Every medical bill must capture every diagnosis, treatment, prescription, and administrative service patients receive. Every error results in financial discrepancies and unpleasant patient experience.
A healthcare billing system allows to streamline invoicing workflow in hospitals and clinics and helps medical institutions reduce billing mistakes that frustrate patients and healthcare providers alike.
Yet, billing is a complex process that requires technical, clinical, and regulatory considerations. That’s why many healthcare providers require help with that, and some of them reach out to us.
I’m a Lead Product Manager at Uptech and I’ll guide you through the stages of developing medical billing software. I’ll explain how medical billing software works and what are your options as a healthcare solution provider.
What is medical billing software?
Medical billing software is software that allows healthcare providers to automate invoicing workflow. Rather than risk human errors, medical billing apps integrate with electronic health record (EHR) systems to capture all billable services throughout the patient’s journey. Both hospitals and smaller clinics will benefit from installing a medical billing system.
How does medical billing software work?
Before I explain further about developing a medical billing system, let's look at how patients are billed in a hospital.
- Patients register their visits at the reception.
- Medical workers check if they are eligible for insurance claims.
- During the consultation, physicians note down the diagnosis and treatment rendered (if any).
- Medical staff assign appropriate medical codes to the patient’s invoice.
- A superbill, which itemizes all medical services and their codes, is issued.
- The healthcare provider sends the invoice to the patient or file a claim with the insurance provider.
- The patient’s insurer may approve, adjust, or reject the claim. Depending on the decision, medical workers may need to adjust and resubmit the claim.
- Upon approval, the billing department records the amount received and collects the remaining balance from patients.
- Financial records are updated to reflect the current status of outstanding receivables and approved claims.
When implemented without automated healthcare software, medical workers must coordinate each step to collect payment for services provided. This takes up time and focus that are better spent on patient care.
A medical billing system provides end-to-end automation in billing workflow, freeing up physicians and staff on redundant work. Hospitals that use the software can speed up payment collection, optimize insurance claims approval, and reduce costly errors that impact financial outcomes. Besides, you can use medical billing apps that use secure storage to comply with HIPAA, GPDR, and other healthcare compliance regulations.
What are the types of medical billing apps?
Medical billing systems can be classified based on how tightly they integrate with other healthcare systems and who has access to billing data. In practice, healthcare providers typically use one of the following approaches.
Integrated billing systems
Integrated (open) medical billing systems connect directly with EHR, practice management, and scheduling software. Billing data is automatically generated from clinical documentation and can be accessed by authorized staff across departments.
This approach enables:
- real-time charge capture,
- fewer manual errors,
- smoother coordination between clinical, administrative, and financial teams.
Integrated billing systems are commonly used by multi-provider clinics, hospitals, and healthcare networks that require seamless data sharing.
Standalone billing systems
Standalone (closed) billing systems operate independently from EHRs and other clinical tools. Billing data is entered manually or imported in batches, and access is usually limited to a specific department or practitioner.
This model resembles the digital version of paper-based billing workflows and is often used by:
- small practices,
- solo practitioners,
- organizations with legacy clinical systems.
While easier to implement, standalone systems increase the risk of data duplication and billing inconsistencies.
Patient-centric billing tools
Patient-centric billing applications focus on transparency and self-service. These tools allow patients to:
- view charges and invoices,
- track payments,
- manage insurance information,
- pay bills online.
They typically do not replace provider billing systems, but rather complement them as patient portals or financial engagement tools. Providers still retain access to core billing and claims data.
In modern healthcare software development, fully integrated billing systems combined with patient-facing portals are considered best practice, especially for organizations aiming to optimize revenue cycle management and patient experience.
How to Build Medical Billing Software: 6 Steps
Medical billing software development is not just a technical project — it requires close collaboration between the development team and the healthcare provider to reflect real billing workflows, payer rules, and compliance constraints.
Let’s look into the process of medical billing software development at Uptech.
1. Run a discovery phase
You don’t want to build a medical billing app that your staff and patients struggle to use. First, you need to map out the processes, conduct market research, analyze competing software, and seek feedback from the target audience to lay a strong foundation for subsequent development work.
Our Product team at Uptech can help you conduct a product discovery, so you'll end up with a ready roadmap for your product.
At this stage, our product and technical teams analyze:
- existing billing and revenue cycle workflows,
- how charges are captured, coded, and submitted,
- current integrations (EHR, clearinghouses, payers),
- regulatory and compliance constraints (HIPAA, payer-specific rules).
We also review competing billing platforms to identify gaps and opportunities.
What we need from our clients:
- access to billing stakeholders (billing managers, finance team),
- sample workflows or documentation,
- insight into current pain points (denials, delays, manual work).
