Hospitals, health systems, physician practices and healthcare organizations are experiencing increasingly complex revenue cycles, working with government and private payers as well as patients to collect.
Here are more than 260 companies with revenue cycle management solutions in the healthcare space. If you would like to add a revenue cycle management company to this list, contact Jack Burns at firstname.lastname@example.org Laura Dyrda at email@example.com.
Note: Revenue cycle companies do not and cannot pay for inclusion on this list. This list is not a ranking or rating, and companies are listed in alphabetical order.
Ability Network (Minneapolis). Ability, an Inovalon company, is an information technology company focused on simplifying the administrative and clinical complexity of the revenue cycle for providers and payers. The company provides specialized applications and analytics for revenue cycle, care quality and workforce management.
Accenture (Dublin, Ireland). Accenture's team of experts provides insights and technologies for healthcare organizations to accelerate insight-driven health. The company gives insight into digital health, operational transformation and healthcare consumerism with clinical and health management services.
Access Healthcare (Dallas). Access Healthcare works with healthcare providers to improve revenue cycle management and focus strategic priorities, including improved profitability and patient experience. Access Healthcare serves healthcare organizations of all sizes, including dental service providers, to achieve better revenue cycle results with best practices that can increase the bottom line.
AccessOne (Charlotte, N.C.). AccessOne offers payment options to help patients manage healthcare costs while driving hospital reimbursement. The company can provide comprehensive low- and no-interest payment options for all patient balance types. There isn't a cap in account size, and patients aren't denied credit for any reason.
AccuReg (Mobile, Ala.). AccuReg offers artificial intelligence-enhanced software-as-a-service products and consulting to boost hospital revenue. Hospitals can use the company's platform to identify issues and prevent denials. AccuReg appeared on Inc. 5000's Fastest Growing Private Companies in 2019 and launched its Estimate My Cost patient-facing tool in June 2019.
ACI Worldwide (Naples, Fla.). Healthcare providers collect up to 27 percent more with new patient financial engagement technology. ACI Worldwide offers innovative new ways to engage patients before, during and after appointments to accelerate cash flow.
ACN Healthcare (India). ACN Healthcare is a revenue cycle management company focused on end-to-end medical billing services. The company provides services such as demo entry, charge entry, coding, accounts receivable follow-up and E/B verification to hospitals and physician groups. ACN has an onshore/offshore model and focuses on healthcare verticals to bring value to client organizations.
AdvantEdge Healthcare Solutions (Lombard, Ill.). AdvantEdge Healthcare Solutions developed a suite of revenue cycle management solutions, including medical billing, coding and analytics. The company is designed to assist ASCs, physician groups, hospitals and behavior health agencies.
Advantmed (Irvine, Calif.). Advantmed is an integrated risk adjustment optimization and quality improvement company dedicated to helping risk-bearing entities. Advantmed partners with organizations to deliver the optimal combination of unique solutions to help them achieve their objectives.
Advantum Health (Louisville, Ky.). Advantum Health helps healthcare providers maximize revenues and practice medicine without administrative burden. Advantum offers full-service revenue cycle solutions — including billing, credentialing, pre-authorization, referral management and intuitive analytics dashboards — through one vendor.
AGS Health (Washington, D.C.). AGS Health is more than a revenue cycle management company – it's a strategic partner for growth. With expert services complemented by AI-enabled technologies and high-touch support, AGS Health is the premier revenue cycle partner for leading health systems, physician groups, and academic medical centers in the U.S. With expert insight into modern revenue cycle practices, the company pairs cutting-edge technology with college-educated, trained RCM experts to help clients achieve a high-performance revenue cycle to optimize workflows, maintain compliance, and prevent revenue leakage. AGS Health employs more than 11,000 team members globally and partners with more than 100 clients across a variety of care settings, specialties, and billing systems
AIE Medical Management (Washington, D.C.). AIE Medical Management provides a full spectrum of solutions for medical groups and hospitals. Revenue cycle management, coding, credentialing, transcription and virtual medical scribe are just a few of the service lines the company offers. AIE works with each practice to navigate the fast-paced and constantly changing world of medicine, ensuring the best outcomes, reducing administrative burden and improving the quality of life for each provider.
All Right Medical Management Services (Chester, Va.). All Right Medical Management Services provides revenue cycle and EHR solutions to healthcare organizations. The company focuses on maximizing a healthcare providers' bottom line through billing and coding, denial management, accounts receivable, and collections services.
Alvaria (Atlanta). Alvaria assists in customer communications with their contact center, workforce management and analytics technologies solutions. The company's client installations worldwide function on Alvaria's omnichannel premise, cloud and hybrid platforms to manage customer contacts.
Americollect (Manitowoc, Wis.). Originally launched as a healthcare collections business in 1964, Americollect was purchased in 1999 and grew into a 340-member team serving more than 120 hospitals and 7,000 physicians. The company focuses on hospital, medical group and radiology collections to recover patient payments. Americollect specialists verify patient demographic data, contact patients and man a 24-hour online chat box that allows users to connect with collectors online.
Amitech Solutions (St. Louis). Amitech is a healthcare data analytics and management consulting firm aiming to leverage the value of data analytics to help payers and providers create value. The company's solutions include management consulting and information management as well as big data- and Internet-of-Things-driven population health solutions to help payers, providers and employers understand their populations and engage them to drive down costs.
ANI Healthcare Solutions (San Francisco). ANI Healthcare Solutions, founded in 2001, specializes in denial management and zero balance payment reviews for hospitals nationwide. The company ensures HIPAA compliance with HITRUST security certification.
AnnexMed (East Brunswick, N.J.). Launched in 2004, AnnexMed is a revenue cycle management services provider for institutions across the country. The company offers medical coding, billing and collections services as well as data entry and accounts receivable management. AnnexMed provides 24/7 customer support for a diverse array of customers and can be scaled up quickly to meet increasing business needs.
Anthro Innovations (Burbank, Ill.). Anthro Innovations is a small group of physicians and revenue cycle specialists who aim to level the playing field between payers and providers with RevRecover, a self-learning artificial intelligence system designed to automatically follow up on rejected claims. The system could increase payments and reduce the time and labor costs associated with working rejected claims.
ApexonHealth (Southfield, Mich.). ApexonHealth helps providers, payers and other healthcare organizations harness the power of AI technologies to reduce costs, improve cash flow and increase customer satisfaction. Solutions are built on the proprietary Newton AI platform, which combines machine learning, robotic process automation and business process management. Companies of any size can modernize their back office without the need for costly system integration.
ApprioHealth (Washington, D.C.). ApprioHealth has advanced technology solutions for hospital revenue cycle management. It helps hospitals use technology to drive patient satisfaction with the revenue cycle and operational improvement. The company launched in May 2019 and had a 280 percent growth rate in its first four months.
Argos Health (Dallas). Argos Health specializes in the billing, follow-up and collection of complex claims such as Veterans Affairs, motor vehicle accidents, out-of-state Medicaid and workers' compensation. Argos Health was named a top performer in the 2020 KLAS Complex Claims report and the No. 1 ranked Complex Claim Vendor in 2019 and 2020 by Black Book.
Aspirion (Columbus, Ga.). Aspirion helps hospitals and health systems maximize revenue recovery by focusing on their most challenging reimbursements. Aspirion achieved the top 2022 Best in KLAS for Revenue Integrity/Underpayments ranking which is reflective of its team of 100-plus attorneys, 30-plus clinicians, and seasoned claims processors and unparalleled technological innovation. From Motor Vehicle Accident, Workers’ Compensation, and Veterans Affairs/TRICARE to Denials, Aging AR, and Out-of-state Medicaid & Eligibility, its 600-plus healthcare clients across 45 states count on Aspirion for superior revenue recovery performance.
Athenahealth (Watertown, Mass.). Founded in 1997, Athenahealth provides medical record, revenue cycle, patient engagement, care coordination and population health services for hospital and ambulatory clients. The company has a network of 140,000 providers that use its practice management, patient engagement and population health services.
Atos (Bezons, France). Atos helps providers deliver a personalized and secure healthcare experience that improves revenue optimization and patient care. Part of a $12.5 billion global company, Atos is one of the fastest growing companies in North American healthcare. Key health information management solutions include end-to-end revenue cycle management, EHR optimization, coding audit and compliance. as well as clinical documentation improvement to help providers prepare for the next generation of healthcare.
Atom Healthcare (New York City). Atom Healthcare offers a comprehensive range of services ranging from simple transaction services to audit and analytical services across the provider and payer domains. The revenue cycle management services provided by Atom Healthcare are an end-to-end solution, which helps hospitals and health systems focus on their core functions.
Avaap (Columbus, Ohio). Avaap is an IT services and management consulting firm for organizations that use enterprise resource planning and EHR software applications. The company's global community includes experienced technical and business process consultants, physicians, nurses and other healthcare professionals who serve as resources to more than 300 customers.
Availity (Jacksonville, Fla.). Launched in 2001 as a joint venture between Florida Blue and Humana, Availity was initially founded to streamline processes among payers and reduce administrative abrasion between payers and providers. Today, the company operates a large real-time information network focused on the healthcare industry, connecting providers, health plans and technology partners.
Aviacode (Salt Lake City). Aviacode provides a medical coding solutions platform aimed at solving coding problems, creating efficiencies, and improving revenue and cash flow. The company includes more than 700 medical coders serving 30,000 physicians in more than 61 medical specialties. Aviacode's solution codes 10 million charts per year.
Ayasdi (Menlo Park, Calif.). More than 300 healthcare organizations use Ayasdi's intelligent applications and artificial intelligence platform to solve care optimization, population health, precision medicine and financial management challenges. The company is focused on helping health systems, payers and medical researchers harness artificial intelligence and big data to improve care and make medical breakthrough discoveries.
BC Services (Longmont, Colo). BC Services is one of the largest accounts receivable management companies in Colorado with our corporate headquarters located in Longmont. The company works with organizations in all 50 states that need expert support managing their revenue cycle and collection unpaid account balances.
BDO USA (Chicago). The BDO USA-Healthcare Advisory team has extensive knowledge assisting organizations to optimize revenue cycle functions to improve and maximize reimbursements. BDO revenue cycle assessments will identify processes within the operations contributing to revenue leakage, slowdown in cash flow or processes that are of risk to organization.
BillingParadise (Diamond Bar, Calif.). BillingParadise was founded as a revenue cycle management company headquartered in California. The company's extended client base and offices are in Texas, Florida, New York, New Jersey and Minnesota. BillingParadise's revenue cycle experts developed a workflow management and productivity tracking application that integrates with major EHRs to help clients streamline and automate their revenue cycle process. BillingParadise has more than 15 years of experience in the revenue cycle industry.
BillingTree (Scottsdale, Ariz.). BillingTree provides payment solution products and services for organizations to increase efficiency and decrease costs associated with processing payments. Founded in 2003, BillingTree aims to understand the marketplace and grow payments with technology so customers can accept multiple payment channels and maximize value.
BKD CPAs & Advisors (Springfield, Mo.). BKD CPAs & Advisors works with more than 310 providers nationwide, including hospitals and health systems, to provide performance improvement services. The $758 million company has a keen understanding of the complicated issues healthcare CEOs and CFOs face and can help make strategic financial and operational performance decisions.
Bluetree Network (Madison, Wis.). Bluetree Network partners with healthcare organizations to maximize Epic's value. Founded by former Epic leaders, the company's experts have distinct knowledge of the challenges associated with implementing the EHR and can help organizations manage their talent, revenue cycle and operations.
