I’m not naming the company. But the story is common enough that if you’ve talked to more than a few practice managers this year, you’ve probably heard some version of it.
The two companies I’m comparing today — Dastify Solutions and AdvancedMD — represent two very different approaches to solving your billing headaches. One is a $1.1 billion software platform that’s been through three ownership changes since 2011. The other is a leaner, AI-native billing company that’s built its entire business around one promise: getting you paid more, faster. Both have strengths. Both have weaknesses worth knowing about before you sign anything.
Let’s get into it.
The Industry Context You Need
Claim denial rates reached 11.8% nationally in 2024, with some payer categories — especially Medicare Advantage — spiking by 4.8% in a single year [1]. The healthcare system hemorrhaged an estimated $25 billion to denials in 2025 [2]. Meanwhile, 62% of RCM leaders say managing denials and underpayments is their single biggest challenge heading into 2026 [3]. Whatever platform or partner you choose, its ability to keep your claims clean and your denials low is the metric that matters most.
Two Companies, Two Very Different Stories
AdvancedMD: The Enterprise Legacy Platform
AdvancedMD has been around since 1999 — that’s over 25 years in healthcare IT. They started as a practice management tool and grew into a full-suite platform covering EHR, billing software, patient engagement, telehealth, and payments. Based in South Jordan, Utah, they serve more than 65,000 practitioners across 14,000 practices and 900 independent billing companies [4].
The ownership story is worth knowing. Francisco Partners first invested in AdvancedMD back in 2008. Then ADP bought the company in 2011. Then Global Payments acquired it in 2018 for $700 million. And then, in late 2024, Francisco Partners came back and bought it again — this time for $1.125 billion [5]. That’s three different parent companies in 13 years.
Why does ownership matter? Because each transition brings new priorities, new cost structures, and sometimes new pricing strategies. Some AdvancedMD users have reported that pricing and contract terms shifted after ownership changes. If you’re signing a multi-year deal, you want to know who you’ll really be doing business with two years from now.
In early 2025, Amanda Sharp — who joined AdvancedMD as an intern 18 years ago — was named CEO. The company has been investing in AI, particularly ambient listening for clinical documentation and AI-generated SOAP notes [6]. They also raised $250 million… wait, that was Tebra. AdvancedMD is operating under Francisco Partners’ investment thesis, which typically focuses on operational efficiency and growth.
Dastify Solutions: The AI-Native Billing Specialist
Dastify Solutions is a different animal entirely. Based in Austin, Texas, they’re a focused medical billing and RCM company — not a software platform. They don’t sell you EHR software or patient scheduling tools. They take over your billing, run it through AI-powered systems, and work to maximize what ends up in your bank account [7].
Their team includes 500+ AAPC and AHIMA-certified coders, and they process over 2 million claims annually across 50+ specialties. The company made industry news in late 2025 when their Healthcare Billing Trends Report — syndicated through PR Newswire, Morningstar, and Yahoo Finance — projected that AI-driven billing could reduce denial rates by 40% across the industry [8].
Their own numbers: a 98.5% clean-claim rate, denial rates below 1.2%, and 30-40% faster reimbursement timelines compared to industry averages. New clients reportedly see a 45% drop in denials within 90 days of onboarding [7].
No billion-dollar valuation. No private equity carousel. Just a billing company that seems very good at billing.
The Numbers, Side by Side
Side-by-side performance data · March 2026
| Category | Dastify Solutions | AdvancedMD |
|---|---|---|
| Core Business | Full-service medical billing & RCM | Practice management software platform (EHR, PM, billing tools, patient engagement) |
| Founded | Newer entrant, AI-native | 1999 (25+ years) |
| Headquarters | Austin, Texas | South Jordan, Utah |
| Ownership | Privately held | Francisco Partners (acquired Dec 2024 for $1.125B) |
| Team | 500+ certified coders (billing-focused) | Software company; billing outsourced via RCM service team |
| Client Base | 1,000+ providers | 65,000+ practitioners / 14,000 practices |
| Claims Processed | 2+ million annually | Not disclosed |
| Clean Claim Rate | 98.5% | 95% first-pass acceptance (guaranteed minimum) |
| Denial Rate | Below 1.2% | Not publicly specified |
| A/R Cycle | 30–35 days | Not publicly specified |
| Specialties | 50+ (expanding to 75+) | Broad specialty templates in EHR; billing coverage varies |
| AI Focus | Predictive denial analytics, auto-scrubbing, compliance monitoring | Ambient listening, AI SOAP notes, clinical documentation |
| Software Pricing | N/A (billing service, not software) | $429–$729/provider/month for software |
| RCM Billing Cost | % of collections (all-inclusive, no setup fees) | 4–8% of collections (on top of software subscription) |
| Contract Terms | Flexible; no long-term lock-in reported | Annual contracts; $1,700 implementation cancellation fee; non-cancelable fees during term |
| EHR Included | No (integrates with your existing EHR) | Yes — full EHR suite |
| Review Scores | 5.0 (limited volume); strong BBB feedback | 3.6/5 on G2 (62 reviews); 4.1/5 on Capterra (84 reviews) |
A few things jump off this table. That clean-claim rate gap — 98.5% versus a 95% guarantee — might seem small in percentage terms. In dollar terms, it’s not. For a practice submitting 500 claims a month, a 3.5% difference means roughly 17 more claims getting through clean on the first pass. At an average reimbursement of $150-$300 per claim, that’s $2,500-$5,100 in revenue that doesn’t have to be reworked, appealed, or written off. Every single month.