The result is a validated product roadmap aligned with real billing operations — not assumptions.
2. Define your requirements
Once we have the initial research's feedback and results, our team translates discovery findings into:
- functional requirements (claims management, coding support, payments),
- non-functional requirements (security, audit logs, scalability),
- integrations (EHRs, clearinghouses, insurance providers),
- compliance and data protection requirements.
We also define the technical stack and architecture suitable for handling sensitive financial and health data.
What we need from our clients:
- confirmation of supported coding standards (ICD-10, CPT, HCPCS),
- list of target payers and clearinghouses,
- compliance expectations and internal policies.
This step ensures the system reflects how billing actually works in your organization.
Most healthcare services also incorporate artificial intelligence and machine learning (AI/ML) to improve efficiency and introduce innovative features. Partnering with AI development companies like Uptech helps you to power your healthcare app with generative AI.
3. Design a proof of concept
Before developing the solution, start with a proof of concept (PoC). A PoC is a minimal solution that you can use to get immediate user feedback. When building a PoC, we apply UI/UX best practices to create layouts that mimic how the final product might look and demonstrate basic functionality and in-app navigation. Usually it visualizes:
- core billing workflows,
- claim lifecycle stages,
- user roles (billers, admins, patients),
- key dashboards and reports.
The PoC may also demonstrate early integrations or automation logic.
Present the PoC to stakeholders involved and use it to get feedback from the target users. Then we use the feedback to refine the app specifications before proceeding.
What we need from our clients:
- feedback from billing and administrative users,
- validation of workflows and terminology,
- approval of assumptions before full development begins.
This reduces costly rework later and ensures usability from day one.
4. Develop the software
The next phase, also the most essential part of the development, begins. App developers, backend/frontend programmers, UI/UX designers, and project managers work closely to integrate the necessary components to develop medical billing software.
Our cross-functional team develops the system in iterative sprints, focusing on:
- secure data handling and encryption,
- payer and EHR integrations,
- role-based access control,
- billing logic accuracy and auditability.
At Uptech, software development occurs in weekly sprints – where we develop, test, and refine the features to meet predetermined milestones. When developing software, we pay special attention to compliance, performance, and scalability from the start.
For example, development teams use a secure, encrypted payment gateway to meet HIPAA requirements. Likewise, your software team must carefully choose private or public cloud providers for deploying the medical billing app. Or we can help with the selection.
What we need from our clients:
- timely feedback on sprint deliverables,
- validation of billing logic and edge cases,
- access to test environments or sandbox payer systems (if available).
Medical billing software must be precise — collaboration here is critical.
Check out more software development services we offer. Take your software to the next level with our professional team.
5. QA and testing
Before releasing the software to medical users, we test it thoroughly to ensure compliance, requirements fulfilment, and no critical issues.
We conduct:
- functional and regression testing,
- performance and load testing,
- security and compliance checks,
- end-to-end billing scenario testing (from charge creation to payment).
We create necessary documentation and run the software to ensure it performs according to the designed workflow. After testing, we collect the test results, evaluate them, and make necessary changes to the software.
What we need from our clients:
- real or anonymized billing scenarios,
- user acceptance testing (UAT) participation,
- confirmation that workflows meet operational needs.
The goal is not only to get bug-free software, but to ensure it helps you achieve your target goals efficiently.
6. Software release and support
We launch the software and continue with ongoing support. In the first few weeks it’s crucial to:
- monitor system performance,
- fix early-stage issues,
- provide technical support and maintenance.
As you integrate your software and have more requirements, we help scale or extend functionality as billing needs evolve.
What we need from our clients:
- user onboarding and internal training participation,
- feedback from real usage,
- prioritization of future improvements.
Remember, training your medical staff and physicians might take time, so ensure you have all required time and knowledge for a smoother onboarding.
Even though long-term support is optional, medical billing rules and payer requirements change frequently, so most of our clients find it essential.
What Are The Tech Stacks For Developing Medical Billing Apps?
Medical billing software requires multiple layers of software components that work collaboratively in a secure and scalable environment. At Uptech, we use these tech stacks to interconnect frontend, backend, database, mobile apps, cloud infrastructure, and third-party components.
Custom vs. Ready-Made Solutions: What to Choose?
Ready-made medical billing apps allow you to automate invoicing in medical establishments almost immediately. They are often offered as licensed software or through recurring subscriptions. For example, Kareo, Amazon Comprehend Medical, and DrChrono are off-the-shelf solutions that hospitals and clinics can use to support their revenue cycle management.
Meanwhile, custom-made healthcare billing software is developed from scratch. Rather than offering a generic solution, you tailor the medical billing app around your invoicing workflow. Each medical establishment has unique requirements, billing practices, and existing healthcare systems, which require custom automation and integrations.
