eClinicalWorks is an EHR and practice-management platform with an optional RCM-as-a-Service add-on. NatRevMD is a managed billing partner that works inside whatever EHR you run, including eClinicalWorks. The core difference is the same one that shows up across most EHR-bundled billing: the software and the first pass at claims are handled well, and the question is what happens when a claim needs more than a resubmission.
| Dimension | eClinicalWorks | NatRevMD |
|---|---|---|
| Product category | EHR + practice management, with an optional RCM-as-a-Service billing add-on | Managed RCM partner that integrates with your existing EHR, including eClinicalWorks |
| Pricing model | EHR plans publicly listed around $449–$599 per provider per month; RCM-as-a-Service publicly reported near 2.9% of collections on top | Percentage of net collections, with no separate EHR fee since we work inside the system you already have |
| Who submits claims and works denials | ECW's RCM team, working inside the ECW platform | A dedicated NatRevMD team, with specialty-specific staff for complex cases like OB/GYN surgical billing |
| Complex denial handling | Handled within ECW's RCM service and software | Every claim touched every 21–30 days or sooner; unresolved issues escalate to a senior lead, tracked outside of email |
| Scope | Billing and claims, inside the ECW ecosystem | Billing, denial management, credentialing, coding audits, bank reconciliation, and front-office operational consulting |
NatRevMD has taken over billing for several practices that were previously using eClinicalWorks' own RCM team. In each case, the recurring pattern wasn't the software falling short on routine claims. It was that anything requiring real judgment — a modifier dispute, a documentation gap, an unusual payer rule — sat without a clear owner until it aged into the kind of AR that's much harder to collect. That's the specific gap a dedicated, specialty-aware team is built to close.
For most independent practices, yes. eClinicalWorks keeps EHR and billing on one system, but complex denials stay inside their general RCM team rather than going to specialty-trained staff — and that gap tends to show up in your AR over 90 days. NatRevMD plugs into the EHR you already have and puts a dedicated, specialty-aware team on the complex claims instead. If your billing needs are genuinely simple and you'd rather keep everything under one vendor, ECW's RCM-as-a-Service is a fair trade — but most practices with any complexity find that trade costs them more than it saves.
NatRevMD works with most EHR and practice-management systems. Talk to our team about your specific setup if you're evaluating a change.
Both price largely as a percentage of collections, so the real comparison is what's included at that rate. ECW's fee is layered on top of its EHR subscription; NatRevMD's fee covers the full billing relationship without requiring you to run our software.
Practices that want a single integrated system for EHR and billing, and that are comfortable with claims and denials being handled entirely inside that one platform.
With NatRevMD, those escalate to a senior team member and get tracked in a shared system until resolved. That's the gap practices most often ask us to close when they're moving off an EHR-bundled billing team.
Yes. We typically go live in about two weeks, though we prefer four weeks to learn your current process and get payer portals set up correctly before we take over.
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.
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