehensive customer support when using Kareo’s services.
  • Needs more tips/tools on how to maximize their services. Some customers say they would have appreciated more assistance from Kareo’s representatives on ways to maximize the benefits of their services. Some say they would feel more confident about the money spent if they were to receive more help with using the system.
  • Telemedicine is a separate department. Unfortunately, Kareo may not be the best solution for practices that use a combination of in-house appointments and telemedicine. Since Kareo has a separate telemedicine department, they may nolt be able to help practices that need an all-in-one solution.

Learn More

If you are considering Kareo for your medical billing needs, we recommend considering CureMD as well. If you are looking into the best medical billing company or software for your practice, we recommend looking into the pros and cons of outsourced medical billing. Additionally, be sure to read our 9 steps for choosing the best medical billing company for your needs.

Are you interested in getting medical billing software to help you better manage your practice’s financials? Read our medical billing software cost guide.

Keep in mind that Kareo is a great medical billing company, but there are tons of others that can fit your needs! If you are ready to compare medical billing price quotes, 360Connect can help. Use our free service to compare up to 5 competitive medical billing prices in your area and save up to 30%!

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