R1 RCM
R1 RCM is one of the largest publicly traded revenue cycle management companies, serving over 750 healthcare organizations and consistently ranked as a market leader, particularly for enterprise clients. The company’s core business is transforming the financial performance of hospitals, physician groups, and health systems through technology and operational excellence. R1 RCM provides end-to-end RCM services that cover the full spectrum of the revenue cycle, from patient access management to claims processing and payment reconciliation. They leverage a strong focus on automation and financial analytics to help providers improve revenue capture and minimize claim denials. Their end-to-end service includes coding, billing, collections, and custom financial reporting, delivering a technology-driven partnership for operational efficiency and financial growth across the healthcare system.
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Waystar
Waystar is a leading healthcare technology company that delivers innovative solutions to simplify and unify healthcare payments. The company was formed from the merger of ZirMed and Navicure and is consistently recognized with multiple Best in KLAS awards for its robust platform. Waystar serves a large client base, including over 500,000 providers and 1,000+ health systems. Their end-to-end RCM platform integrates all aspects of the process, utilizing intelligent automation and machine learning. Key services include AI-driven charge capture, predictive analytics for denials prevention, and patient financial clearance tools. Waystar focuses on optimizing every step from patient registration and eligibility to billing and payments, which helps healthcare organizations streamline their entire revenue cycle and process billions in annual payments efficiently.
Athenahealth
Athenahealth is a prominent cloud-based platform provider known for seamlessly integrating electronic health records (EHR) with revenue cycle management (RCM) solutions. Their platform is a popular choice among ambulatory practices and large practices, serving over 160,000 healthcare providers. The company’s strategy is to reduce administrative burden by combining clinical and financial workflows into a single system. Athenahealth’s RCM service leverages AI-powered analytics to proactively prevent denials and optimize financial performance. They offer a powerful automation system to evaluate and perform routine A/R follow-up tasks. By providing a unified system with predictive insights, Athenahealth helps medical organizations increase automation, foster best practices, and get paid faster with less work.
Change Healthcare
Change Healthcare is a well-known, independent healthcare company and a major player in the RCM industry, providing comprehensive, data, and analytics-driven solutions across various healthcare settings. The company’s mission is to inspire a better healthcare system by improving clinical, financial, and patient engagement outcomes and taking costs out of the system. Change Healthcare offers a comprehensive suite of end-to-end RCM services, including claims management, payment analytics, and electronic data interchange. Their approach is highly technology-driven, utilizing AI and machine learning to address inefficiencies, enhance payment accuracy, and streamline claims processing. The focus on robust denial management and advanced analytics helps providers boost revenue collection and achieve sustainable financial growth.
Optum 360
Optum 360, leveraging the extensive resources of the broader UnitedHealth Group ecosystem, is a key provider of integrated revenue cycle solutions, particularly for large health systems and hospitals. The company is a top vendor in terms of installation volume, underscoring its significant presence in the healthcare RCM market. Optum 360’s comprehensive platform is engineered to manage complex billing requirements and is a best pick for health systems due to its scalability and robust performance. Their RCM services are designed to optimize financial performance by complementing integrated clinical and financial systems. Key offerings include financial clearance, contract management, and high-performance RCM tools, all designed to streamline operations and ensure efficient revenue capture across large-scale enterprises.
NextGen Healthcare
NextGen Healthcare is a well-established RCM provider, offering integrated solutions that combine electronic health records (EHR), practice management, and patient engagement tools. The company caters to a wide range of healthcare providers, from small practices to large healthcare systems. NextGen’s RCM services are end-to-end, providing billing and financial solutions that are designed to streamline processes and improve claim accuracy. They emphasize automation and data analytics to reduce denials and optimize collections. With AI-powered claims management and analytics-driven financial reporting, NextGen Healthcare helps providers maximize reimbursements and minimize administrative burdens, ensuring a highly efficient revenue cycle workflow, especially for ambulatory care settings.
eClinicalWorks
eClinicalWorks is a leading healthcare technology company that offers a fully integrated, all-in-one cloud-based platform encompassing both electronic health records (EHR) and revenue cycle management (RCM). This integrated system is highly utilized in ambulatory healthcare settings. The company is committed to boosting operational efficiency and improving financial outcomes through a robust billing management system. Their RCM offerings feature automated claim processing, real-time analytics, and AI-driven claims management to help improve cash flow and reduce denials. By combining clinical and financial tools, eClinicalWorks provides a comprehensive suite of solutions that ensures revenue maximization while allowing healthcare providers to focus on patient care.
Conifer Health Solutions
Conifer Health Solutions is a prominent RCM provider that specializes in revenue cycle outsourcing and value-based care solutions. The company is highly rated by industry analysts for its end-to-end RCM services for integrated delivery networks. Conifer provides full end-to-end hospital and physician revenue cycle management, including hosted practice management and A/R management. Their solutions are strategically designed to optimize financial performance, improve access to care, and acquire appropriate reimbursement for hospitals, health systems, and physician groups. Conifer Health’s expertise lies in elevating the overall healthcare experience by providing comprehensive revenue cycle and financial risk management services that streamline operations and enhance financial resilience.
CureMD
CureMD is a technology company and RCM industry leader known for offering end-to-end healthcare revenue cycle management solutions for practices of all sizes. With over 25 years of experience, the company is recognized for its feature-rich, budget-friendly platform that is a top choice for multispecialty groups. CureMD focuses on patient financial experience optimization, AI automation for billing and coding, and swift denial resubmissions. They boast a high first-pass claims acceptance rate of 96% and are able to resolve denials rapidly. CureMD provides custom dashboards and reporting tools for data-driven decision-making, delivering a simplified and highly automated solution that accelerates cash flow for its clients.
Experian Health
Experian Health, a division of the global information services company, is a major vendor in the healthcare technology market, providing solutions for revenue cycle management, identity management, and patient engagement. The company is noted for its high install volume, demonstrating its extensive reach and integration across the healthcare system. Experian Health offers industry-leading RCM solutions, including Patient Access Management, Claims Management, and Performance Management solutions with integrated analytics. With a massive network of payer connections and billions of annual eligibility transactions, the company provides the essential infrastructure to enhance financial performance and optimize the revenue cycle for healthcare organizations.
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