Revenue Cycle Management (RCM)

Canvas Medical is an EHR and revenue cycle management platform that focuses on providing a complete UI for clinicians while providing SDKs and APIs for extending capabilities.

Athenahealth provides a platform featuring integrated electronic health records, telehealth services, interoperability, revenue cycle management, and population health management, designed to streamline clinical workflows and improve patient care delivery.

Candid Health is an end-to-end revenue cycle management platform. It enables claims submission, detects and resolves billing issues, integrates with existing healthcare infrastructure via API, and provides real-time analytics for tracking and improving financial performance.

Enter Health is a revenue cycle management platform offering automated claims processing, payment posting, denial management, patient collection, and real-time reporting.

Adonis is a revenue cycle management platform that offers end-to-end billing solutions, revenue cycle automation, and integrates with EHR and practice management systems to provide medical billing and revenue-related insights.

Apero is a healthcare management platform offering integrated solutions for note-taking, scheduling, billing, and prescriptions, with automated workflows, payer enrollment, and robust security features.

Change Healthcare offers a variety of revenue cycle management, clinical and imaging, and patient engagement tools, and are well-known for their insurance clearinghouse.

Hint Health Core is a membership management and billing platform for healthcare providers, automating enrollment, invoicing, and employer contract management.

NextGen RCM streamlines financial processes from patient appointment scheduling to final payment, focusing on optimizing revenue and ensuring regulatory compliance.

pVerify offers patient insurance verification with real-time, API, and batch solutions for various healthcare providers.

Waystar is an end-to-end revenue cycle management company, offering eligibility verification, claims submission, payment posting, denials management, and analytics.

Weave is a patient communications platform with features like phone services, texting, appointment reminders, reminders, team chat, payment processing, two-way texting, online review management, online scheduling, mobile app access, and call analytics.

Fathom Health is an AI medical coding platform that uses both deep learning and LLMs to provide accurate coding services across areas including radiology, emergency departments, and other high-volume specialties.

Opkit is a customizable AI phone call platform with both AI agents and human agents. Common use-cases include eligibility checks, prior authorizations, denied claim appeals, formulary checks, and appointment scheduling.

SuperDial is a platform for AI-enabled payer phone calls for insurance verification, prior authorization, credentialing and enrollment, and claim follow-ups.

Aideo is a medical coding vendor offering technologies and services to improve coding efficiency.

Apex EDI provides claims processing, error-checking, and submission to payers, and is integrated with various practice management and EHR systems.

Arintra is an AI powered autonomous medical coding vendor.

Athelas RCM provides a platform for healthcare revenue cycle management focusing on financial reporting and end-to-end billing cycles.

Availity Essentials is a healthcare provider portal offering functionalities like eligibility and benefits checking , claims processing, remittance advice, provider information management, prior authorization and referral management.

Banjo Health streamlines the prior authorization process for health plans and pharmacy benefit managers.

Basys.ai uses AI to streamline prior authorization for health plans and systems.

Brellium offers automated chart review software using AI to flag clinical anomalies, coding errors, and billing issues.

Calvient Channels is a patient engagement platform that integrates with Cerner to provide appointment reminders, customizable communication templates, online registration, and targeted messaging for patient interaction.

Cedar is a patient payments platform for billing and payment workflows, with features including personalized patient engagement and real-time insights to increase payment rates.

Chargebee is a platform for managing subscription billing and revenue operations.

Claim.md is a healthcare clearinghouse with an electronic claims processing portal for providers and payers.

Clearwave automates patient scheduling, registration, eligibility verification, and communications.

Co:Helm is a generative AI platform for payer organizations, providing a co-pilot dashboard to improve UM nurse efficiency.

CodaMetrix is an AI medical coding platform for multiple specialties, particularly in radiology and pathology, within large healthcare systems. The platform uses NLP and machine learning to translate clinical notes into accurate billing and diagnostic codes.

Cohere Health streamlines prior authorization processes using automation and machine learning.

CollaborateMD offers practice management and billing software for small to mid-sized practices.

Conifer Health Solutions provides revenue cycle management services and value-based care solutions for health systems, provider groups and employers to improve financial outcomes.

CorroHealth is a provider of revenue cycle management solutions and analytics.

CoverMyMeds helps automate prior authorization for medications, connecting healthcare networks to improve patient medication access.

