Let me paint a picture you probably recognize. You’re running a private practice — maybe solo, maybe a small group — and your billing situation is… messy. Claims are getting denied at rates that would’ve been unthinkable five years ago. Your front desk is drowning in prior auth requests. And every month, you watch thousands of dollars in legitimate revenue just vanish into the space between “claim submitted” and “payment received.”
So you start shopping for help.
Two names show up repeatedly in 2026: Dastify Solutions, an AI-powered medical billing company that’s been turning heads with its denial reduction numbers, and Tebra, the billion-dollar platform (formerly Kareo) that half the independent practices in America seem to already know. They look similar from a distance. Up close? They’re fundamentally different products built on different philosophies — and choosing the wrong one could make your billing problems worse, not better.
I’ve spent considerable time digging through their pricing, tech stacks, customer reviews (the good and the ugly), BBB complaints, and real-world performance data. Here’s what I found.
Why This Matters More Than Ever
Claim denial rates hit 11.8% nationally in 2024 and have continued climbing. Some payer categories — particularly Medicare Advantage — saw denial spikes of nearly 5% in a single year [1]. The industry lost an estimated $25 billion to denials in 2025 alone [2]. For a small practice, even a 2-3% improvement in clean-claim rates can mean tens of thousands of dollars recovered annually. The stakes here are real.
First Things First: These Are Not the Same Kind of Company
This is the single most important thing to understand before you compare a single feature or price point.
Dastify Solutions
Dastify Solutions is a dedicated medical billing and RCM company. You hand them your billing. Their team — 500+ AAPC/AHIMA-certified coders backed by AI — processes your claims, manages your denials, handles your A/R, and works to maximize your reimbursements. They’re doing the work for you [3].
Tebra
Tebra is primarily a software platform. Think of it as a technology company that builds tools for independent practices — EHR, practice management, patient engagement, online scheduling, reputation management. They also offer billing, but here’s the catch: Tebra doesn’t actually do your billing themselves. They either give you software to manage billing in-house, or they match you with a third-party billing partner from their network [4].
That distinction matters enormously. With Dastify, you’re hiring a billing team. With Tebra, you’re buying software (and maybe getting referred to someone else for the actual billing work). These are different value propositions, different price structures, and different risk profiles.
The Side-by-Side Breakdown
Side-by-side performance data · March 2026
| Category | Dastify Solutions | Tebra |
|---|---|---|
| What They Are | Full-service RCM & medical billing company | Practice management software platform with billing tools & partner matching |
| Headquarters | Austin, Texas | Corona del Mar, California |
| Founded | Newer entrant, AI-native | 2004 (as Kareo); rebranded Tebra in 2021 after merger with PatientPop |
| Funding | Privately funded | $387M–$537M total; valued at $1B+ after 2022 Series B; raised $250M in Dec 2025 |
| Team Size | 500+ certified coders | ~500–1,000 employees (platform company, not a billing team) |
| Billing Model | They do your billing end-to-end | DIY with software tools, or outsource via their partner network |
| Claims Processed | 2+ million annually | Not disclosed (platform processes through billing partners) |
| Clean Claim Rate | 98.5% | Varies by billing partner (TABS partner claims 99.6% first-pass rate) |
| Denial Reduction | Up to 45% within 90 days | ~10% improvement via managed billing (per Tebra's own data) |
| A/R Cycle | 30–35 days | Not publicly specified |
| Specialties | 50+ (expanding to 75+) | Dozens of specialty templates in EHR; billing partner coverage varies |
| AI Technology | Core platform: predictive denial analytics, auto-scrubbing, real-time compliance | AI Note Assist for clinical docs, TriZetto integration for claims scrubbing |
| Pricing | % of collections (varies by practice size/specialty); zero setup fees | $99–$399/provider/month for software; $500/provider onboarding; managed billing costs extra |
| EHR Included | No (integrates with your existing system) | Yes — EHR, PM, scheduling, patient portal all included |
| BBB Status | Accredited | Listed; multiple complaints documented in 2025–2026 |
| Review Scores | 5.0 (limited volume); strong BBB feedback | 3.6/5 on Capterra (524 reviews); mixed on Trustpilot and BBB |
Pricing: The Math Gets Interesting
On the surface, Tebra looks like the more affordable option. Their software subscription starts at $99/provider/month. For a three-provider practice, that’s roughly $300/month for EHR, practice management, and billing tools. Not bad.