If you’re starting a practice with a limited budget, getting a ready-made solution is a reasonable choice. However, most medical establishments outgrow generic software when they offer more services to a broader range of patients. They cannot customize off-the-shelf solutions to meet changing and complex business requirements.
Choose custom medical billing solutions if you need flexibility, require particular features, and value integration for a larger practice. By developing your own app, you have complete control over data security, user experience, billing workflow, and more. Despite the initial investment, a custom solution offers a better return on investment, particularly for medical establishments with multiple departments or physical premises.
Key Requirements for Medical Billing Software
Some medical billing software provides a wide range of features to automate invoicing practices. However, you’ll only need a handful when developing a minimum viable product (MVP).
Automation of billing processes
A hospital billing system aims to free medical workers from invoicing workload by automating most of the workflow. From patient registration to claim reimbursement, the software passes information it captures from one department to another without manual intervention. You can set up billing rules once, and the app will automatically apply the same rules to each registered patient.
Integration with electronic health records (EHR)
EHR integration allows healthcare providers to manage patient care and improve workflow efficiency. It can also reduce billing errors by consolidating data accurately from other healthcare systems with standards like HL7.
User-friendly interface and customization options
Applying the best UI/UX practices, such as using appropriate descriptions for the intended audience, and ensuring accessibility for different user categories is important for a functional medical billing app. Besides, providing medical staff the flexibility to customize billing workflows improves adoption.
Reporting and analytics capabilities
Reporting features allow medical staff to generate reports, visualize patient payment trends, and identify actionable insights. They provide healthcare and financial teams with transparency and oversight of revenue growth, expenses, and profitability to support the decisions they make.
Thinking of developing a Healthcare CRM? Read our guide to learn how to develop a healthcare CRM software that adds value to your users, how much money it takes to build one, and what features are a must-have.
Compliance, Compliance, Compliance
Prioritize regulation compliance when developing medical billing apps. Such apps collect, process, store, and exchange sensitive patient information with other systems. Security oversight in software architecture, data storage, third-party integrations, and other development modules might result in data breaches. In such cases, healthcare providers may face heavy penalties for failing to safeguard health data.
Depending on where you market the medical billing solution, these regulations may apply.
- HIPAA, FDA, HITRUST( US)
- GPDR, IVDR, MDR ( Europe)
- PCI DSS (Worldwide)
- Local and regional regulations.
- CMS Regulations (Centers for Medicare & Medicaid Services)
Medical software used for billing must adhere to specific regulations set by the CMS to ensure accurate billing practices and compliance with government healthcare programs.
When we develop medical software, we help you determine the required regulations and procedures to ensure a compliant and certified solution. Most regulatory bodies require companies to submit an application and specific documentation for review. For example, you’ll need to submit security policy, risk assessment reports, mitigation plans, and technical specifications for security measures when applying for HIPAA accreditation.
The Average Cost to Build a Custom Medical Billing Software
So, how much does it cost to build a custom medical billing software? There's no fixed price, but it’s safe to say that building medical billing software from scratch can cost anything from $80k to $190k or higher.
What does this price depend on?
App Complexity
Development costs vary when building a medical invoicing solution. Depending on the features, complexities, supported platforms, and more, the price might differ. The hospital billing app with various integrations and AI features costs more than a simple one with one or two key features.
Outsourcing partner rates
The cost to build medical billing apps depends on the cost of your development team. If you hire developers from countries like the US and the UK, you’ll pay for the higher rates they charge. Conversely, working with developers from Eastern Europe, like Uptech, is more affordable.
Check out our comprehensive guide to software development rates.
Compliance requirements
Compliance requirements also play a crucial role in determining the overall price. Healthcare software, including medical billing applications, must adhere to various compliance standards, which can vary significantly from country to country. This aspect alone can have a substantial impact on the project cost. It's important to consider these compliance standards, especially since they differ based on the nature of the healthcare software.
Third-party Providers
Additionally, third-party involvement, research, and integration may impact the project cost. For instance, you might need third-party services for automatically verifying a user's eligibility for insurance coverage or facilitating doctor scheduling, especially if the platform doesn't include a custom solution for these purposes. These integrations and research efforts are crucial for a seamless and efficient billing process, but they do add to the overall cost.
If you need an accurate quote, reach out to our team. We'll discover your particular case and provide you with a realistic estimate.
How Medical Billing Software Benefits Your Business
Automating the process with software benefits healthcare providers in several areas.