Boncura Health Solutions (Downers Grove, Ill.). Launched in 2011, Boncura Health Solutions has grown to serve more than 14,000 provider partners as well as manage more than 500,000 lives and process 2.5 million claims per year. The physician-owned and directed organization focuses on efficient management of at-risk patient populations as well as cost-effective care delivery.
Cantata Health Solutions (Austin, Texas). Cantata Health provides advanced revenue cycle management and EHR applications for acute and post-acute care hospitals as well as long-term care facilities.
Capio (Lawrenceville, Ga.). Capio manages healthcare accounts with the goal of maximizing returns on nonperforming accounts and improving revenue cycle management.The company provides a variety of bad debt solutions, including primary, secondary and debt purchase solutions, leveraged at any point after accounts have been designated as bad debt. Their solutions are CMS compliant and customized to align with provider's needs by access to immediate cash and confidence knowing patients will be managed by an experienced healthcare-focused team.
CareCloud (Somerset, N.J.). CareCloud provides cloud-based revenue cycle management, practice management, EHR and patient experience management solutions for high-performance medical groups. CareCloud helps clients increase financial and operational performance, streamline clinical workflows and improve patient care nationwide.
CareCredit (Costa Mesa, Calif.).CareCredit is a health, wellness and personal care credit card with 35+ years’ experience, giving patients the flexibility to pay over time for their rising out-of-pocket healthcare costs. *This includes deductibles, copays and other medical expenses not covered by insurance. CareCredit has 12.7 million cardholders and is accepted at 260,000 provider and retail locations nationwide. Practices get paid in two business days, with no recourse^ (CareCredit assumes the liability), helping providers save time, increase cash flow, and reduce A/R.
CarePayment (Nashville, Tenn.). CarePayment is a patient financial engagement company that accelerates providers' transition to the new consumer-driven healthcare market. Powered by advanced technology and analytics, the company's innovative patient financing solutions improve patient satisfaction and loyalty while delivering superior financial results.
Cascade365 Family of Companies (Petaluma, Calif.). Cascade365 is a family of companies that provide accounts receivable liquidity solutions to the healthcare industry, promoting financial accountability while treating guarantors in a fair, dignified, and lawful manner. Cascade365's suite of products and services includes AR purchase, factoring, master servicing, third-party collections and revenue cycle optimization.
CBOSS (Boardman, Ohio). CBOSS is a service provider and partner to government and private-sector clients, providing the CBOSS Central Payment Portal to centralize administration for all electronic payments. The company provides bank integration support and 24/7 access for clients and their customers.
Cedar (New York City). Cedar is a patient payment and engagement platform for hospitals, health systems and medical groups. The platform is designed to leverage advanced data science, machine learning and smart segmentation to deliver a better experience for patients.
Centauri Health Solutions (Scottsdale). Centauri Health Solutions works with healthcare payers and providers to improve the lives of their members and patients through compassionate outreach, sophisticated analytics, and data-driven solutions. The company's reimbursement-focused services and unparalleled expertise lead to more accurate payment rates; a reduction in uncompensated care; transparent provider pricing; and quality measurement compliance.
Change Healthcare (Nashville, Tenn.). Change Healthcare is a large, independent healthcare technology company that works alongside customers and partners to enable better patient care, choice and outcomes at scale. The company provides software and analytics, network solutions, and technology-enabled services for government payers, employers, hospitals, physicians and others.
CHMB (Escondido, Calif.). CHMB works with providers and health systems to manage the revenue cycle, maximize reimbursements, reduce costs and increase cash flow. More than 11,000 physicians use CHMB solutions to improve practice profitability and optimize healthcare technology investments.
Cimcor (Merrillville, Ind.). Founded in 1997, Cimcor focuses on software security, integrity and compliance. The company's flagship software product helps organizations monitor and protect physical, virtual and cloud-based IT assets in real time. The software tracks the user that makes changes, what changes are made and how changes are made.
CIPROMS (Indianapolis). Since 1982, CIPROMS has partnered with physicians to provide customized medical billing that includes personalized service and timely and reliable information with transparent and trusted accountability. CIPROMS' services are designed to increase revenue, improve cash flow, reduce costs and minimize the administrative aggravations associated with ever-changing rules and regulations.
Cirius Group (Pleasant Hill, Calif.). Cirius Group's flexible, scalable and customizable revenue cycle solutions transform healthcare organizations into the most efficient financial powerhouses in the nation. For 36 years, healthcare leaders have trusted Cirius Group to help them push the boundaries of what their revenue cycle can do.
ClaraPrice (Austin, Texas). ClaraPrice is a digital health company that provides cost estimates for surgery. The cloud-based software provides revenue cycle training tools to improve the patient experience and a knowledge base for patient education regarding EHR access. ClaraPrice offers audit services for posted prices and balance billing prevention
ClearBalance (San Diego). ClearBalance Healthcare provides patient financing and patient pay services and has served healthcare exclusively for nearly 30 years. ClearBalance maintains the industry's highest patient financing repayment rate at 90 percent nationally. The company specializes in providing a seamless patient pay experience that reduces bad debt, improves patient satisfaction and encourages consumer loyalty.
ClinIntell (Seattle). ClinIntell is a clinical documentation improvement data analytics and physician training software firm that leverages proprietary predictive analytics to affect long-term change in physician documentation practices. The company's analytics provide a vehicle to measure and report individual physician documentation performance.
CodeOne (Monument, Colo.). CodeOne was founded in 2001 and provides services in all aspects of the revenue cycle. In addition to medical billing, CodeOne also provides consulting services in areas including practice analysis, coding review, audit reconciliation, practice compliance and business coaching. The CodeOne team comes from a diverse background of medical billing, practice management, managed care leadership and payer organizations.
Colburn Hill Group (Manchester, N.H.). Colburn Hill Group provides management expertise and automated solutions for healthcare provider revenue cycle management, including follow-up, denials, work listing and cash reconciliation functions. The company provides consulting and management, low balance solutions, interim management and improved clean claim rates to customers.
Collect Rx (Bethesda, Md.). Collect Rx provides services to maximize out-of-network reimbursement to hospitals, ambulatory surgery centers, physicians and other healthcare providers. The company's proprietary CRXIS business intelligence engine and industry expertise help healthcare providers increase revenue, save time and improve the bottom line.
Collection Licenses (Irvine, Calif.). Collection Licenses is a full-service licensing support company focused on providing a comprehensive approach to the debt and revenue cycle industries. The company helps organizations obtain and maintain state licensing and registration.
CommerceHealthcare (Kansas City, Mo.). CommerceHealthcare provides automated receivables management and payment services, patient loan financing and lending solutions to healthcare providers and patients. CommerceHealthcare brings together a team of healthcare and banking professionals.
Commvault (Tinton Falls, N.J.). Commvault is a data protection and information management solutions provider focused on helping healthcare organizations handle high volumes of data, meet compliance requirements and deliver quality care through a single integrated platform. The company has more than 2,700 healthcare customers using its products and services.
Conifer Health Solutions (Frisco, Texas). Conifer is a strategic partner to clients in more than 135 regions of the U.S., including Tenet Healthcare, CommonSpirit Health, LCMC Health, Keck Medicine of USC and Dartmouth Health. The company has earned a No. 1 or No. 2 ranking in healthcare market research company Black Book's end-to-end RCM outsourcing survey for integrated delivery networks.
Contego Solutions (Nashua, N.H.). Contego drives increased revenue for ASCs through its comprehensive out-of-network claims and appeals process. Contego's expertise lies in predictive modeling, deductible and coinsurance management, detailed application of the Department of Labor claims and appeals process and pinpointed utilization of legal resources, which together drive revenue.
Coronis Health (Sykesville, Md.).Coronis Health is a healthcare revenue cycle and medical billing company combining technology with high-touch relationship building. The company helps hospitals, ASCs and medical practices with revenue cylce management, processing more than 31.2 million claims per year.
Cotiviti (South Jordan, Utah). Cotiviti offers solutions and analytics for payers, providers and employers to collaborate and improve the healthcare revenue cycle. Cotiviti recently launched Caspian Clarity, which includes clinical, financial and other medical data on 40 percent of Americans, providing a longitudinal view of population health and the patient journey. The company’s Payment Accuracy platform is a real-time, prepay, integrated claim accuracy and fraud detection solution scalable for all payer sizes.
Craneware (Atlanta). Craneware provides automated value cycle solutions to improve hospital financial performance. Its solution helps hospitals and healthcare organizations price, charge, code and retain earned revenue for patient care services and supplies.
Credit Management Co. (Pittsburgh). Credit Management Co. offers customized outsourcing processes that deliver solutions that will accelerate cash flow, lower operating expenses, reduce customer delinquency and improve customer care and support. Our primary services include: first party A/R management, debt recovery and customer care. Credit Management Co. has been providing full-service accounts receivable and collection management programs across several industry segments since 1966.
Credit Solutions (Lexington, Ky.). Credit Solutions is a national revenue cycle management company that exclusively provides services to hospitals, healthcare systems and physician groups. We provide tailored extended business office solutions, bad debt recovery, physician billing and coding and denials management services.
Crowe (Chicago). Crowe is a public accounting, consulting and technology firm with offices around the world. Through its patented Crowe Revenue Cycle Analytics software, Crowe captures every patient transaction each day from hospital partners. The Crowe RCA solution is designed to help accelerate and increase net revenue by providing unique insights regarding revenue cycle benchmarking, denials and credits performance, charge capture opportunities and integration of automation.
Crossroads Health (Goshen, Ind.).Crossroads Health offers the most complete credit balance solution for healthcare providers. Leveraging proprietary resolution software, the company's experienced team of U.S.-based credit balance analysts work all credits, regardless of source or dollar amount. Unlike "free" payer-aligned credit balance recovery services, Crossroads Health never accepts payer contingencies; the company's incentive is to completely eliminate credits by identifying and preventing their root causes.
Currence Physician Solutions (Chicago). Currence empowers physicians and healthcare executives with financial insight. It serves as a medical practice partner providing outsourced and co-sourced revenue cycle management, financial management, private equity advisory and real-time analytics dashboards.
Cynerio (Ramat Gan, Israel). Cynerio is a healthcare fraud detection platform working with healthcare organizations to protect all medical devices, patient records and even patient health by preventing hacks on crucial healthcare devices involved in delivering care. Cynerio visually maps all network connections in a hospital and uses artificial intelligence and machine learning to diagnose the connections and monitor the medical context of information being exchanged.
DaisyBill (Claymont, Del.). Specifically built for the complex revenue cycle challenges of workers' comp, DaisyBill offers cloud-based solutions to get providers who treat injured workers paid. DaisyBill's solutions include SaaS billing software as well as complete end-to-end account management services.
Datica (Minneapolis). Datica aims to solve the problem of HIPAA compliance in the cloud and enable the secure exchange of digital health data to EHRs. Datica helps hospitals ensure their clouds are compliant and their data is securely interoperable.
Dolbey (Concord, Ohio). Dolbey supports a suite of solutions designed to improve productivity while delivering better documentation for coding and billing. The solution offers physicians a flexible workflow with dictation or speech recognition as well as powerful computer-assisted coding, clinical documentation improvement, care measures abstraction and reporting.
eCatalyst Healthcare Solutions (Phoenix). eCatalyst provides coding, auditing, clinical documentation improvement, message passing interface, revenue cycle and strategic health information management consulting to hospitals, physician practices and health systems. The company's Synergy Engage real-time ambulatory CDI solution is designed to increase throughput and improve hierarchical condition categories capture rates.