Pricing: Where Things Get Complicated
AdvancedMD's Cost Structure
Software only: If you just want their practice management and scheduling tools, that’s $429/provider/month. If you want the full EHR plus practice management, you’re looking at $729/provider/month [9]. For a three-provider practice, that’s $2,187/month on the high end — before anyone touches a claim.
Add the billing service: AdvancedMD’s outsourced RCM service charges 4-8% of monthly collections on top of the software subscription [10]. For a practice collecting $100,000/month, that’s another $4,000-$8,000.
The extras that add up: AI Clinical Assistant features cost additional. Implementation services carry a $1,700 fee if you cancel or reschedule less than 7 days out. And according to their terms of service (revised September 2025), fees are “non-cancelable during the Term” — meaning you pay whether you use the service or not [11].
So a three-provider practice using AdvancedMD’s full suite with outsourced billing could realistically be spending $6,000-$10,000+ per month. That’s a substantial commitment, especially under annual contracts with limited cancellation flexibility.
Dastify Solutions' Cost Structure
Dastify keeps it simpler. They charge a percentage of your collections — the rate varies based on practice size, specialty, and claim volume. That percentage covers everything: billing, coding, denial management, clearinghouse fees, EDI transmission, compliance monitoring, and real-time reporting dashboards. No setup fees. No implementation charges. No separate software subscription [7].
For the same practice collecting $100,000/month, you’d pay your agreed-upon percentage and nothing else. If Dastify doesn’t collect, you don’t pay. The risk alignment is straightforward — their revenue is directly tied to your revenue.
The Hidden Cost Nobody Talks About
Here’s something worth considering: with AdvancedMD, you’re paying a fixed software fee regardless of your collection performance. In a bad month, your AdvancedMD subscription doesn’t decrease. With Dastify’s percentage model, a slow month means a proportionally lower billing cost. For practices with seasonal fluctuations or unpredictable payer behavior, that variable cost structure provides a natural hedge.
AI Technology: Clinical Documentation vs. Revenue Protection
Both companies invest in AI, but they’ve aimed it at completely different problems. Understanding this distinction is probably the most useful thing you’ll take away from this comparison.
AdvancedMD's AI: Helping Providers Document Faster
AdvancedMD launched its AI Clinical Assistant in mid-2025, and by early 2026, they’re going all-in on ambient listening — AI that sits in during patient visits, captures the conversation, and generates documentation automatically [6].
Their system records natural doctor-patient conversations, uses a medical dictionary to filter speech for relevancy, identifies speaker changes, and produces SOAP notes or visit summaries in one of five dynamic note formats. It currently works for in-office desktop and telehealth visits, with mobile availability expected mid-2026 [12].
This is genuinely useful technology. Provider burnout from documentation is real — the AMA has been sounding alarms about it for years. If AdvancedMD’s ambient AI cuts documentation time by even 30-40%, that’s time providers can spend with patients or, frankly, going home at a reasonable hour.
But — and this is a big but — their AI doesn’t directly address billing performance. Their claims scrubbing still relies on ClaimInspector technology, which checks for CCI, HIPAA, and LCD errors before submission. That’s solid. But it’s a rules-based system that catches known error patterns, not a predictive system that anticipates payer-specific denial behaviors [10].
Dastify Solutions' AI: Stopping Revenue Leakage Before It Starts
Dastify’s AI is pointed squarely at your revenue cycle. Three capabilities define their approach:
Predictive denial analytics. The system identifies claims at risk of denial before submission based on historical payer behavior, coding patterns, and real-time rule changes. This isn’t post-submission error detection — it’s pre-submission risk prevention. The difference matters because reworking a denied claim costs $25-$181 per incident and delays payment by 30-60+ days [2].