Increased patient satisfaction
Patients visiting medical institutions expect their bills to be precise, prompt, and transparent. Moreover, 91% of patients prefer to pay their medical bills online. Therefore, healthcare providers must ensure all expenses they charge for services provided are paid with minimum fuss to ensure patient satisfaction.
Enhanced Risk Mitigation
Medical billing software plays a crucial role in mitigating risks associated with legal compliance and data security. By maintaining legal compliance, healthcare providers can avoid penalties and reputational damage. The software ensures that all transactions are secure and patient data is safeguarded.
This not only protects the institution from legal and financial repercussions but also builds trust with patients, who are increasingly concerned about the privacy and security of their medical information.
Improved revenue growth and cash flow
Automating medical billing with software improves medical providers' financial stability. According to a published report, 77% of healthcare providers took more than 1 month to collect payment, citing heavy patient responsibility as one of the causes. Medical billing is simpler with automation. It reduces patient confusion and enables healthcare practitioners to be paid in a shorter duration.
Streamlined financial audit
Medical institutions, large or small alike, must keep proper financial records for audit purposes. A billing software ensures that all invoices, reimbursements, and payments are correctly filed and recorded. It also strengthens efforts to meet HIPAA, GDPR, and other regulatory requirements.
How Uptech Can Help You Develop a Medical Billing Software
Uptech believes in delivering value to clients through great software – and that includes medical billing apps. Rather than focusing on writing code, we turn our attention to the medical users and patients.
Our project team studies the target users and uses their feedback to adjust and enhance the UX of the app. As a result, we can better meet users' needs and expectations. We solve real problems, and in this case, billing issues that all healthcare providers face.
Besides adopting a user-centric approach, our team applies field-proven skills to integrate the tech stack required for healthcare software development. More importantly, we’re working with HIPAA and other regulatory requirements. In each medical and billing app we built, our team applied stringent security practices to store and process patient data securely.
Our compliant approach allowed us to deliver several healthcare and financial apps to clients worldwide. These are some notable examples.
- Sprent is an on-demand delivery app that lets customers order, ship, and track items. We took great care when integrating the app with external payment gateways to enable secure credit card processing.
- We created a neobanking app for fintech client that engages customers with gamification features. During development, our team complied with legal and regulatory requirements that govern financial products.
- Uptech is the software development partner for a mental health app that targets the US market. We ensure the app meets HIPAA and other compliance checks to protect users’ privacy.
- We developed MicrogenDX, a solution for at-home DNA testing with great accuracy, impeccable user experience, and complete compliance.
- Clearly, our internal project, provides users with comprehensive telehealth services from choosing the therapist to securing the payment and conducting the sessions.
Conclusion
Medical billing apps automate invoicing workflows to reduce reimbursement discrepancies and allow prompt payment. Physicians, patients, and healthcare providers benefit when medical bills are precise and concise. With such software, you can reduce time spent on patient registration, assigning medical codes, insurance claims, and other steps to collect payment for medical services provided.
The development process requires a clear understanding of the goals and existing processes, a professional development team with domain expertise and compliance experience, and close collaboration between your team and the vendor to achieve the goals.
Developing custom medical billing apps is the sensible choice for healthcare providers that require control, flexibility, and tailor-made solutions. We'd be honored to use our experience in the healthcare and financial domains to help you make healthcare even more transparent and user-friendly for both workers and patients.
Reach out, and work with our team to build your medical billing app.
FAQs
How to create a medical billing software?
So, how do you develop custom medical billing software from scratch? Here are the steps that we take at Uptech to build such apps.
- Run a discovery phase
- Define your requirements
- Design a proof of concept
- Develop the software
- Run prelaunch testing
- Make a software release and support the app
How much does it cost to build medical billing software?
The cost of building medical billing software from scratch can vary from $80k to $190k or higher. It depends on several factors, like the complexity of the app, the vendor location, and the required third-party services.
What tech stack is needed for medical billing and coding?
Here is the complete tech stack for building a compliant, scalable, and reliable medical billing software:
- Backend: Node.js, Nest.js/Express.js, Typescript.
- Frontend: JavaScript, HTML5, CSS, Next.js, React + Redux / MobX, TypeScript, Next.js, Cypress, Storybook, Jest
- iOS: Swift, RxSwift, MVVM/Redux, SnapshotTesting, XCTest
- Android: Kotlin, Coroutines/RxJava, Dagger, Retrofit, Room, Clean Architecture
- Cloud: AWS Cloud, Google Cloud
How do you create a billing system?
To create a billing system for a medical software, app developers, backend/frontend programmers, UI/UX designers, and project managers work closely to integrate the necessary components to develop the software. At Uptech, software development occurs in weekly sprints – where we code, test, and iterate. We stay focused on the design specifications, integrations, security considerations, and compliance requirements.