Echelon Medical Capital (Delray Beach, Fla.). Echelon Medical Capital focuses on accounts receivable liquidity solutions for healthcare providers taking insurance or medical liens against pending personal injury cases. It is among the largest funding companies in the nation and provides services to hospitals, surgery centers and physician groups of any size.
Eclat Health Solutions (Herndon, Va.). Eclat Health Solutions is a comprehensive domestic and international healthcare support service provider of medical coding, medical billing and ICD-10 auditing, that delivers efficient, accurate, secure and affordable RCM. Eclat works with a variety of U.S. healthcare providers, from large hospital facilities to small independent practices.
EMPClaims Solutions Inc (Lombard, Ill.). EMPClaims is an end-to-end medical billing and RCM company. With over 10 years in the industry, EMPClaims helps small and medium-sized medical practices and physician groups to streamline their billing processes and optimize revenue. EMPClaims' processes and workflows ensure highest reimbursements for the services medical practices provide to their patients.
Enable Healthcare (Hanover, N.J.). Enable Healthcare delivers health IT solutions and services to independent and group practices across the U.S. The company's solutions and services include revenue cycle management, virtual care, remote patient monitoring and more. In 2021, MedChi of Maryland chose Enable Healthcare to provide virutal health services to the state's 2,400 practices.
EnableComp (Franklin, Tenn.). EnableComp partners with over 800 healthcare providers to maximize their complex claims reimbursement by having the best people, processes, products and performance. Our industry-leading technology and analytics identify the right payer, at the right time, for the right amount, ensuring clients collect the appropriate revenue for their complex claims.
Encore Exchange (Winston-Salem, N.C.). Encore Exchange is an employee-owned company founded in 1972 that provides hospitals and physicians with low-cost collections services and software. The company has expertise in health information services, patient communications, revenue cycle management and payment technologies.
Ensemble Health Partners (Mason, Ohio). Ensemble focuses on revenue cycle management with its suite of technologies. It has clients across the U.S. and Europe and has helped healthcare providers save millions of dollars. It currently has 7,200 associates and partnered with Golden Gate Capital to continue growth and innovation.
eSentire, Inc. (Waterloo, Ontario). eSentire Inc., is a managed detection and response company that helps healthcare organizations prevent cyberattacks. Its security operations center, staffed by elite security analysts, hunts, investigates and responds in real time to known and unknown threats before they become business- disrupting events.
eSolutions (Overland Park, Kan.). eSolutions’ powerful, easy-to-use revenue cycle and workflow management tools, paired with advanced performance insights, strengthen your revenue health. Hospitals trust eSolutions to reduce time between claims submission and payment, improve overall operational efficiency, minimize denials and lessen audit and compliance risk.
Excalibur (Grand Junction, Colo.). As a healthcare finance and revenue cycle operations performance management, analytics, and outsourcing organization, Excalibur offers services that give our clients proven methods to slash bad debt, reduce A/R days, and minimize manual touches per claim. Most importantly, we can help you migrate to a data-driven performance management culture that sustainably increases net revenue yield. Excalibur partners with organizations to set meaningful leading and lagging targets at a granular level and then exceed them through professional services and analytics-enabled outsourcing.
Experian Health (Costa Mesa, Calif.). Experian Health partners with 63 percent of U.S. hospitals and health systems, as well as 7,700 other healthcare providers, on revenue cycle management, identity management, patient engagement and care management. Experian focuses on solutions to help healthcare providers make the transition to value-based care by automating the front- and back-end revenue cycle management processes.
Experity (Rockford, Ill.). Experity provides integrated technology solutions to more than 5,700 urgent care centers and on-demand healthcare practices nationwide, including RCM and billing services, EMR and practice management, patient engagement, teleradiology and business intelligence. Experity’s RCM services make billing easy by eliminating complexities around coding, billing, payer contracts and compliance, resulting in optimized revenue and reimbursement for providers.
ezDI (Louisville, Ky.). EzDI focuses on developing health IT solutions that leverage technologies including natural language processing, machine learning, semantic web and high-performance cloud computing. The goal is to put operational data into the hands of healthcare professionals to help them proactively identify patients at risk, patterns in disease and treatment outcomes.
FCI/RevCare (Fairlawn, Ohio). FCI/RevCare is a leader in providing innovative, technology-driven RCM solutions to health systems across the United States. The company provides end-to-end solutions from pre-service and POS Medicaid Eligibility, Early Out and bad debt solutions.
Firstsource Solutions Limited (Mumbai, India). Firstsource is a leading global provider of business process management services offering transformational solutions and services spanning the customer lifecycle across healthcare and other industries. The Firstsource Healthcare Cloud is an innovative platform in revenue cycle management and eliminates revenue leakage; empowers health team collaboration; delivers better health insights and outcomes; strengthens security, compliance and ease of interoperability; and deepens patient engagement across eligibility, enrollment and recovery. It ultimately helps organizations transform financial performance and patient experience.
Flywire (Boston). Flywire provides payment support solutions that make it easier for patients to manage and pay their out-of-pocket medical expenses. With rising deductibles, the company's solution empowers providers to automatically identify, engage and activate payment terms for patients who need help paying their bills.
Formativ Health (Jacksonville, Fla.). Formativ Health partners with physician practices, hospitals and health systems to help them improve financial health, adapt to changing risk-based payment models, increase practice productivity and physician satisfaction and significantly enhance the patient experience. The company's holistic RCM solutions are enabled by agnostic technology.
FrontRunnerHC (Plymouth, Mass.). FrontRunnerHC's software, Patient Remedi, automates the identification of active and billable coverage for patients with inaccurate or missing coverage on file. Patient Remedi reduces the need for human intervention, and in turn, improves the accuracy of patient data, freeing up time to work on higher yield projects and improve client and patient satisfaction.
FTI Consulting (Brentwood, Tenn.). FTI Consulting works with virtually every segment of the healthcare and life sciences industry to discern innovative solutions that optimize performance in the short term and prepare for future strategic, operational, financial and legal challenges. The company provides a one-company team of experts across the spectrum of healthcare disciplines.
Galen Healthcare Solutions (Chicago). Galen Healthcare Solutions is a health IT technical and professional services and solutions company providing cross-platform expertise. Galen has partnered with more than 300 specialty practices, hospitals, health information exchanges and healthcare organizations to provide consulting services.
GBS Corp. (North Canton, Ohio). GBS provides revenue cycle management services for healthcare organizations, assisting in reaching financial objectives by streamlining collection. GBS helps improve profitability and productivity while reducing costs and overhead.
GeBBS Healthcare Solutions (Culver City, Calif.). GeBBS Healthcare Solutions is a KLAS-rated leading provider of revenue cycle management services and risk adjustment solutions. GeBBS’ technology and robust analytics, combined with its more than 10,000-member global workforce, helps clients improve their financial performance and enhance the patient experience.
Global Healthcare Resource (Atlanta). Global Healthcare Resource is a full-service, international RCM outsource firm with over 20 years of experience providing coding, accounts receivable, end-to-end billing, self-pay and patient experience services to the ambulatory, acute and post-acute segments. Global is SOC 2 Type 2-compliant with highly skilled and certified team members ready to help providers and billing companies streamline their revenue cycle.
Global Recovery Alliance AG (Baar, Switzerland). Global Recovery Alliance AG assists hospitals and health systems with international accounts receivable. Launched in 1998, the company has worked with 1,600 hospitals in the U.S., supporting the patient financial services team in global collections.
Grant Thornton (Chicago). Grant Thornton delivers solutions and operational improvements that help providers meet patient care, compliance and business needs. The company provides security and privacy protection, revenue cycle management and health technology solutions with personalized insight into how organizations can standardize processes and integrate workflow optimization for increased value.
Greenway Health (Tampa, Fla.). Greenway provides software and services to ambulatory practices. A partnership with Greenway and its revenue cycle management service gives practices full insight into their financial standing and proactive service from an expertly trained staff.
Guidehouse (Chicago). Guidehouse (formerly Navigant) is a specialized, global professional services firm offering impactful industry-leading healthcare solutions. In addition to being recognized as "best in KLAS" for revenue cycle optimization, Guidehouse has earned seven No. 1 KLAS rankings for revenue cycle outsourcing solutions in the last decade and was named the top healthcare RCM consulting firm in 2020 and 2021 by Black Book.
Revele (Jefferson City, Mo.). Revele provides full-service revenue cycle management services, including medical coding, billing, accounts receivable management, analytics, consulting and patient call centers. Specializing in eClinicalWorks, the company partners with practices using its software to maximize their return on investment.
Harmony Healthcare (Tampa, Fla.). Harmony Healthcare provides healthcare revenue cycle management strategies and workforce solutions and expertise to help healthcare organizations improve clinical and financial outcomes. The company provides coding support, health information management leadership, clinical documentation improvement, audit validation review and revenue integrity solutions to help healthcare organizations manage their revenue cycles.
Harmony Healthcare IT (South Bend, Ind.). Harmony Healthcare IT offers a product that allows users to decommission legacy systems and secure records in the long term. The solution consolidates data silos and reduces maintenance costs in IT and helps organizations create better workflows for clinicians and health information management resources.
Harris & Harris (Chicago). Harris & Harris is among the leading accounts receivable recovery solution providers in the nation, with a comprehensive business unit dedicated to the healthcare industry. Using a collaborative approach and advanced proven processes, Harris & Harris is unmatched in the customer service and financial recoveries it provides their clients. Harris & Harris healthcare partners benefit greatly from its in-house law firm and high security standards it holds for the government vertical.
Healogics (Jacksonville, Fla.). Healogics provides advanced wound care services and manages nearly 600 wound care centers across the country that serve nearly 300,000 patients per year. The connected network of centers, partner hospitals and academic medical centers use an evidence-based, systematic approach to chronic wound management.
Healthcare IT Leaders (Alpharetta, Ga.). Healthcare IT Leaders is professional services firm with deep expertise in EHR, enterprise resource planning, workforce management and revenue cycle management. Healthcare IT Leaders was ranked No. 1 for business solutions, implementation services, in the 2020 "Best in KLAS" report. The company provides end-to-end revenue cycle management consulting services, including strategy, operations and technology.
Healthcare IP (Edmond, Okla.). Healthcare IP is an integrated clearinghouse partner to hospitals, health systems and provider organizations, advocating data transparency and better user experience in the revenue cycle. Offering innovative solutions for patient access, claims and denial management, its flexible SCALE platform improves client performance by reducing touchpoints and organizes data to make sense.
Healthcare Receivables Group (Knoxville, Tenn.). Since 1993, Healthcare Receivables Group has specialized in serving healthcare providers around the country by effectively managing accounts receivable through a careful integration of people, technology and ideas. HRG’s services range from managing active self-pay and third-party receivables in our extended business office division, to bad debt collections that improve financial performance while protecting patient relationships.
Healthcare Resource Group (Spokane Valley, Wash.). Health Resource Group provides revenue cycle management service solutions for healthcare facilities. The company's suite includes tools to optimize patient financial services and health information management departments designed to increase efficiency and profitability.