But that’s the software price. It doesn’t include someone actually doing your billing.
If you want Tebra’s managed billing — where they connect you with a third-party partner to handle claims — that’s an additional cost on top of the software subscription. Tebra doesn’t publicly list what their billing partners charge, but industry-standard outsourced billing runs 4-10% of collections [5]. So for a practice collecting $80,000/month, you might be paying $300/month for the software plus $3,200-$8,000/month for the billing partner. And there’s the $500/provider onboarding fee on top [6].
There are other costs that add up too. Tebra’s AI Note Assist runs about $99/provider/month, and their payment processing takes 2.75% + $0.30 per transaction (or 2.9% + $0.30 through Stripe) [6].
Dastify Solutions charges a percentage of collections — their rate varies based on practice size, specialty, and claim volume. But here’s what’s different: that percentage includes everything. Billing, coding, denial management, compliance monitoring, clearinghouse fees, EDI transmission costs. No setup fees. No separate software subscription. No surprise line items three months in [3].
For practices that want someone else to handle billing entirely — and most practices searching for billing companies do — Dastify’s all-inclusive model tends to be more straightforward. You know exactly what you’re paying as a percentage of what you collect. If they don’t collect, you don’t pay.
The Real Cost Question
Technology: Two Very Different AI Strategies
Both companies talk about AI. But they’re using it for entirely different things, and that tells you a lot about their priorities.
Dastify's AI: Built for Revenue Recovery
Dastify’s AI sits at the center of their billing operation. It does three things that matter most for your bottom line:
Predictive denial analytics. Before a claim is submitted, the system flags it if it’s likely to be denied based on payer-specific patterns, coding issues, or compliance gaps. This is pre-submission intervention — catching problems before they cost you 30-45 days of waiting and $25-$181 per reworked claim [2].
Automated claims scrubbing. Every claim goes through AI-powered review for coding accuracy, LCD policy compliance, gender-specific rules, NCCI edits, and specialty-specific requirements. Their 98.5% clean-claim rate suggests this actually works [3].
Real-time compliance monitoring. CMS and payer rules don’t change on a convenient schedule. Dastify’s system tracks updates automatically and adjusts claim logic accordingly. As their Director Anum Naveed told PR Newswire: “CMS, HIPAA, and payer updates shift constantly. Automated compliance is no longer optional” [7].
The company’s internal research, published through PR Newswire and syndicated by Morningstar and Yahoo Finance, projects that AI-driven billing could cut denial rates by 40% across the industry [7]. Their own clients reportedly see a 45% drop in denials within 90 days of onboarding.
Tebra's AI: Built for Clinical Efficiency
Tebra’s AI investment — accelerated by their $250 million raise in December 2025 [8] — focuses primarily on the clinical side. Their AI Note Assist helps providers generate SOAP notes faster, automates repetitive documentation tasks, and includes features like SALT (pulling forward past visit content) and reusable macros [9].
On the billing side, Tebra integrates with TriZetto for claims scrubbing, and their Track Claims Status tool helps staff follow up on unpaid claims and flag rejections [5]. These are solid features for practices managing billing in-house.
But here’s the gap: Tebra’s AI doesn’t do predictive denial prevention the way Dastify’s does. Their tools help you process claims and catch some errors. Dastify’s tools try to predict and prevent denials before they happen. In a year where Medicare Advantage denials spiked 4.8% and RCM teams are spending 51-75 hours per week managing denial-related work [10], that’s a meaningful difference.
