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Digital RCM solutions are software platforms and technologies that automate and optimize the healthcare revenue cycle. These tools leverage advanced algorithms, artificial intelligence, and data analytics to streamline financial processes, improve efficiency, reduce errors, and provide actionable insights.
Healthcare systems today face numerous challenges that impact their financial stability and operational efficiency through increasing complexity of reimbursement models, rising costs, and growing patient financial responsibility. In this landscape, digital solutions for revenue cycle management have the potential to address these issues and optimize healthcare financial operations.
Transforming revenue cycle management (RCM) through digital innovation is no longer just a back-office necessity; it’s a strategic imperative for healthcare organizations. By leveraging advanced RCM solutions, organizations can not only reduce administrative burdens and improve cash flow but also elevate the patient financial experience. A seamless, data-driven revenue cycle empowers healthcare providers to reinvest in their mission, delivering higher-quality care, expanding access, and driving sustainable growth in an increasingly complex environment.
The above Market Map was created in partnership with the AVIA Insights team and may not be comprehensive. For a view of the landscape inclusive of company self-categorization, see AVIA Marketplace.
The Top Revenue Cycle Management Companies Report is a resource designed to guide healthcare professionals in their quest for exceptional operational and customer oriented solutions. This report offers perspective on prominent provider documentation companies as reflected in the client reviews gathered on AVIA Marketplace and presents a selection of leading-edge solutions and companies.
This report is organized around client reviews that provide insight into the impact these solutions have had with the organizations they work with and include concise summaries that could assist in pinpointing solutions tailored to your unique needs. Our AVIA Marketplace serves as an additional resource, facilitating access to detailed company profiles, verified client lists, comparison of various solutions, and Match Scores to streamline your selection process. For even greater depth, AVIA experts are available through a Marketplace Product Review (for digital health solutions) and AVIA Membership (for hospitals and health systems). Ready to learn more? Send us a note!
The data that powers this report stems directly from the AVIA Marketplace, informed by reviews and by the number of verified health system clients associated with each company featured in the marketplace. In observance of confidentiality agreements, the complete client lists may not always be available from vendors.
Please note that the data presented is dynamic and subject to change over time. Therefore, we advise that decisions drawn from this information should be made judiciously, backed by thorough consideration.
Please note that this information does not reflect the opinions or views of AVIA as a whole, or AVIA Advisory Services. Rather, it reflects data captured on AVIA Marketplace at a point in time. This data is subject to change over time.
We at AVIA acknowledge the diverse strategies hospitals employ when selecting technologies. The reviews herein can offer valuable insight, but we also encourage considering other factors, like EMR integration, experience with clients similar to your organization, or overall market presence, which may prove pivotal in decision-making. We endeavor to provide a comprehensive analysis on these other aspects as well.
Our unique Product Grid, powered by our proprietary Match Score, is a useful tool to consider in your evaluation process. This methodology ensures that the products featured not only meet the buyer’s specific requirements but also exhibit solid market establishment.
The top-rated revenue cycle management companies were the most-reviewed within their product category. Companies in this section have all received the “top-reviewed” recognition and the order does not indicate a ranking.
5.0
HealthNautica’s eORders solution automates the entire perioperative process. We don’t replace an organization’s scheduling system or EMR. What we do replace is the inefficient, cumbersome and error prone phone/fax/paper systems for managing the perioperative process. eORders improves surgical revenues and volumes, patient and physician satisfaction, staff efficiency and overall organization performance and outcomes. eORders also reduces denials, 24-hour cancellations (often to less than 1%) and delayed starts. In 2018, HealthNautica had nearly 5,000 physicians registered and accounted for more than 250,000 surgical cases in the greater Chicago area alone.
*Note that HealthNautica may also fit in a Perioperative category but is also listed here based on relevance and reviews gathered
5.0
Waystar delivers innovative technology that simplifies and unifies healthcare payments. The company’s cloud-based platform helps healthcare providers across all care settings streamline workflows, improve financial performance and bring more transparency to the patient financial experience. Waystar solutions have been named Best in KLAS or Category Leader by KLAS Research 16 times (across multiple product categories) and earned multiple #1 rankings from Black Book. The Waystar platform is used by more than half a million providers, 1,000 health systems and hospitals, and 5,000 payers and health plans—and integrates with all major hospital information and practice management systems. On an annual basis, Waystar’s AI-powered solutions process $5B in patient payments, generate $4B in out-of-pocket estimates and process claims representing approximately 40% of the U.S. patient population.