HealthPay24 (Mechanicsburg, Pa.). HealthPay24 is a technology services company that provides patients financial peace-of-mind and providers the opportunity to collect revenue earlier in the consumer journey. The company integrates with any back-end system to make sure a healthcare provider’s workflows are automated to reduce payment complexity and enhance staff efficiency.
HealthRise (Southfield, Mich.). HealthRise is an end-to-end revenue cycle management consulting firm that identifies, prioritizes and eliminates obstacles in the way of a healthy revenue cycle. The company provides people with relevant expertise to maximize clients’ workforce processes, technology and results.
HELP Financial Corporation (Plymouth, Mich.). HELP Financial provides patient financing to customers across the country. The company helps patients manage out-of-pocket healthcare expenses, providing upfront funding while decreasing the payment plan administration on the provider side.
HGS Healthcare (Lisle, Ill.). Hinduja Global Solutions focuses on business process management and optimizing the customer experience lifecycle. HGS Healthcare's suite of revenue cycle management services include front-end patient access services, midcycle charge integrity, medical coding and billing services, back-end insurance claims resolution offerings, clinical denial appeals and customer-driven, self-pay, early-out services.
Himagine solutions (St. Louis). For more than 20 years, Himagine has focused on the healthcare industry and has grown to the largest independent provider of outsourced health information management services in the U.S. Himagine's services include coding, audit, CDI, registry and consulting.
Hiteks Solutions (New York City). The Hiteks Insight Real-Time Revenue Rescue platform provides computer-assisted physician documentation solutions at the point of care inside the EHR. The platform combines proprietary artificial intelligence and subsecond technology to send clarifications to physicians instantaneously.
HITrust (Frisco, Texas). The Health Information Trust Alliance is a nonprofit that develops, maintains and provides broad access to compliance management and deidentification frameworks, as well as related assessment and assurance methodologies to organizations so they can create, store and exchange information securely.
HMI (Brentwood, Tenn.). HMI is a diversified healthcare company assisting providers in reducing costs and improving financial health and compliance through contract coding and coder quality reviews; improving professional staff clinical documentation and compliance; and providing revenue cycle services.
Hollis Cobb Associates (Duluth, Ga.). Since 1977, Hollis Cobb has provided early out and bad debt collections services, as well as insurance follow-up, denials management, accounts receivable work down, special projects and other business office functions.
Hospital IQ (Newton, Mass.). Hospital IQ works with hospitals and healthcare providers to optimize long-term strategies for the future. The company's cloud-based operations planning and management platform solutions are designed to provide operational clarity and data transparency that can help organizations achieve financial stability and growth.
Huntington Technology Finance (Chicago). Huntington Technology Finance is an asset and finance provider with more than 30 years of experience partnering with hospitals. The company's inpatient Technology Refresh Programs are designed to integrate into existing processes to help control costs and include wearable clinical devices and mobile workstations for pharmacy automation.
Huron (Chicago). Huron is a global consultancy focused on improving performance and sustaining leadership in markets they serve. The company's revenue cycle business works with clients to stabilize their financial core through sustainable and proven reimbursement processes.
IC System (St. Paul, Minn.). IC System, privately owned since 1938, is an expert in healthcare billing collections. Our more than 4,000 healthcare clients represent over 70 percent of our client mix and have an average tenure of 16 years. We are a medical collections company that cares about the patient experience, delivers superior performance, and are devoted to improving your revenue cycle.
Imagine Software (Charlotte, N.C.). Imagine Software provides billing automation software and revenue management applications, offering technology solutions for medical billing offices, practices and hospitals. The company serves more than 75,000 physicians across multiple specialties, helping to improve financial efficiency, build provider reputation and enhance the patient experience.
Impact Advisors (Naperville, Ill.). Impact Advisors is a national healthcare consulting firm focused on delivering strategic advisory, implementation and optimization services. The company provides a suite of patient access, clinical and revenue cycle services.
In2itive (Overland Park, Kan.). In2itive Business Solutions is a full-service healthcare revenue cycle management consulting firm focused on the ambulatory surgery center, hospital and physician practice fields. In2itive's healthcare business consultants plug into existing software or create a new hosted system to set up a fully transparent workflow that helps organizations keep finances on track.
Inbox Health (New Haven, Conn.). Inbox Health uses personalized interactions to deliver an optimal patient billing experience that reduces administrative waste and improves payment metrics. Their communication platform's advanced technology uses a combination of emails, text messages, voice calls and paper bills to reach patients.
Infinx (San Jose, Calif.). Infinx provides revenue cycle management solutions for healthcare practices in multiple specialties, including radiology, pharmacy, pathology and plastic surgery. Combining the strength of a cloud-based RCM platform with an expert team of AAPC-certified medical coders and billing specialists, the company delivers solutions that focus on increasing revenue and improving cash flow.
Ingenious Med (Atlanta). Ingenious Med focuses on improving physician productivity and hospital performance. The point-of-care mobile and web solution captures charges across the continuum, improves coding speed, accuracy and compliance and helps providers proactively manage care in value-based programs. It also enhances communication to align care teams and reduce variation in care.
Innovaccer (San Francisco, Calif.). Innovaccer is a healthcare technology company that pioneers the Fast Healthcare Interoperability Resource-enabled Data Activation Platform, a smart platform with unified patient records, analytics and decision support tools to enable transparent, real-time and collaborative healthcare.
Innovative Healthcare Systems (Edmond, Okla.). Innovative Healthcare Systems provides revenue cycle management solutions to organizations to assist with contracting, credentialing, coding and billing processes, as well as reimbursement analysis.
InstaMed (Philadelphia). InstaMed, a J.P. Morgan company, powers a better healthcare payments experience on one platform that connects consumers, providers and payers for every healthcare payment transaction. InstaMed’s patented, private cloud-based technology securely transforms healthcare payments by driving electronic transactions, processing payments and moving healthcare data seamlessly, and improving consumer satisfaction.
Integra Connect (West Palm Beach, Fla.). Launched in 2017, Integra Connect was purpose-built to help specialty medical practices thrive, clinically and financially, in the midst of the rise of value-based care. Integra Connect's technology-enabled RCM solution optimizes revenue for specialty practices operating under both fee-for-service and value-based payment models.
InTouch Health (Santa Barbara, Calif.). InTouch Health offers providers technology-enabled solutions to assist in delivering virtual care. The company assists healthcare systems in deploying telehealth applications enterprisewide or off site, such as in unaffiliated hospitals and rehab centers.
iPatientCare (Cincinnati).iPatientCare is an AssureCare brand, acquired in 2019 to tie in the EHR component of complete care on the healthcare continuum. AssureCare has been working to solve the challenge of disjointed healthcare for more than 25 years. Since 1998, AssureCare has been providing comprehensive integrated population health management software solutions to leading healthcare and human services organizations throughout the United States and globally. The solutions encapsulate years of experience in the implementation of technology to support fully integrated healthcare solutions and best practices.
Jive Software (Campbell, Calif.). Jive Software offers a single platform for care coordination, critical communication and EHR experience. Jive supports HIPAA compliance and signs HIPAA business associate agreements with its customers.
Kemberton (Franklin, Tenn.). Kemberton secures reimbursement for motor vehicle, workers' compensation and complex claims. It partners with healthcare providers to collect the revenue considered "uncollectible" with claims workflow automation, process optimization, rules-engine technology and teams resolving complex claims.
KeyBridge (Lima, Ohio). KeyBridge, brings a different approach to early stage patient balance recovery and medical bad debt collection. They believe in providing financial services with care and empathy to enhance the patient experience, ultimately bringing maximum value back to hospitals and practices.
Knack Global (Woodbridge, N.J.). Knack Global is a comprehensive solution provider for revenue cycle management, technological solutions and staffing support for healthcare providers. With over a decade of experience, the company has provided efficient solutions to hospitals, healthcare systems, physician groups, ASCs and more.
LexBlue Professional Billing (Lexington, Ky.). LexBlue Professional Billing is a private and HIPAA-compliant medical billing company that offers highly personalized services to tailor to each client's needs. The company's intuitive software along with our staff will streamline everything from scheduling and storing patient information to sending insurance claims and collecting balances.
Lifepoint Informatics (Glen Rock, N.J.). Lifepoint Informatics provides solutions on a unified workflow platform for seamless interoperability across multiple modalities, application layers and end-user devices. The company provides data integration solutions that facilitate health information exchange, EHR interfacing and integration, population health management and quality reporting among disparate clinical systems.
Lightning Bolt Solutions (San Francisco). Lightning Bolt Solutions is the leading provider of automated physician scheduling for hospitals and health systems around the world, managing more than 3 million physician shift hours each month. Lightning Bolt uses advanced AI technology to optimize hospital operations by providing source-of-truth scheduling data to payroll and HR systems.
L J Ross Associates, Inc. (Jackson, Mich.).L J Ross Associates is a nationally licensed, certified Women's Business Enterprise (WBE) founded in 1992 with a passion for helping businesses successfully manage their revenue recovery programs. The company does this through the most ethical and patient-friendly collection practices, sure to maintain the relationships that clients have built with their patients, along with state-of-the-art technology that allows for the most comprehensive and cost-effective interventions. For 30 years, L J Ross has focused on our people, our performance, and our commitment to provide stellar returns, exceptional service, and ensure promotion of the goodwill of clients across the United States.
Loyale Healthcare (Lafayette, Calif.). Loyale Healthcare offers an end-to-end suite of solutions addressing provider collections. Founded in 1990 as CashNet, the company focuses on solutions to help providers collect from patients through financing options, balance notification, online payment options and secure digital communications.
Managed Resources (Long Beach, Calif.). Managed Resources is a professional consulting group assisting health systems, hospitals and payers across the U.S. in achieving accurate and appropriate charging, documentation and payment through revenue cycle management services. Their services include denials and appeals management for clinical and technical denials, clinical denial audits, charge audits and CDI services.
Mastercard Healthcare Solutions. Mastercard is a technology company in the global payments industry transforming its business by moving beyond cards and reimagining how its technology and capabilities benefit the healthcare ecosystem. With Mastercard Healthcare Solutions, a new suite of products is dedicated to helping healthcare partners detect fraud, waste and abuse, capture more revenue and protect patient health data.
MC AnalyTXs (Houston). Founded in 1995, MC AnalyTXs's Medicare Review Project has recovered millions in underpayments for hospital clients, including some of the largest teaching hospitals in the country. MCA's proprietary computer system identifies discrepancies in claims for inpatient and outpatient visits for government and managed care payers.
Medaptus (Boston). Medaptus offers a comprehensive revenue cycle optimization platform that has delivered measurable returns for hundreds of physician groups, hospitals, infusion clinics and other care settings. The solution integrates seamlessly with any EHR to improve the accuracy and timeliness of documented billing data; applying such artificial intelligence in turn helps increase staff productivity.
Medasource (Indianapolis). Medasource is a national healthcare technology company that offers flexible human capital solutions and customized engagement models to meet and scale projects. The company's consultants support popular technologies for healthcare organizations, including enterprise-level health systems; pharmaceutical, diagnostic and device companies; and health insurers.
MedAssist (Louisville, Ky.). MedAssist provides a suite of revenue cycle solutions aimed at helping hospitals achieve financial stability. The company's solutions focus on eligibility and enrollment, accounts receivable management and hospital business office management to meet clients' needs as patients are responsible for a greater portion of the payment, and the complexity of the revenue cycle grows.
