AdvantEdge Healthcare Solutions

Why AdvantEdge Healthcare Solutions?

AdvantEdge Healthcare Solutions (“AdvantEdge”) is a technology-enabled provider of healthcare revenue cycle and business management solutions that improve decision-making, maximize financial performance, streamline operations and mitigate compliance risks for healthcare providers.

AdvantEdge is recognized as one of the top-10 medical billing, coding and practice management companies in the U.S.; has nearly 600 employees in seven regional offices in the U.S. and one office in Bangalore, India; and collects approximately $1 billion annually for its physician, hospital, ambulatory surgery, behavioral health and large office-based clients.

AdvantEdge serves physician groups, hospitals, surgery centers, and behavioral health agencies. AdvantEdge customers enjoy increased net collections, reductions in accounts receivable, ‘Client First’ service, and they have complete access to financial and other information anytime, anywhere.

AdvantEdge is unique because it both develops and uses medical billing technology. Hands-on billing experience is reflected immediately in AdvantEdge software, using highly reliable IBM Power Systems technology. Clients automatically get rapid response to industry changes and AdvantEdge staff has the tools to deal with each client’s specific needs.

Early experience with complex hospital-based radiology practices lead to expertise in linking hospital systems and medical billing software. By working closely with these radiology practices, RIS and other radiology report sources were also linked. Today, AdvantEdge is able to code directly from radiology, cardiology, and pathology reports using a combination of artificial intelligence and workflow technologies. This is just one example of how AdvantEdge grew by using high-tech solutions to drive billing productivity.

Next, AdvantEdge enhanced its technology and workflow to meet the specific, and demanding, needs of anesthesia practices. The unique requirements for time, units, and concurrency were incorporated into a powerful anesthesia module and workflow that dramatically improves collections performance versus other anesthesia systems. In addition, AdvantEdge ProductionEdge technology was incorporated, allowing paper anesthesia records and face sheets to be captured quickly, avoiding delays and speeding cashflow.

Market Opportunity

The market for AdvantEdge’s services is estimated to be more than $10 billion annually, which includes hospital-based physician revenue cycle management and office-based revenue cycle management. The ongoing pressures created by provider consolidations, reimbursement pressures and accountable care initiatives present challenges for players in the revenue-cycle management space particularly for the smaller companies in the industry that do not have the scale, technological capabilities or economic resources to meet the evolving needs of the market. AdvantEdge intends to capitalize on these industry dynamics to grow its franchise over the long-term.

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Company Milestones

  • AdvantEdge acquires anesthesia billing company Professional Billing & Management Services
  • AdvantEdge partners with IBM as the only Vertical Industry Program (VIP) provider of medical billing software
  • AdvantEdge acquires medical billing company Physicians' Service Center
  • AdvantEdge acquires anesthesia billing company Medical Account Services
  • AdvantEdge acquires billing services company AHP Billing Services
  • AHS acquires medical billing company AMSplus
  • AdvantEdge acquires medical billing company COMPUDATA
  • AdvantEdge completes SSAE-16 certification
  • AdvantEdge acquires medical billing company Hill Associates
  • AdvantEdge launches QualityEdge app for mobile billing and coding
  • AdvantEdge achieves HIPAA and SOC 1 Type 2 security compliance