5.0
EvidenceCare is a unique type of clinical decision support system (CDSS) with its EHR-integrated and content-agnostic platform that empowers better care decisions by improving clinical workflows.
Founded in response to the professional experience of emergency physician Dr. Brian Fengler, the platform provides clinicians with evidence-based insights and measurable outcomes that improve hospital margins.
Based in Nashville, Tennessee, EvidenceCare is a 2x honoree of the INC 5000 list of fastest growing companies, a 2x Fierce Healthcare Best Product winner, and one of Modern Healthcare’s Best Places to Work in Healthcare.
5.0
CampTek Software is a Full-Life-Cycle Intelligent Automation SaaS Provider with proven results implementing and supporting automation solutions through our successful methodology. Our unique hosted model offers many powerful advantages including a shorter time to market, 24/7 support and overall lower cost of entry. Our approach is simple and repeatable.
CampTek will be with you on every step of your RPA & AI Journey!
4.75
TQA Healthcare enables healthcare and life sciences organizations to transform the patient experience and reduce costs through increased personalization, intelligent automation, and AI.
The practice’s solutions impact patient access, the revenue cycle, order processing, and clinical needs at the most critical stages of the patient journey, resulting in a seamless encounter.
By empowering individuals to actively manage their unique experiences, TQA Healthcare increases the satisfaction of every healthcare consumer: patients, staff, and clinicians.
Houston-based, TQA Healthcare is formerly Element Blue.
5.0
Valer’s technology speeds and simplifies prior authorization and referral management by automating submissions, status checking, verification, reporting, and EHR synchronization across all mid-to-large sized healthcare settings, specialties, and payers from one platform and portal. All built just for you.
Valer’s automation technology enables our clients to reduce labor cost, claim denials from avoidable prior authorization errors, and writeoffs stemming from denials. With prior authorization approvals further in advance of scheduled treatments and procedures, Valer enables fewer rescheduled and abandoned appointments. Patients are happier, providers are happier, and staff are happier.
4.67
RevSpring leads the market in healthcare engagement and payment solutions that inspire patients to participate in and pay for their healthcare. We’ve built Engage IQ™, the industry’s only connected patient engagement suite designed to coordinate patient interactions from pre-care to post-care to payment. RevSpring’s intelligent, holistic platform puts patient understanding at the center of one connected personal experience, allowing providers to fully optimize patient satisfaction, data accuracy, staff efficiency and financial outcomes. The company’s OmniChannel communications and payment solutions are backed by intelligence, analytics, contextual messaging and user experience best practices. RevSpring was rated #1 for Most New Capabilities in Patient Engagement by KLAS in 2023 and Best in KLAS in Patient Communications in 2024.
4.67
XpertDox is a healthcare technology company committed to reducing administrative burdens for physicians, healthcare teams, and leaders while enhancing patient care through AI-driven solutions. XpertDox employs AI, RPA, and Big Data technologies to improve healthcare outcomes.
XpertDox’s commitment to innovation is demonstrated by its flagship product, XpertCoding, an autonomous medical coding software with Clinical Documentation Improvement(CDI) designed to accelerate the revenue cycle by processing medical claims with high accuracy in less than 24 hours.
XpertDox was founded in 2015 and is currently based in Scottsdale, Arizona.
5.0
Infermedica is a leading digital health company, specializing in AI-powered solutions for symptom analysis and virtual triage. The company’s mission is to make healthcare accessible, convenient and affordable for everyone worldwide, by automating primary care, from symptom to outcome.
5.0
Elevate medical practice by earlier disease detection and improved diagnosis via more accurate data collection, better risk and symptom assessment, faster charting, and increased revenue by higher level E&M billing. Now, achieve better outcomes in less time for more money.
Discover SOAP, a patented and clinically validated, Epic, AthenaHealth, etc. EHR-integrated, conversational AI-powered patient and physician-facing interface for more accurate patient data collection and analysis; an unrelenting focus on improving patient outcomes and eliminating administrative burdens.
5.0
Rhinogram recently recognized by KLAS TOP 20 Emerging Solutions: Improving Patient Experience & Reducing Cost of Care. With Rhinogram healthcare systems optimize their communication and connections with patients and healthcare organizations securely and effectively. Studies show that 83% of patients would prefer to text messages. Rhinogram gives healthcare systems and their patients HIPAA-compliant methods of communication that elevate care, patient compliance, and profitability. Streamline and liberate clinical and administrative teams across your organization, and increase the quality of care your facility provides, all while increasing billable services, and providing better care to patients through better connections.