MedData (Houston). MedData is a national provider of healthcare technology solutions designed to engage patients and improve financial outcomes throughout the healthcare continuum. The company partners with more than 2,000 facilities nationwide to provide a unified managed service technologies solution and help them adapt to the changing healthcare environment.
MedeAnalytics (Richardson, Texas). MedeAnalytics provides solutions that enable measurable impact for healthcare payers and providers. Through robust workflow engines and actionable insights delivered on a self-service SaaS platform, MedeAnalytics has helped partners achieve amazing results such as reducing AR by $34.9 million in four months, reducing denial rate by 11percent, improving CMI by 21 percent, and improving appeal success rate by 18 percent.
MedEvolve (Little Rock, Ark.). MedEvolve enables physician practices to work smarter and more accurately through practice management, revenue cycle management and practice analytics software and services. The company's unique consultative approach ensures that solutions fit with existing processes so providers begin to see positive results from Day One. MedEvolve gives physician practices a new level of insight that helps them identify problem areas and resolve issues quickly to improve the practice's financial performance.
Medfinancial (Knoxville, Tenn.). Backed by over 30 years of loan origination and servicing experience, Medfinancial's suite of revenue cycle services are making a positive impact for provider partners and the patients they serve. By integrating proven servicing methodologies throughout the entire patient-financing life cycle, the company consistently sees high utilization rates, successful patient retention for Medfinancial and hospital partners, and industry-leading repayment rates.
Medical Consults, LLC (Stamford, Conn.). Medical Consults is a nationwide full-service revenue cycle management company. It reviews billing, coding, reimbursement processes, financial systems, process flows and operational efficiencies. The company's recommendations have increased revenue by an average of 20 to 30 percent in just six months.
Medical Payment Exchange (Rockville, Md.). MedX's services assist organizations with the 277 claim status. The company's automated process interrogates payer portals to identify denied, pending or unprocessed claims to provide organizations with actionable data long before the remittance arrives. MedX offers a cash advance to hospitals on both payer and patient responsibilities if necessary.
Medical Practice Success (Texarkana, Texas). Medical Practice Success focuses on delivering custom solutions tailored to clients' revenue cycle operations. The company offers revenue optimization, revenue cycle management, medical billing and coding, credentialing and contracting, and more. Medical Practice Success also offers a 15 percent net cash improvement guarantee.
MediRevv (Coralville, Iowa). MediRevv is a national revenue cycle management company that focuses on helping healthcare organizations grow more cash and keep more patients. The company's solutions include end-to-end revenue cycle management, early out, insurance A/R follow up, coding services, A/R wind down and revenue cycle consulting.
Medkoder (Mandeville, La.). Medkoder is a full-service medical coding management services and technology provider. The company offers medical coding expertise in all physician service lines for the inpatient and outpatient setting, medical risk adjustment management, DRG coding management, coding education, clinical coding documentation improvement and revenue cycle consulting.
Med-Metrix (Parsippany, N.J.). Med-Metrix provides a full suite of revenue cycle software and outsourced services to the healthcare provider marketplace. The company works within customers' existing structures to enhance day-to-day operations and increase the bottom line. Med-Metrix's revenue cycle services include patient accounting, patient access, denial recovery and accounts receivable services.
MediMobile (Georgetown, Texas). MediMobile offers a highly customizable, enterprise-level suite of tools, including revenue cycle management, practice management, care coordination and business intelligence. A new technology the company developed provides visibility to clinical documentation in real time and is currently used to maximize revenue through reconciliation.
MediSync (Cincinnati). MediSync has developed a training system for coding that is taught by physicians in small groups. To date, the company has trained over 30,000 doctors, five physicians at a time, at some of the most prestigious health systems in the United States. A Lean Six Sigma approach to coding that results in a predictable ROI while giving doctors the confidence to be paid correctly for the work they do.
Medphine Billing Services (U.S./India). Medphine is a comprehensive, end-to-end practice management company, focused on improving overall profitability and efficiency of the healthcare providers and entities. The company specializes in providing revenue cycle management services to superspecialties such as oncology, neurology, rheumatology and infusion-based services.
MedPut (New York City). As an employee benefits program, MedPut provides funds for out-of-pocket medical expenses and achieves repayment through payroll deductions at zero percent interest. The company's goal is to encourage employees to undergo medical treatment in the early stages without using credit cards and reduce outstanding receivables for providers.
Meduit (Charlotte, N.C.). Meduit is one of the nation’s leading top three revenue cycle solutions companies with decades of experience in the RCM arena, serving more than 850 hospitals and physician practices in 47 states. Meduit combines a state-of-the-art accounts receivable management model with advanced technologies and an experienced people-focused team to ensure that healthcare organizations have the resources available to provide more quality healthcare services to more patients.
Mimecast (Boston). Founded in 2003, Mimecast provides next-generation cloud-based security, archiving, and continuity services to protect customers' email and make data safer. The company delivers comprehensive email-risk management services in a fully integrated subscription service.
MiraMed (Lombard, Ill.). MiraMed Global Services is the premier global provider of business-process outsourcing solutions to healthcare organizations nationwide. MiraMed partners with hospitals, health networks, physician practices and related industry service organizations to provide customizable solutions, uncover and capitalize on hidden financial opportunities, improve productivity and ultimately increase profits.
Modernizing Medicine (Boca Raton, Fla.). Modernizing Medicine provides EHR systems designed for medical specialists and specialty practices. The company's EHR solutions provide automated suggested coding, as well as practice management systems and business operations services.
National Medical Billing Services (St. Louis). National Medical Billing Services is a revenue cycle outsourcing company focused on ASCs and affiliated surgeons. The company also partners with hospitals that have ASC joint ventures to maximize the value of their centers. National Medical provides a wide range of services, including full revenue cycle outsourcing, managed care contracting, due diligence and specialized financial analysis for ASCs.
Nemadji (Bruno, Minn.). Nemadji helps healthcare facilities reduce uncompensated care and increase net revenue through a back-end eligibility detection solution, which reviews patient accounts for unknown or missing coverage from Medicare, Medicaid and commercial insurance.
Netsmart (Overland Park, Kan.). Netsmart is a healthcare IT company developing technology and providing services that support individualized care and improve outcomes. Netsmart offers comprehensive revenue cycle management (RCM) services, including flexible resourcing and full back office support built to help organizations reduce costs and improve cash flow.
Ni2 Health (Bothell, Wash.). Ni2 Health specializes in identifying new high leverage opportunities to improve an organization's financial performance. The company also provides execution leadership and support to ensure the opportunities identified become real bottom line improvements. Ni2 Health's goal is to identify and deliver $1 million to $2 million in financial performance improvement for smaller community hospitals and more for larger organizations.
Nordic (Madison, Wis.). Nordic provides consulting services focused on strategy, technology and operations. The company earned the KLAS Top Performer in Revenue Cycle Optimization best in KLAS for 2017, 2018 and 2019. It is also the Black Book No. 1 in Epic EHR Consulting and Advisory Services category for 2018 and 2019.
Nordis Technologies (Coral Springs, Fla.). Nordis Technologies provides cloud-based technology solutions for billing communications and payments that improve patient and provider experience and patient collections. Nordis’ customer communications management platform makes it fast and easy to develop personalized bills and other patient communications while applying each provider’s specific language, policies, brand and other requirements.
FinThrive (Alpharetta, Ga.).FinThrive works with healthcare organizations to advise on revenue cycle processes and develop optimized financial performance for hospitals and health systems. The company earned the 2019 KLAS Category Leader in Contract Management recognition.
Nuance (Burlington, Mass.). Nuance's healthcare solutions are designed to capture and communicate patient information to physicians and healthcare organizations. The company offers clinical speech recognition, medical transcription, coding and diagnostic imaging solutions to drive better patient care and financial outcomes. Nuance serves more than 10,000 healthcare organizations in the U.S.
Nym (New York). Nym is a leader in transforming clinical language into actionable information, automates revenue cycle management for hospitals, health systems and physician offices across the U.S. Uniquely designed to understand clinical language and medical billing workflows, Nym's coding engine uses provider notes within patient charts to rapidly produce accurate, compliant and explainable diagnostic and billing charge codes, all with zero human intervention.
Olive (Columbus, Ohio).Olive's solutions use artificial intelligence to optimize the revenue cycle. Its platform automates the administrative processes to eliminate tedious tasks. The company is proud to partner with more than 85 health systems and 1,000-plus hospitals across the U.S.
OM1 (Boston). OM1's outcomes management and predictive analytics tools are designed to take big data and make it meaningful and personalized to institutions. The company is focused on helping hospitals succeed with value-based care and alternative payment models, optimizing outcomes and providing tools to predict high-risk patients that can lower the total cost of care.
Omega Healthcare (Boca Raton, Fla.). Omega, founded in 2004, is an offshore provider of a broad array of revenue cycle support services. The company has more than 18,000 employees in the U.S., India and the Philippines. Omega provides services to many of the premier RCM companies.
Oncospark (Ashland, Ky.). Oncospark is an end-to-end revenue cycle management company with more than a decade of experience in fighting on behalf of physicians, hospitals and home healthcare companies. A global footprint and decades of healthcare RCM experience of its founders puts Oncospark in a position to offer best-in-class, technology-enabled solutions to complex billing problems.
Oneview (Dublin). Oneview provides interactive patient engagement and clinical workflow solutions to healthcare organizations. The Oneview Patient Engagement and Clinical Workflow Solution provides the foundation for Oneview's services and functions. The platform provides a point-of-care access to IT systems through a variety of end-user devices.
Finvi (Muncie, Ind.). Finvi, formerly Ontario Systems, is responsible for managing receivables at more than 600 hospitals, including five of the 15 largest hospital networks in the U.S. Founded in 1980, the company provides accounts receivable management and revenue cycle management solutions to healthcare providers.
Optum (Eden Prairie, Minn.). Optum, part of UnitedHealth Group, provides 80 percent of hospitals with at least one revenue cycle management solution from its Optum360 products, managing $65 billion in billings annually. Optum360 helps healthcare organizations optimize their revenue cycle in the fee-for-service environment while preparing for value-based care with cost-saving automation, efficient staffing and standardized technology.
EfficientC (Pewaukee, Wis.). EfficientC has proved instrumental to healthcare business offices — from critical access hospitals to large health systems seeking to improve GDRO, cash flow and aging. The company provides a single solution for clearinghouse services, claim scrubbing and editing, appeal processing and denial management.
OSG Diamond Healthcare Solutions (Carol Stream, Ill.). OSG Diamond Healthcare Solutions specializes in creating and delivering patient obligation communications for healthcare revenue cycle management. Through their proprietary technology, tools and processes, they help providers accelerate their accounts receivable cash flow, enhance financial management and improve their image with their patients.
PatientPoint (Cincinnati). PatientPoint develops technologies that provide actionable intelligence on conditions, treatments and lifestyle choices during healthcare delivery. The company's platforms include a digital waiting room screen, patient mobile, digital wall board, exam room and infusion room tablet.
P3 Healthcare Solutions (Ontario, Calif.). P3 Healthcare Solutions, also known as P3Care, was founded in 2015 and is primarily a medical billing service and a CMS-recognized MIPS Qualified Registry. The company's goal is to expedite the care process by unburdening providers as their technology-driven HIT enterprise. Moreover, practices can consult P3 Healthcare Solutions for Medicare credentialing and enrollment and HIPAA security risk analysis accounts receivable in addition to the whole revenue cycle management process.