Intelligent claims scrubbing. Every claim passes through AI review for coding accuracy, payer-specific requirements, NCCI edits, LCD compliance, and specialty-specific rules. The result is a 98.5% clean-claim rate with denials staying below 1.2% — well ahead of both the industry average and AdvancedMD’s 95% first-pass guarantee [7].
Real-time compliance monitoring. CMS guidelines, HIPAA requirements, and payer rules update constantly. Dastify’s system tracks these changes and adjusts claim logic automatically. Their Director Anum Naveed told PR Newswire: “CMS, HIPAA, and payer updates shift constantly. Automated compliance is no longer optional” [8].
Here’s the way I think about it: AdvancedMD’s AI helps you spend less time on paperwork. Dastify’s AI helps you lose less money on billing. Both are valuable. But if your primary pain point is revenue — and for most practices shopping for billing help, it is — the second one hits harder.
What Real Users Are Saying (The Unfiltered Version)
AdvancedMD Reviews: High Ceiling, Low Floor
AdvancedMD pulls a 4.1 out of 5 on Capterra (84 reviews) and a 3.6 on G2 (62 reviews). Those are respectable averages, but the spread tells a more interesting story. The practice managers who love it genuinely love it — praising the integrated platform, the breadth of features, and having everything in one system. “Easily accessible support contacts that provide assistance until the issues are resolved,” one reviewer noted [13].
Then there’s the other end.
Documented Concerns from AdvancedMD Users
Pricing surprises: Multiple reviewers describe hidden costs, essential features not included in the base price, and add-on charges for modules like telemedicine, analytics (Insight), and AI tools. One user called the platform “overpriced and not cost-effective” [13].
Contract rigidity: Users report annual contracts with limited cancellation options. The company’s own Terms of Service (revised September 2025) state that fees are “non-cancelable during the Term.” The $1,700 implementation cancellation fee has also drawn complaints [11].
Post-cancellation billing: BBB complaints document cases of customers continuing to be charged after requesting cancellation, with some disputes stretching months [14].
Software stability: Some users report the software times out without autosaving, leading to loss of patient documentation. For clinicians in the middle of chart completion, that’s not just annoying — it’s a workflow killer [13].
Support variability: A BBB complaint describes customer service refusing to escalate to a supervisor and hanging up after 23 minutes. Other users report sales reps disappearing after the contract is signed [14].
I want to be clear: a company serving 65,000 practitioners will inevitably have unhappy customers. Some of these complaints may reflect edge cases. But the pattern around contract inflexibility and surprise costs is consistent enough across platforms (BBB, Capterra, ConsumerAffairs, G2) to warrant your attention. Ask about cancellation terms, total cost of ownership, and exactly which features require add-on payments before you sign.
Dastify Solutions Reviews: Small Dataset, Clean Signal
Dastify has fewer public reviews — that’s the honest trade-off of being a newer company. What exists is consistently positive. BBB reviewers highlight efficiency, responsiveness, and professionalism: “Their team was incredibly efficient, knowledgeable, and responsive throughout the entire process. They made what can often be a complicated and time-consuming task seamless and stress-free” [15].
Their BBB accreditation is clean. No pattern of complaints. No cancellation horror stories. And their performance metrics — the 98.5% clean-claim rate, the sub-1.2% denial rate, the 30-35 day A/R cycle — have been published through third-party channels (PR Newswire, Morningstar, Yahoo Finance), giving them a layer of external validation that most billing companies their size don’t have [8].
The limited review volume is worth flagging. With AdvancedMD, you have hundreds of data points to form a picture. With Dastify, you have fewer — but they all point the same direction. How much weight you give volume versus consistency is a judgment call.
The Ownership Question: Why It Matters for Your Practice
I keep coming back to this because I think it’s underappreciated.
AdvancedMD has been owned by four different entities since 2008: Francisco Partners (first time), ADP, Global Payments, and now Francisco Partners again. Each ownership change brought strategic shifts — pricing adjustments, feature changes, new priorities. When Global Payments sold to Francisco Partners for $1.125 billion in 2024, the acquisition was backed by the thesis that AdvancedMD could grow faster as a standalone company [5]. That’s a reasonable strategy. But private equity firms typically operate on 3-7 year investment horizons, which means another transition could be on the table within a few years.
For a practice signing a multi-year contract, that’s relevant information. Will pricing stay stable? Will the product roadmap continue in its current direction? Will support quality hold? These aren’t scare tactics — they’re legitimate due diligence questions.
Dastify is privately held with no reported PE involvement. That’s simpler from a stability standpoint, though it also means less capital for large-scale platform investments. The trade-off is focus: they don’t need to justify billion-dollar valuations or satisfy PE return targets. They just need to keep their clients’ revenue flowing.