5.0
Experian provides industry-leading solutions for revenue cycle management, identity management, patient engagement and care management.
5.0
R1 RCM is a leading provider of technology-driven solutions that transform the patient experience and financial performance of healthcare providers. R1’s proven and scalable operating models seamlessly complement a healthcare organization’s infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience.
5.0
Flywire is a global payments-enablement and software company, trusted by organizations around the world to deliver on their customers’ most important moments. Our responsive billing and payments platform leverages deep analytics and machine learning to understand your patients capacity to pay, their preferred method of engagement, and where on their healthcare journey we need to meet them. We’re delivering on your patients most important payments and maximizing collections for you and financial peace for your patients.
5.0
Cohere Health is a clinical intelligence company that provides intelligent prior authorization as a springboard to better quality outcomes by aligning physicians and health plans on evidence-based care paths for the patient’s entire care journey. Cohere’s intelligent prior authorization solutions reduce administrative expenses while improving patient outcomes. The company is a winner of the TripleTree iAward and has been named to both Fierce Healthcare’s Fierce 15 and CB Insights’ Digital Health 150 lists. Cohere’s investors include Flare Capital Partners, Define Ventures, Deerfield, Polaris Partners, and Longitude Capital.
5.0
Cedar offers the first and only holistic solution that enables providers and payers to come together to offer an exceptional and affordable consumer financial healthcare experience. We’re reimagining the consumer aspects of healthcare, from the time an appointment is booked all the way to final payment. Only Cedar can take advantage of critical payer information and bring it together with provider financial and administrative processes to create the optimal experience for consumers navigating our challenging healthcare system.
4.0
Epic Systems Corporation is a healthcare-focused software company that develops and offers products to improve the health of people. The company’s products are used at community hospitals, academic medical centers, children’s organizations, safety net providers, retail clinics, multispecialty groups, integrated delivery networks, rehab centers, and patients’ homes as well as in many other aspects. Epic Systems Corporation was established in 1979 and is based in Verona, Wisconsin.
Companies in this section did not have any reviews on AVIA Marketplace at the time of publishing. However, based on the number of verified clients we were able to gather, we include them here as other RCM companies to consider. They are listed in alphabetical order.
AGS Health is an analytics driven, technology enabled Revenue Cycle Management ('RCM') Company providing medical billing, medical coding and business analytics services to leading healthcare providers across the US.
Alpha II delivers revenue integrity by enabling proactive denial intervention throughout the revenue cycle. We empower precision through coding, compliance, claims editing, quality reporting, and revenue recovery analysis. Our clients and partners include professional and acute care providers, clearinghouses, billing services, payers, government entities, consultants, and other healthcare software development companies. Serving a broad variety of clients allows us to hone the functionality, design, value, and effectiveness of our solutions with provided experience and insight.
Change Healthcare is inspiring a better healthcare system. We are a leading independent healthcare company that provides data and analytics-driven solutions to improve clinical, financial and patient engagement outcomes in the U.S. healthcare system. Our comprehensive suite of software, analytics, technology-enabled services and network solutions take costs out of the healthcare system by driving improved results in the complex workflows of payers and providers by enhancing clinical decision-making and simplifying billing, collection and payment processes, and enabling a better patient experience. We are creating a stronger and more efficient healthcare system that enables better patient care, choice, and outcomes at scale.
Connifer provides full end to end hospital and physician revenue cycle management including hosted practice management and reporting systems.
Nuance meets you where you are in your CDI journey, with AI‑driven documentation integrity solutions that meet your needs. In‑workflow intelligence keeps the patient at the center of the story, supporting quality outcomes and appropriate reimbursement.
A leading provider of revenue cycle management solutions, The SSI Group (SSI) partners with healthcare providers and payers. Our product suite includes Patient Access Management, Claims Management, and Performance Management solutions with integrated analytics. A privately held company with 35 years of steady growth, we know our clients rely on us to streamline workflow, increase revenue, improve efficiencies, reduce costs, and more. We remain focused on providing the highest level of client service and our associates share in that mission, each and every day. Our clients know it – our average client tenure is over 20 years.
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