Parallon (Nashville, Tenn.). Parallon's experts bring decades of experience in technology and complex revenue cycle management to its relationship with providers. Parallon's specialty solutions include self-pay services, bad debt collections, extended business office and insurance functions and physician billing as well as accounts receivable resolution.
Patientco (Atlanta). Patientco is an enterprise payment solution designed to help healthcare systems maximize patient payments. Patientco offers a user-friendly automated payment platform and keeps the process moving from initial co-pays to statements and eBills that provide an efficient and secure solution to maximizing patient revenue.
PatientFocus (Nashville, Tenn.). PatientFocus was founded in 2009 as an outsourced, patient-pay billing solution extending the business offices of healthcare clients with non-recourse patient financing and full-service patient outreach, including statements, call center and online portal. The company has a long track record of increasing patient revenue while protecting the patient experience for all clients.
PatientKeeper (Waltham, Mass.). PatientKeeper is a leading provider of healthcare applications for physicians, offering a suite of solutions that streamline physicians' workflow and integrate with existing information systems. PatientKeeper’s software streamlines the billing process by electronically capturing professional charges right within a physician's workflow while also improving reimbursement and revenue assurance.
Patientory (Atlanta). Patientory is a blockchain solution for healthcare, developed to drive population health management by allowing healthcare organizations to store and submit data securely through the blockchain and smart contracts. The company connects physicians, care providers and consumers on one secure platform to work together on providing patient care.
PatientPay (Durham, N.C.). PatientPay helps revenue cycle management groups collect more patient payments than traditional methods while reducing costs by up to 50 percent. The company collects payments in fewer than 14 days on average with a patient payment suite that reduces call volume and manual efforts.
PayMedix (Milwaukee). PayMedix is designed to help patients pay for upfront out-of-pocket medical costs and alleviate the stress of bad debt for providers. They guarantee prompt full payment to healthcare providers and offer manageable repayment plans to patients for all allowed in-network, out-of-pocket charges up to a patient’s maximum out of pocket amount. Having processed more than $5 billion in payments thus far and with 30 percent growth year over year, PayMedix is poised to tackle the growing needs of a fractured healthcare system with a scalable and consumer-approved financial technology platform that helps all stakeholders involved.
PCG Software (Las Vegas). PCG Software focuses on technologies to improve operational efficiency, profitability and reduce internal resources for administrative functions and manual claims review. The company's iVE Coder, a web-based platform, was launched in 2019 to give healthcare providers access to the same clinical intelligence that healthcare payers have been using for 25 years.
Pelitas (Plano, Texas). Pelitas provides technology solutions to help hospitals and physicians improve patient experience, maximize revenue and eliminate inefficiencies throughout the revenue cycle. The company's ntegrated patient access solution is designed to financially clear patients at the first point of contact.
Perry Johnson & Associates (Henderson, Nev.). Perry Johnson & Associates offers more than 30 years of expertise and innovations in healthcare information technology that increases healthcare providers’ efficiencies, accuracy and financial performance. PJ&A Solutions include clinical documentation, coding and auditing and revenue cycle management.
PhishLabs (Charleston, S.C.). PhishLabs provides 24/7 cybersecurity services to protect against threats. The company's proprietary technology, intelligence and human expertise combined can detect, analyze and stop targeted attacks. Founded in 2008, the company aims to protect data and healthcare systems while reducing the risk for online fraud.
Phreesia (Raleigh, N.C.). Phreesia provides a suite of applications to help healthcare organizations manage the patient intake process. It has a software-as-a-service platform that engages patients in their care and ensures a consistent patient payment experience. It also streamlines the verification process and reduces the manual workload on staff.
Plutus Health (Dallas). Plutus Health is a 15-year-old leading healthcare revenue cycle management organization based in Dallas. Plutus Health provides coding, pre-billing audits, billing and insurance accounts receivable collections. We address significant challenges facing ASC organizations in the U.S. with a combination of services by industry experts and advanced technologies such as machine learning and robotic process automation.
PMMC (Charlotte, N.C.). PMMC provides revenue cycle services to healthcare delivery systems, acute care hospitals, critical access hospitals and physician groups. The company focuses on contract management, providing estimates for patients with high-deductible health plans and chargemaster review. With more than 30 years of revenue cycle expertise, the company's services help healthcare organizations uncover missed revenue opportunities in underpayments and denials, price transparency and value-based reimbursement.
Privacy Analytics (Ottawa, Ontario). Privacy Analytics provides data de-identification and anonymization for healthcare organizations to ensure individual privacy and legal compliance. Services include certification, training, data governance advisory and consultation to help healthcare organizations establish organization-wide best practices.
Precision Medical Billing (Houston). Precision Medical Billing launched in 1995 and is dedicated to helping physicians, home health agencies and hospice groups with medical billing and claims management. The company provides revenue collections services as well as practice management consulting and medical billing chart audits.
Professional Credit (Vancouver, Wash.). Professional Credit provides tools and services to improve patient financial engagement and cash flow. The company has more than 80 years of experience in accounts receivable management, collections and accounts receivable outsourcing and aims to improve the self-pay experience.
Progressive Management Systems (West Covina, Calif.). Progressive Management Systems is an employee-owned receivables solution company focused on serving the healthcare industry. Founded in 1978, the company works with healthcare organizations to improve financial performance while maintaining the organization's reputation in the community. The company provides first-party collections, third-party collections and insurance follow-up services.
Promantra (Somerset, N.J.). Promantra is a provider of revenue cycle management services that offers end to end revenue cycle management services through its billing company partners and helps healthcare facilities such as hospitals, physician groups and surgery centers streamline their RCM.
Promedical (Lexington, Mass.). Promedical is a national healthcare revenue cycle management company. Its complex claims solutions include workers' compensation and motor vehicle accident billing. Since 1995, the company has provided the healthcare community with a client-focused, technology driven revenue cycle partner.
Pure Storage (Mountain View, Calif.). Pure Storage provides health systems an option for simplifying digital storage for mission-critical EHR, VDI and enterprise imaging environments. The company's end-to-end data platform is powered by cloud-connected software, allowing users to manage data from anywhere on a mobile device.
PwC (New York). Established in 2002, the Virtual Business Office specializes in providing revenue cycle managed services for hospitals, medical groups, and payers in a surge, partial, or full function outsource capacity. The Virtual Business Office provides access to thousands of resources onshore and provides optional offshore capability, depending on a client’s needs. Voted Best in KLAS again in 2022, we’re proud to serve healthcare organizations.
QGenda (Atlanta). QGenda provides cloud-based automated physician scheduling software to more than 4,000 customers in 45 medical specialties. QGenda is designed to optimize hospital and health system workforce with smart resource management, centralized scheduling and real-time mobile access to clock in and out.
Quadax (Cleveland). Quadax is the healthcare revenue cycle technology and services company ranked No. 1 for claims management by KLAS for 2018 and 2019. Quadax offers premier electronic transaction management tools supported by a reliable, responsive customer service organization.
Quest Diagnostics (Secaucus, N.J.). Quest Diagnostics is a provider of medical billing solutions and services that include denial management, payer management and fee schedule review. The company provides billing specialists to maintain fee schedules and support financial reporting. The company also offers payment solutions and includes Quanum EHR and Quanum Practice Management within its Quanum Revenue Cycle Management solution.
Qventus (Mountain View, Calif.). Qventus' platform is designed to help hospitals interpret data and close the gap between data and action. The artificial intelligence software solution allows for operational improvement in real time and could improve financial performance, patient experience and patient safety while reducing cognitive burden on the frontline teams.
R1 RCM (Chicago). R1 RCM is a leading provider of technology-enabled RCM services that transform and solve revenue cycle performance challenges across hospitals, health systems and group physician practices. R1's proven and scalable operating models drive sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience.
RCM Enterprise Services/SCC Soft Computer (Clearwater, Fla.). RCM Enterprise Services works with hospitals to build revenue-generating programs that leverage the hospital's laboratory assets for higher profit margins. The company provides healthcare organizations with laboratory, pathology and genetics software as well as front-end client connectivity, back-end claims management and professional services with minimal capital expense.
Rectangle Health (Valhalla, N.Y.). Rectangle Health provides a suite of payment and patient engagement solutions for healthcare providers, insurers and billing services. The company was founded in 1992 and ranked in the Silicon Review's "50 Fastest Growing Companies" of 2019.
Redox (Madison, Wis.). Redox is an integration platform and service for healthcare systems and digital healthcare applications. The company's interoperable network and standardized API allows organizations to integrate software applications with EHR.
Regent Revenue Cycle Management (Westchester, Ill.). Regent Revenue Cycle Management is a division of Regent Surgical Health that provides cost-effective billing and collections services for ASCs. The company has a history in the ASC space, and Regent RCM consistently outperforms industry benchmarks so managers can focus on high-value activities.
Relatient (Franklin, Tenn.). Relatient is a web-based patient relationship and engagement solution that uses real-time healthcare data to communicate with patients. The company empowers provider networks to improve patient engagement with automated communication that helps improve revenue, increase compliance, lower costs and foster patient relationships.
RevClaims (Jackson, Miss.). RevClaims is a highly specialized revenue cycle management solution partnering with healthcare revenue cycle management professionals and patients affected by accidental injuries. The company can help clients navigate third-party liability, motor vehicle accidents, workers compensation or U.S. Department of Veterans Affairs billing.
Revco Solutions (Durham, N.C.). Revco Solutions augments 75 years of healthcare revenue cycle experience with the latest omni-channel patient communications and innovative business intelligence tools. Applying adaptive strategic enhancements, within an industry leading security and compliance framework, Revco Solutions defines best practices in healthcare accounts receivables. Voted us 'Best Places to Work in Collections' for 2021, in the Large Company category, by insideARM.
RevCycle (Marshfield, Wis.). RevCycle partners with healthcare organizations as a single vendor for all revenue cycle needs. The company's comprehensive suite of business office solutions are designed to optimize the revenue cycle and handle bad debt collections. RevCycle provides class services ranging from coding to claim denial management, insurance follow-up, point-of-service solutions and patient responsibility collections in addition to other services.
Revecore (Franklin, Tenn.). Revecore provides revenue recovery solutions for underpayments and denial prevention as well as complex claims reimbursement. The company combines its proprietary technology with a highly skilled billing team to provide coding, clinical and revenue cycle expertise.
Revele (Indianapolis). Revele is an end-to-end eClinicalWorks revenue cycle management firm providing eClinicalWorks training, optimization, reporting, consulting and revenue cycle management services to health systems and physician groups. Revele's truly integrated eCW billing service includes a patient services call center, monthly performance consulting by a dedicated client success team and a 10 percent increase in cash flow guarantee.
RevOps Health (Wellesley, Mass.). RevOps Health is an end-to-end billing platform that blends data from disparate data sources and software in provider practices to cleanse data and provide a digital source of truth as to the current and historical state of the practice. Offered as an SaaS technology solution, applications running on the platform include anomaly detection, automation and advanced analytics tools.
RevSpring (Nashville, Tenn.). RevSpring is a technology services company that helps healthcare providers engage patients throughout their encounter. The company's end-to-end integrated patient engagement platform is powered by big data, analytics and automated workflow decisions that communicate with the patient on billing and payments.
RightPatient (Atlanta). RightPatient is a cloud-based platform that can recognize patients through photos and link to their medical data. Health systems including Charlotte, N.C.-based Novant Health; Durham, N.C.-based Duke Health; Columbus-based OhioHealth and Coral Gables-based Baptist Health South Florida use RightPatient to identify and access patient information securely.
