When independent practices compare medical billing companies, they are usually choosing between an EHR-bundled billing add-on and an outsourced RCM (revenue cycle management) partner. Here's an honest breakdown of NatRevMD against athenahealth, ModMed, and eClinicalWorks, so you can see what actually differs before you sign anything.
athenahealth, ModMed, and eClinicalWorks are EHR platforms with a billing service bolted on. NatRevMD is a managed billing partner that plugs into whatever EHR you already run. That one structural difference explains most of what follows.
| Dimension | NatRevMD | athenahealth | ModMed | eClinicalWorks |
|---|---|---|---|---|
| Product category | Managed RCM partner, works with your existing EHR | EHR + built-in billing (athenaCollector) | Specialty EHR + optional BOOST RCM service | EHR + optional RCM-as-a-Service |
| Pricing model | Percent of net collections | Percent of collections, publicly reported around 3–8%, negotiated by volume | Custom quote, not published | RCM-as-a-Service publicly reported near 2.9% of collections, plus EHR/PM fees |
| Coding review | Practice or NatRevMD's CPCs code, reviewed against the chart before submission — specialty teams for cases like OB/GYN surgical coding | Billed by athena staff from your documentation; complex disputes route back to the practice | ModMed's RCM team works inside the ModMed EHR | ECW's RCM team works inside the ECW EHR |
| Denial management | Every claim touched every 21–30 days or sooner; unresolved issues escalate to a senior lead; tracked outside of email | Straightforward denials worked by athena; complex ones land in a practice "hold bucket" | Denials worked inside ModMed's own team and software | Denials worked inside ECW's own team and software |
| Best for | Practices with an office manager or admin lead who want a dedicated, specialty-aware team, not a shared queue | Practices willing to staff and own complex denials themselves in exchange for one combined bill | Practices willing to keep denials inside ModMed's shared RCM queue rather than a dedicated team | Practices willing to keep denials inside eClinicalWorks' shared RCM queue rather than a dedicated team |
An EHR-bundled billing add-on still needs someone on your team watching it. A managed partner takes the claim, the denial, and the follow-up off your desk entirely.
If the billing improvement requires migrating your whole practice to a new EHR, the cost of switching is part of the price, even if it's never on the invoice.
Ask specifically what happens when a denial isn't a simple resubmission — a modifier dispute, a documentation gap, an unusual payer rule. Does it go to a senior person, or does it sit in a queue until someone gets to it?
A lower headline rate on an EHR-bundled plan can cost more once you add the staff or second vendor you need to clear the complex work the bundle doesn't fully handle.
OB/GYN, surgical, and multi-provider billing all have their own denial patterns. A generalist team learns them on your dime; a specialty team already knows them.
If the billing service is inseparable from the EHR, changing billing partners later means changing your entire practice-management system too.
Each comparison below is honest about where the other platform is the better fit, and where NatRevMD is.
An all-in-one EHR and billing bundle vs. a dedicated RCM partner that plugs into any EHR, including athenahealth's.
Read comparison →ModMed's specialty EHR plus BOOST RCM vs. a specialty-dedicated billing team that works alongside ModMed.
Read comparison →ECW's EHR and RCM-as-a-Service vs. an outsourced partner built for complex, multi-provider billing.
Read comparison →Software gives your staff tools to submit claims and track denials themselves. A service means a team does that work for you, including calling payers, appealing denials, and reconciling what actually hit your bank account. Most EHR vendors sell the first with an option to add the second; NatRevMD only does the second.
No. NatRevMD works inside the EHR and practice-management system you already run, including Epic, athenahealth, ModMed, eClinicalWorks, and others. Switching EHRs to get better billing is usually a sign the billing improvement isn't really separable from the software.
Most billing services price as a percentage of collections, typically in the mid-single digits, sometimes tiered by claim volume or practice size. Software-only platforms charge a flat per-provider subscription instead, with billing services priced separately on top.
It's the share of your outstanding insurance receivables that are more than 90 days old. The older a claim gets, the harder it is to collect. A well-run billing operation keeps this under 20%, ideally under 10%; above that, money you've already earned is quietly disappearing.
For anything beyond routine visits, yes. Surgical and specialty coding especially benefits from a certified coder (CPC) reviewing the chart against the claim, so the code matches what was actually documented and done.
The best fit is a practice with two or more providers and an office manager or administrator who can act as the day-to-day partner for the billing team. Solo practices with no administrative support can still outsource, but the transition takes more upfront work to build the processes a billing partner needs.
The free metric audit takes a few minutes to request. We'll look at your denial rate, your AR over 90 days, and your underpayments, and give you the real number.