Where Each Company Fits Best
The Verdict — Choose Based on Your Practice's Needs
Choose Dastify Solutions if:
- You want to fully outsource billing to a dedicated team — not manage it in-house with software
- Denial prevention and maximum reimbursement are your top priorities
- You already have an EHR you're happy with and don't need to switch platforms
- You want transparent, all-inclusive pricing with no setup fees, module charges, or contract lock-in
- Your payer mix includes Medicare Advantage or other high-denial payers
- You want one company accountable for your entire revenue cycle
- You value AI that directly impacts your bottom line (predictive denial prevention vs. documentation automation)
Choose AdvancedMD if:
- Provider burnout from documentation is your primary pain point, and AI ambient listening could help
- You have in-house billing staff who need better software tools, not a replacement
- You're a larger practice or multi-location group that benefits from a unified ecosystem
- You value a 25-year track record and a platform used by 65,000+ practitioners
- You're comfortable with annual contracts and have budget certainty for per-provider software costs
- You're comfortable with annual contracts and have budget certainty for per-provider software costs
- You need a complete practice management platform — EHR, PM, scheduling, patient engagement, telehealth — all in one system
Proceed carefully with AdvancedMD if:
- Budget flexibility is a concern — the layered cost structure (software + RCM + add-ons) adds up fast
- You need easy cancellation options or short-term contracts
- You're a solo practitioner or small practice where $429-$729/provider/month is a significant line item
- You want outsourced billing that reports directly to you, not a platform's RCM service layer
The Bottom Line (For Real This Time)
AdvancedMD is a capable, mature platform. After 25 years in the market and over a billion dollars in acquisition value, they’ve clearly built something that works for a lot of practices. Their AI ambient listening features are genuinely exciting for reducing documentation burden, and their all-in-one platform approach saves time for practices that want a single system.
But capable and ideal aren’t the same thing.
If your core problem is billing — if denials are eating your revenue, if your A/R days are climbing, if you’re tired of surprises on your EOBs — Dastify Solutions is purpose-built for exactly that. Their AI catches billing problems before they become billing losses. Their pricing is tied to your collections, which means their success and your success are the same thing. And their contract terms won’t leave you feeling trapped if things don’t work out.
One more thought. When you’re evaluating either company, ask this question: “What happens to my revenue in the first 90 days?” AdvancedMD will likely talk about platform implementation, training timelines, and feature rollouts. Dastify will likely talk about denial rates, clean-claim percentages, and reimbursement speed. The difference in those answers tells you everything about where each company’s priorities actually sit.
Sources:
- Aptarro (2026). “50+ US Healthcare Denial Rates & Reimbursement Statistics for 2026.” aptarro.com
- OS Inc. Healthcare (2025). “Denial Rates Are Climbing: What Healthcare Revenue Cycle Leaders Should Be Watching in 2025.” os-healthcare.com
- Fierce Healthcare (2026). “RCM leaders cite payer behaviors, claims denials as major risks in 2026.” fiercehealthcare.com
- AdvancedMD (2025). “AdvancedMD Accelerates Growth & Expands Leadership Team.” advancedmd.com
- Francisco Partners (2024). “Francisco Partners to Acquire AdvancedMD from Global Payments.” franciscopartners.com; Also: Fierce Healthcare, “Francisco Partners plans to buy AdvancedMD for $1.1B.”
- AdvancedMD (2026). “AI Clinical Assistant From AdvancedMD.” advancedmd.com
- Dastify Solutions (2026). Company homepage and service pages. dastifysolutions.com
- Dastify Solutions via PR Newswire (2025). “AI Expected to Reduce Denials 40% in 2025, Says Dastify Solutions Report.” Syndicated by Morningstar and Yahoo Finance.
- SoftwareFinder (2026). “AdvancedMD: Pricing, Free Demo & Features (2026).” softwarefinder.com
- Business.com (2026). “AdvancedMD EHR Software Review and Pricing.” business.com
- AdvancedMD (2025). “Terms of Service.” Rev. September 2025. advancedmd.com (PDF)
- AdvancedMD (2026). “Advanced Artificial Intelligence Solutions.” advancedmd.com/ai; Also: Morningstar, “AdvancedMD Top Predictions for AI in 2026.”
- Capterra (2026). “AdvancedMD EHR Reviews 2025 — Verified Reviews, Pros & Cons.” capterra.com
- Better Business Bureau (2026). “AdvancedMD, Inc. — BBB Complaints.” bbb.org
- Better Business Bureau (2026). “Dastify Solutions, LLC — Business Profile.” bbb.org
- Wikipedia (2026). “AdvancedMD.” wikipedia.org