Rivia Health (Phoenix). Rivia Health's intelligent payment engagement platform reduces administrative operational costs and helps healthcare organizations reach financial goals by increasing patient payments. As a complement to existing payment platforms and revenue cycle operations, Rivia Health reduces the amount of outstanding patient responsibility and overall accounts receivable.
RSource (Boca Raton, Fla.). With the goal of improving revenue cycle performance and patient satisfaction,. RSource maximizes third-party reimbursements for hospitals through the company's payer experts and innovative business processes. The company has programs to help reduce the number of claims denied or delayed and provide clinical denial recovery using RSource payer experts and legal and nursing teams.The newest program can help reduce clinical denials by 60 percent.
Salucro (Phoenix). Salucro is focused on providing a retail-like payment solution for patients that is secure and compatible with EHR platforms. The company's online bill pay solutions and provider-facing payment applications offer multiple payment types, including PayPal.
Salud Revenue Partners (Lafayette, Ind.). Salud Revenue Partners helps healthcare providers reduce revenue cycle complexity, freeing leaders and staff to focus on improving operations and results. Its services and technology help streamline business offices, diagnose performance gaps, achieve the highest coding accuracy, resolve difficult accounts receivable and implement patient-centered solutions to self-pay.
Savista (Alpharetta, Ga.). Savista partners with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients and nurture their communities. The company collaborates with clients to craft patient engagement, HIM, revenue integrity and AR management solutions in order to achieve financial success. Four thousand colleagues strong, Savista's global organization serves 350 clients in the United States.
Serbin Medical Billing (Fort Myers, Fla.). Serbin Medical Billing is a revenue cycle management company focused on providing coding, billing and accounts receivable management services to ASCs, hospital joint venture centers and anesthesia providers. Founded more than 30 years ago, the company tailors services to each client and aims to provide efficient, compliant and quality-driven revenue cycle assistance.
Sherloq Solutions (Tampa, Fla.). Sherloq Solutions delivers a healthier bottom line to health systems, hospitals and physician groups nationwide. With an emphasis on patient satisfaction and outstanding revenue recovery, their RCM experts provide unmatched results in early-out self-pay, customer service, insurance billing and follow-up, denials and appeals management, and third-party debt collection.
Simpler Consulting (Ottumwa, Iowa). Simpler Consulting, part of IBM, is a management consulting firm that helps organizations improve performance through lean transformations. The company works with clients to develop organizational culture and continuously seek opportunities for improvement.
Sipi Asset Recovery (Elk Grove Village, Ill.). Sipi Asset Recovery provides collections, transportation and logistics, data wiping, remarketing and asset destruction and recycling, as well as asset redeployment and regulatory management services. The company helps organizations overcome surplus technology challenges while protecting sensitive data and documenting all relevant security, environmental and industry regulations.
Smart Source Healthcare Communications (Westborough, Mass.). Smart Source is a global communication solutions provider that aims to enhance the patient experience. The company's solution reaches the entire revenue cycle, from appointment reminders to statements, offering payment estimations and point of sale collections in addition to a digital wayfinding app.
Softek Solutions (Prairie Villages, Kan.). Softek provides consulting services and software solutions to optimize system performance and revenue integrity at Cerner Millennium hospitals. Softek gives users visibility into acute and chronic system issues that could put patients and business at risk and provides expertise to resolve the issues.
SOC Telemed (Herndon, Va.). SOC Telemed is a telemedicine provider for hospitals and health systems as well as post-acute providers and physician networks. Telemed IQ is the company's technology platform, which connects physicians to patients for healthcare organizations to build sustainable programs.
S&P Consultants (Braintree, Mass.). S&P Consultants have a 20-year history in health IT, facilitating realistic infrastructures among all parties in health information system implementation. The InTegritySM approach provides a genetic roadmap and adaptive framework to organizations aiming for success with Cerner projects.
Sphere (Nashville, Tenn.). Sphere, powered by TrustCommerce technology, provides secure payment processing, offering a comprehensive suite of healthcare solutions with a focus on payment security, data protection and risk mitigation. Sphere solutions assist healthcare providers and partners reduce the cost and complexity of payment card industry data security standards compliance, and it provides payment services for many of the largest healthcare systems.
Spok (Alexandria, Va.). Spok created the Spok Care Connect platform to deliver clinical information to care teams and improve patient outcomes. The platform is designed to enhance clinician workflow, support administrative compliance and provide better patient experiences.
SSI Group (Mobile, Ala.). SSI Group provides revenue cycle management solutions and analytics to partnering healthcare providers, payers and ASCs. The company's product suite covers claims management, access management and performance management with integrated analytics.
State Collection Service (Madison, Wis.). State Collection Service, a Healthcare Financial Management Association peer-reviewed organization, helps providers maximize the cash value of self-pay patient revenue while improving their patients' financial experience. The company's decades of experience, certified revenue cycle representatives staff and a commitment to first call resolution deliver superior service and results.
Streamline Health (Alpharetta, Ga.). Streamline Health provides revenue cycle optimization solutions and technology-enabled services and analytics for healthcare organizations. The company's solutions are designed to provide revenue integrity and drive quality across the enterprise.
Surgical Information Systems (Alpharetta, Ga.). Since 1996, Surgical Information Systems has served around 3,000 surgical facilities and 10,000 operating rooms across North America. The company provides a web-based ASC clinical documentation system solution, ASC management solution and analytics designed specifically for the outpatient setting.
Surgical Notes (Dallas). Founded in 1997, Surgical Notes is a healthcare IT solutions company focused on revenue cycle products and services for the ASC industry. The company provides transcription, coding, medical records, billing and collections, and revenue cycle management software solutions for ASCs.
Svast (Nashville, Tenn.). Svast is a leading provider of revenue cycle management services including credentialing, coding, billing, denial management, AR management, practice growth and staffing for Independent practices and groups. The company's mission is to improve the financial performance of providers through personalized service using best in class people, process and technologies. Most of their clients experience a revenue increase of 15 percent within 6 months of working with them.
Symplr (Houston). Symplr offers payer enrollment services with federal and commercial health plans as well as initial credentialing, recredentialing and relocating providers. The company works with payers on the healthcare provider's behalf to complete the credentialing process, enabling providers to ramp up, cover overhead and mitigate bad debt.
Synergen Health (Dallas). Synergen Health provides services to clients in more than 45 states that range from physician groups, hospitals, surgery centers, urgent care and enterprise diagnostics labs. Synergen's RCM transformation services seamlessly scales, supports and streamlines a healthcare organization's revenue cycle process from patient intake to payment collections.
TailorMed (Raanana, Israel). TailorMed offers a unique value proposition in healthcare — improving the financial performance of healthcare providers (e.g., hospitals, oncology centers and healthcare systems) while reducing economic hardships for patients. The company uses a SaaS model algorithm to create a unique cost profile of each patient.
Tanium (Kirkland, Wash.). Tanium provides enterprisewide security, control and management of endpoints throughout large healthcare organizations and government enterprises. The company works with the security and IT operations teams to examine endpoints across the enterprise, retrieve data on the current and historical state and execute necessary change.
TechSolve (Cincinnati). TechSolve has more than 4 billion claims records in its database, which is updated every 33 days. The company has more than 35 years of experience in the industry, working with more than 100 hospitals and health systems to provide process improvement training, assessments, project implementation, lean transformation and consulting support.
Telcor (Lincoln, Neb.). Telcor empowers laboratories to improve back office processes by streamlining the revenue cycle workflow, thus reducing labor-intensive processes and operating costs. Telcor RCM provides a high level of visibility to business operations, allowing executives the ability to make more informed decisions.
TigerConnect (Santa Monica, Calif.). TigerConnect provides more than 7,000 facilities with clinical communication solutions designed to help providers communicate and collaborate more effectively. The technology is also designed to increase productivity, reduce costs and improve patient outcomes.
Titan Health Management Solutions (Tucson and Phoenix, Ariz.). Titan Health was founded in 2002 by two veteran health plan executives who saw how frustrating the reimbursement process was becoming for healthcare providers. The company's dedicated audit and collection professionals review thousands of claims and collect millions of dollars for clients every year, making a positive difference for hospital partners and the patients they serve.
TransUnion (Chicago). TransUnion Healthcare makes mutual trust possible between patients, providers and payers by helping them navigate payment uncertainty with revenue protection solutions that leverage comprehensive data and accurate insights to engage patients early, ensure earned revenue gets paid and optimize payment strategies.
TriumpHealth (Southlake, Texas). TriumpHealth is a revenue cycle management, predictive revenue analytics, and value-based consulting company who helps medical practices and hospital systems achieve their financial and regulatory compliance goals. Being a full-service company, TriumpHealth is a single vendor and point of responsibility. Customers maintain a resource that can promptly respond to any issues and keep track of their revenue cycle, provider credentialing and regulatory compliance needs.
TriZetto Provider Solutions, a Cognizant Company (Earth City, Mo.). TriZetto Provider Solutions leverages industry-leading solutions to provide comprehensive revenue cycle management services to help organizations with billing, analytics, appeals, clinical integration and digital patient engagement.
TruBridge (Mobile, Ala.). TruBridge offers services and software solutions designed to increase productivity and maximize reimbursement. TruBridge experts help organizations overcome challenges and improve the revenue cycle end to end.
TrueRCM (Arlington Heights, Ill.). TrueRCM provides end-to-end solutions (RCM, practice management, technology, compliance, credentialing, auditing and assessments) for new or existing organizations to achieve aggressive growth initiatives. TrueRCM curates custom solutions to meet the needs of any organization from single physician, medium-sized practices to large independent physician associations.
Unified Health Services (Memphis, Tenn.). In 1997 UHS pioneered the concept of end-to-end management of the work comp revenue cycle. Today, the company continues to combine unmatched expertise, technology, and best practices to automate workflow and manage the complexities associated with work comp claims processing. UHS works with physician practices, specialty groups, ASCs, hospitals and health systems across the entire country within all jurisdictions and federal programs too.
United Collection Bureau (Toledo, Ohio). United Collection Bureau offers customized solutions to healthcare organizations to provide financial stability, acute analytical skills and technical capabilities for a more effective revenue cycle. The company's solutions include the Extended Business Office, presumptive charity analytics, insurance resolution, bad debt recovery and call center services.
Upfront Healthcare Services (Chicago). Upfront Healthcare helps medical practices grow market share through the transition from fee-for-service to value-based care. Upfront Healthcare's Visit Value Technology was developed to predict and prioritize visits in need of pre-visit action and visit optimization services. The company uncovers the root causes for low-value visits and helps clients drive top-of-license care.
USCB America (Los Angeles). Founded in 1915, USCB America is a nationwide leader in innovative business process outsourcing and accounts receivable management solutions to some of the largest private and public healthcare organizations and academic institutions in the nation.
Verity IT (Downers Grove, Ill.). Vision96 works with clients to develop customized IT solutions. The company develops end-to-end IT solutions to ensure availability and security of mission-critical data and applications.
Vee Technologies (New York City). Vee Technologies is a leading global business services and consulting company that works as a trusted partner to deliver technology-enabled solutions to organizations around the world. Headquartered in New York City, their strategic solutions enable organizations, ranging from Fortune 500 firms to mid-size companies, to achieve extraordinary outcomes.