The Review Situation — And Why It Matters
I’m going to be blunt here because I think it’s important.
Tebra's Review Profile: Volume with Volatility
Tebra has 524 verified reviews on Capterra with an overall score of 3.6 out of 5. That’s a lot of data. And 41% of reviewers gave 5 stars, which means plenty of practices love the platform [11].
But 18% gave 1 star. That’s almost one in five. And the complaints aren’t minor.
Documented Complaints Worth Knowing About
Billing disputes: Multiple customers reported being charged thousands above agreed rates after attempting to downgrade or cancel services. Some describe charges continuing for months after cancellation requests were submitted [12].
Account access issues: At least one provider reported their entire account was suspended overnight — locking them out of their system — after disputing an incorrect charge [12].
Cancellation difficulties: Several BBB complaints describe a process where cancellation requests were submitted through the portal, then closed without resolution. One provider reported a cancellation process that stretched from April to November 2025 [12].
Support responsiveness: A recurring theme across reviews is long wait times, delayed ticket responses, and difficulty reaching someone who can actually resolve problems [11].
I want to be fair: every large software company accumulates complaints, and Tebra serves a massive customer base. Some friction is inevitable. But the pattern around billing disputes and cancellation barriers is specific enough and recent enough (January 2026 complaints) to warrant attention before you sign a contract.
One more detail: a BBB complaint alleged that Tebra published a customer’s personal cell phone number and home address without consent on their online directory [12]. For a healthcare company handling sensitive data, that’s the kind of thing that should concern you — even if it’s an isolated incident.
Dastify Solutions' Review Profile: Small but Strong
Dastify has significantly fewer public reviews. On the BBB, clients praise their credentialing and billing efficiency: “Their team was incredibly efficient, knowledgeable, and responsive throughout the entire process” [13]. Their ResellerRatings profile shows a perfect 5.0, though from limited reviews.
The limited volume is a legitimate consideration. You’re trusting a newer company with fewer data points. On the other hand, the data points that exist are consistently positive, and their performance metrics have been published through third-party outlets (PR Newswire, Morningstar, Yahoo Finance) — not just on their own website. That’s a level of external validation most billing companies their size don’t have [7].
Who Actually Owns the Relationship?
This is something people don’t think about until it becomes a problem.
With Dastify, you have a direct relationship with the team managing your billing. If something goes wrong with a claim, you contact Dastify. If you need your denial strategy adjusted, you talk to Dastify. One company, one point of accountability.
With Tebra’s managed billing, you have a three-party arrangement: you, Tebra (the software), and the billing partner (the service). If a claim goes wrong, who do you call? If the billing partner underperforms, does Tebra intervene? If you’re unhappy with the billing partner, can you switch without disrupting your software? These are real operational questions that get complicated in practice.
Tebra’s own messaging says they “match you with the right partner” and that the partner “works as an extension of your team” [4]. That sounds great. But in practice, you’re managing a relationship with a company that Tebra selected — and whose performance Tebra doesn’t directly control.
What Each Company Does Best
Where Tebra Wins
If you need an all-in-one practice management platform — EHR, scheduling, patient engagement, telehealth, reputation management, online booking — Tebra is hard to beat. That’s their core product, and they’ve invested over $500 million in building it. The platform handles clinical workflows well, and providers who manage billing in-house appreciate the integrated tools [9].
Their specialty-specific EHR templates cover a wide range of practices. The AI Note Assist feature (at $99/provider/month) genuinely speeds up documentation. And if you already use Tebra for your EHR and just need billing software to give your in-house team better tools, their billing module integrates seamlessly because it’s the same platform.
Tebra also has the advantage of scale and brand recognition. With 150,000+ customers and $112 million in revenue in 2025 [14], they’re not going anywhere. For practices that value stability and an established ecosystem, that matters.
Where Dastify Solutions Wins
If you want someone to take billing off your plate entirely — and do it with AI-powered precision — Dastify is the stronger play. Their entire business is built around one thing: maximizing your reimbursements and minimizing your denials. They don’t sell EHR software. They don’t run a patient portal. They bill.