Ventra Health (Dallas). Ventra Health provides anesthesia and emergency medicine revenue cycle management services. It was founded by the combination of Abeo, DuvaSawko and Gottlieb, and the company is well positioned to help hospitals solve pressing financial and operational challenges.
VestaCare (La Jolla, Calif.). VestaCare helps hospitals and other medical care providers secure patient-responsibility revenue. The company's systems secure near-term and final patient payments at the time of service, and VestaCare's single sign-on solution integrates its patient pay portal with hospital EHR portals.
VisiQuate (Santa Rosa, Calif.). VisiQuate provides an enterprise-scale business analytics solution to integrate and simplify complex data as well as provide insights and actionable workflows. The company offers revenue and denial management analytics, patient pay segmentation and analytics, workflow performance analytics , and value care analytics.
VisitPay (Boise, Idaho). VisitPay's solutions are focused on patient financial engagement. Its third-generation cloud-based platform is used at large health systems in the U.S. to help manage patients' financial obligations. It also has proprietary analytics to tailor consistent and compliant financing options for patients.
VitalWare (Yakima, Wash.). VitalWare is a mid-revenue cycle SaaS solutions provider, specializing in health IT applications. The company aims to make the business of healthcare easier through its intuitive cloud-based technologies and regulatory content expertise.
Voluware (Huntington Beach, Calif.). Voluware provides cloud-based, automated solutions for manual administrative healthcare transactions. The company's platform automates prior authorization for all payers, then places the information into one workspace.
Vyne (Dunwoody, Ga.). Vyne has a single highly integrated platform for end-to-end protected health information exchange and communication management between patients, providers, health plans and partners. The National Association of Healthcare Access Management honored Vyne with the Murray Rimmer award in 2018.
Wakefield & Associates (Aurora, Colo.). Wakefield & Associates provides healthcare revenue cycle solutions by partnering with facilities to provide exceptional accounts receivable management services that augment their internal practices, improve customer service, and increase collections on active and bad debt accounts.
Waystar (Louisville, Ky.). Waystar provides technology to simplify the healthcare revenue cycle and improve the financial health of their clients across care settings. The company's cloud-based software-as-a-service platform addresses revenue cycle functions including patient billing and payments, financial analytics, denial management and revenue integrity.
WebPT (Phoenix). WebPT is an EHR software, revenue cycle and practice management solution for physical, occupational and speech therapists. It has 90,000 members using its technologies. WebPT also provides rehab therapy-specific solutions and has a 99 percent customer retention rate.
WhiteSpace Health (Boca Raton, Fla.). WhiteSpace Health is a deep analytics company. The company's revenue intelligence platform uses AI to detect, predict and resolve RCM issues and effectively manage operations. WhiteSpace brings value to clients by identifying and stemming revenue leakage, preventing and resolving denials and reducing patient no-shows. Together, this lifts revenue.
The Wilshire Group (California). The Wilshire Group provides an optimal blend of industry-leading Epic expertise and operational experience to tackle revenue cycle management’s most complex challenges. They specialize in optimizing end-to-end revenue cycle workflows, providing interim leadership, and serving as a bridge between IT and Operations.
Windstream (Little Rock, Ark.). Windstream is a Fortune 500 company dedicated to connecting healthcare providers and assisting in effective communication and collaboration to deliver personalized healthcare experiences. The company provides customized solutions for healthcare providers to safeguard private patient information, improve the patient experience and centralize the scheduling, transfers and referrals functions.
Wolters Kluwer (Alphen aan den Rijn, Netherlands). Wolters Kluwer provides research products and software solutions for regulatory, legal and business professionals. Healthcare organizations use the company's MediRegs and ComplyTrack platforms to ensure practical compliance, reimbursement and risk management solutions.
Workday (Pleasanton, Calif.). Workday is a leading provider of enterprise cloud applications for finance and human resources. Founded in 2005, Workday delivers financial management, human capital management, planning and analytics applications.
XIFIN (San Diego). XIFIN is a health IT company that leverages diagnostic information to improve the quality and economics of healthcare. The company's cloud-based technology platform, RPM 10, is an automated revenue cycle management solution that aims to maximize efficiency, refine medical cycle billing and improve cash collection.
XSOLIS (Nashville, Tenn.). XSOLIS serves health systems, hospitals and payer organizations nationwide with its utilization review technology, denials management consulting, and physician advisor services. CORTEX®, its AI-driven technology platform, uses real-time predictive analytics to continuously assign an objective medical necessity score and assess the anticipated level of care for every patient – enabling review automation and a clinical source of truth for more efficiency and collaboration for payers and providers.
Xtend Healthcare (Hendersonville, Tenn.)Xtend Healthcare is an industry-leading provider of revenue cycle management (RCM) and public health solutions. Xtend is 100% focused on healthcare. Our seasoned team, HITRUS-certified proprietary technologies, local market knowledge, agility, scale, and tailored solutions help optimize customers’ programs, so they can deliver on their missions.
Zayo (Boulder, Colo.). Zayo provides communication infrastructure services, including fiber and bandwidth connectivity, connection and cloud infrastructure. The company aims to reshape healthcare as hospitals are moving toward digitization of records and experiencing demand for bandwidth and high-performance, private, reliable connectivity and infrastructure.
Zotec Partners (Carmel, Ind.). Zotec Partners provides revenue cycle management solutions to large multispecialty groups and health systems. The company's enterprise solutions serve hundreds of hospital-based, multispecialty physicians and manage more than 80 million medical encounters.
Zync (Carrollton, Ga.). Zync has created the first Intelligent payer portal gateway built for healthcare. Zync enables health systems with secure control around the hundreds of employees who access payor portals daily and the ability to audit that access to ePHI. In addition, Zync delivers efficiency gains for those in revenue cycle by accessing all payor portals in one single application.
- Incomplete or Incorrectly Recorded Patient Information. Medical billing begins with the first health provider and patient encounter. ...
- Increased Patient Financial Responsibility. ...
- Manual Record Keeping. ...
- Inaccurate Medical Coding.
1. Pre-appointment. For most general care, the first stage of the revenue cycle begins when a patient contacts a provider to set up their appointment. Generally this is when relevant patient information will begin to be collected for the eventual bill, referred to on the financial side of healthcare as a claim.
Total patient care revenue = number of patient care services x average reimbursement rate For example, if a healthcare facility delivered 100 patient care services and the average reimbursement rate was $100 per service, the total patient care revenue would be $10,000.
The Six stages of the revenue cycle are provision of service, documentation of service, establishing charges, preparing claim/bill, submitting claim, and receiving payment.
Here is what's involved in the revenue cycle: Charge capture: Rendering medical services into billable charges. Claim submission: Submitting claims of billable fees to insurance companies. Coding: Properly coding diagnoses and procedures.
Preregistration is the first and most vital step in the revenue cycle process. Preregistration allows the medical practice to capture demographic information, insurance information and eligibility in real-time through a clearinghouse, often while the patient is still on the phone.
This is why successful medical practices use a revenue cycle management (RCM) program, which is another name for a streamlined billing process.
The KPIs are net days in accounts receivable (A/R), cash collection as a percentage of net patient services revenue, claim denial rate, final denial write-off as a percentage of net patient service revenue, and cost to collect.
Five key performance indicators for healthcare organizations: People, quality, time, growth & financial performance.
Healthcare organizations obtain income from both public and private sources. The three main payers of their service include Medicare and Medicaid, private insurance, and self-paying patients. Other forms of revenue include grants, donations, and the sale of assets.
|1||Certified Revenue Cycle Representative Program (CRCR)||HFMA|
|2||Certified Revenue Management Executive (CRME)||HSMAI|
|3||Certified Revenue Cycle Professional (CRCP)||AAHAM|
|4||Certified Manager Certification (CM)||ICPM|
RCM: An Important Tool for Providers and Patients
Revenue cycle management increases provider revenue while decreasing the time spent on administrative and clinical functions. This means more money and time devoted to the patient and their treatment.
There are two types of denials: hard and soft. Hard denials are just what their name implies: irreversible, and often result in lost or written-off revenue. Conversely, soft denials are temporary, with the potential to be reversed if the provider corrects the claim or provides additional information.
- Implementing Workflow Automation.
- Investing in Staff.
- Understanding Patient Preferences.
- Collecting Payments Upfront.
- Tracking Performance.
- Outsourcing RCM.
- Improving RCM for Patients and Providers.
Healthcare revenue cycle management is the financial process facilities use to manage the administrative and clinical functions associated with claims processing, payment, and revenue generation. The process consists of identifying, managing, and collecting patient service revenue.
The nature and importance of the services provided, as well as the regulations, are factors that contribute to the complexity of the revenue cycle in health care.
Increased operating costs and competition, evolving regulatory issues, complex billing, and a global pandemic are all factors impacting providers. Together they also all reinforce the need for organizations to ensure their revenue cycle management (RCM) is streamlined and efficient.
- Type of Insurance Policy. - The patient's insurance may be covered either by a federally funded program such as Medicare or Medicare or a private insurance program. ...
- The Nature of the Disorder. ...
- Who is Performing the Evaluation. ...
- Medical Necessity. ...
- Length of Treatment.
What are three factors that set the healthcare industry apart from most other industries with regard to accounts receivable? ›
What are the three factors set the HC industry apart from most other industries? The nature of services provided, the cost of the services provided, and the method of payment for the services provided.
- Provisions of services to patient.
- Documentation of those services.
- Generation of charges.
- Prep of bill/claim.
- Submission of the bill/claim to the respective payer.
- Collection of payment.
Billers tend to deal with two types of claim forms. Medicare created the CMS-1500 form for non-institutional healthcare facilities, such as physician practices, to submit claims. The federal program also uses the CMS-1450, or UB-04, form for claims from institutional facilities, such as hospitals.
Your reimbursements on claims filed and the money paid out of pocket by patients are the basis of your revenue cycle. The extent to which you effectively manage your payment processes and have a handle on collecting payments that are past due is an indicator of your practice's financial health.
- Focus on the patient. ...
- Consolidate systems. ...
- Focus on collecting payments early. ...
- Give patients alternative ways to pay. ...
- Focus on improving systems on the back-end.
- How to Optimize Revenue Cycle Management.
- Invest in the Right Technology.
- Outsource RCM Services.
- Automated Eligibility Verification.
- Automated Charge Capture.
- Claim and Denial Management.
Currently one of the most common reimbursement models, the Fee-for-Service (FFS) payment model bases patient pricing on the cost of each individual service or product that a physician orders.
The three primary fee-for-service methods of reimbursement are cost based, charge based, and prospective payment. Under cost-based reimbursement, the payer agrees to reimburse the provider for the costs incurred in providing services to the insured population.
- Incorrect patient information. ...
- Incorrect provider information. ...
- Incorrect Insurance provider information. ...
- Incorrect codes. ...
- Mismatched medical codes.
This book focuses on health care account- ing and finance (figure 1-1). Accounting is a system for providing financial information. It is generally broken down into two prin- cipal elements: financial accounting and managerial accounting.
Set Payment Expectations and Collect Patient Portions Promptly. Providers can reduce patients' delinquent payments by setting the expectations for their financial responsibility ahead of scheduled visits.
Accounts Receivable (AR) is the money owed to Providers or medical billing companies for the medical care rendered to patients. The generated invoices are sent out to insurance companies or patients for payment. It is important that the staff keep a tab on the AR and see if the payments reach on time.