The numbers back it up. A 98.5% clean-claim rate. A 45% denial reduction within 90 days. A 30-35 day A/R cycle against an industry average that’s often 40-50+ days. All-inclusive pricing with zero setup fees. And an AI system that doesn’t just process claims — it predicts which ones will be denied and fixes them before submission [3].
For practices bleeding revenue through denials, slow reimbursements, or coding errors, that focus is exactly what’s needed. You don’t need a Swiss Army knife. You need a scalpel.
The Verdict: It Depends on What Problem You're Solving
Choose Dastify Solutions if:
- You want to fully outsource billing to a dedicated team with AI-powered denial prevention
- Denial reduction and faster reimbursement are your top priorities
- You already have an EHR you're happy with and just need billing handled
- You want transparent, all-inclusive pricing — no surprise line items
- You value a single point of accountability for your entire revenue cycle
- Your practice has complex payer mixes, especially Medicare Advantage
Choose Tebra if:
- You need a full practice management platform (EHR + billing + scheduling + patient engagement)
- You prefer managing billing in-house with software tools rather than outsourcing
- You're starting a new practice and need an all-in-one system from day one
- AI-assisted clinical documentation is a high priority for your providers
- You value a large, established platform with an extensive user community
Be cautious with Tebra if:
- You need fully outsourced billing — you'll be relying on a third-party partner, not Tebra directly
- Clear cancellation terms and responsive support are deal-breakers for you
- You're a virtual-first practice (some reviewers report the platform is structured more for brick-and-mortar clinics)
Our Honest Take
These companies aren’t really competitors. They’re solving different problems for different practices.
Tebra is a technology platform that does a lot of things — EHR, practice management, patient engagement, billing software, telehealth. If you need the whole stack and want to keep billing in-house, it’s a solid choice with 20+ years of evolution behind it (counting the Kareo days). Just read the contract carefully, understand what you’re committing to, and budget for the full cost including add-ons and potential billing partner fees.
Dastify Solutions is a billing company that uses AI to do one thing exceptionally well: get you paid more, faster, with fewer denials. If your practice’s core pain point is revenue leakage through the billing process — and for most practices searching for billing help, it is — Dastify’s focused, all-inclusive model is hard to argue against on the merits.
The best advice I can give? Be honest about what you actually need. If the answer is “I need better software to run my practice,” call Tebra. If the answer is “I need someone to fix my billing and maximize my revenue,” call Dastify. And if you’re not sure, talk to both — the quality of that first conversation tells you a lot about how they’ll treat you as a client.
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
- Dastify Solutions (2026). Company homepage and service pages. dastifysolutions.com
- Tebra (2026). “Outsource Medical Billing — Managed Billing.” tebra.com
- Business.com (2026). “Tebra Medical Billing Software Review and Pricing in 2026.” business.com
- SoftwareFinder (2026). “Tebra EHR: Pricing, Free Demo & Features (2026).” softwarefinder.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.
- Wikipedia (2026). “Tebra.” wikipedia.org — December 2025 funding details.
- Tebra (2026). “EHR Software for Private Medical Practices.” tebra.com
- Fierce Healthcare (2026). “RCM leaders cite payer behaviors, claims denials as major risks in 2026.” fiercehealthcare.com
- Capterra (2026). “Tebra Reviews 2026 — Verified Reviews, Pros & Cons.” capterra.com
- Better Business Bureau (2026). “Tebra — BBB Complaints.” bbb.org
- Better Business Bureau (2026). “Dastify Solutions, LLC — Business Profile.” bbb.org
- GetLatka (2025). “How Tebra hit $112.2M revenue and 150K customers in 2025.” getlatka.com
- NCDS Inc. (2026). “RCM Benchmarks for 2026: A/R Days, Denial Rates & Collections Explained.” ncdsinc.com