Curation Health offers a clinical decision support platform integrated with major electronic health records, providing analytics-driven insights to assist healthcare providers and plans in the transition to value-based care.

Develop Health uses AI to streamline medication prior auth for providers.

Distill is an AI chart review platform that uses LLMs to analyze clinical notes to support a variety of use cases such as registry submissions, quality measurement, and clinical documentation improvement.

EIQ by Ensemble Health Partners is a cloud-based, analytics-driven workflow tool for end-to-end RCM.

Eligible is an insurance billing API platform that enables eligibility checks, insurance verifications, real-time cost estimations, claims filing, and accessing insurer information.

emtelligent is a medical NLP platform that processes medical records and supports medical data collection and analysis.

Ethermed is an AI solution that fills and submits prior authorization requests for providers.

Experian Insurance Verification automates eligibility and coverage checks for providers.

EZClaim is a medical billing platform with features like electronic billing, eligibility verification, and reporting, tailored for small to medium-sized healthcare providers and billing companies.

Fairway Health is an AI assistant for health insurers that uses LLMs to analyze medical records and make prior authorization determinations.

FastAuth is a prior authorization platform that helps automate patient insurance eligibility and approval.

Fourier Health is a clinical summarization tool for pre-visit chart preparation, referral documentation, and risk adjustment. It integrates with EHR systems, accepts uploaded PDFs, and accesses HIE records via CommonWell and CareQuality.

Gentem is revenue cycle management software that helps automate medical billing and payment processes for providers.

Health Harbor is an AI agent that calls insurance companies for eligibility and claim status checks.

Inference Analytics’ Physician Concierge solution uses AI to draft clinical reports.

Inference Analytics’ Workforce Concierge solution uses AI analyze medical data for revenue cycle and research use cases.

InstaMed offers digital patient payment solutions for healthcare providers.

Iodine Aware CDI improves clinical documentation accuracy and efficiency, aiming to reduce revenue leakage in healthcare systems.

Latent uses AI to streamline specialty pharmacy and infusion prior authorization for hospitals and clinics.

Maverick is an AI-powered autonomous medical coding platform.

MaxRTE provides insurance verification software to assist with real-time eligibility and insurance discovery.

meMR is an AI medical record retrieval platform for providers and life sciences.

Mend is a front-office and telehealth platform that offers features like automated patient payments, HIPAA-compliant virtual visits, digital intake forms, group video conferencing and scheduling, telepsychiatry software, and integration with electronic health records and practice management systems

Myndshft offers medical and pharmacy prior authorizations, leveraging AI and machine learning to automate and expedite the process.

NexHealth offers both an EHR integration platform (NexHealth Synchronizer) to enable pulling or pushing data to EHRs, as well as a patient engagement suite built on the Synchronizer that offers scheduling, patient communications, forms, and payments.

Nirvana Health offers real-time mental health insurance verification and cost estimates via both API and web UI.

Nym is an AI medical coding product that deciphers clinical language in patient charts and assigns ICD-10 and CPT codes to them using advanced machine learning and semantic technologies. They offer services for outpatient coding for both professional and facility charges, as well as inpatient coding for professional charges.

Office Ally enables healthcare providers to submit electronic claims to payers, and has features like claim scrubbing, status tracking, and integration with various practice management systems.

PayGround is a payments platform designed to automate patient billing and payment processes, with features like EHR/PM integration and automated payment reminders.

Phare Health is a developer of AI technology addressing revenue cycle management functions such as medical coding.

Pledge Health offers an automated patient billing and payments platform, focusing on insurance benefit verifications, patient cost estimates, patient statements, and payment processes to enhance the financial experience for both healthcare providers and their patients

pMD offers integrated healthcare solutions that enhance care delivery and practice efficiency, featuring mobile charge capture, telehealth, and revenue cycle management services

Quench is AI clinical records analysis software for legal use cases, such as in workers’ compensations claims or insurance claims disputes.

R1 RCM offers a revenue cycle management platform for hospitals and healthcare systems across payment models, patient engagement strategies, or settings of care.

Raxia automates patient accounts receivable processes, enhancing efficiency and patient engagement through personalized digital experiences.

Regard is an AI clinician assistant platform that is embedded in the EMR and summarizes patient data, generates clinical notes, and suggests diagnoses.

Relatient combines online self-scheduling, real-time chat, digital registration, personalized communication, and mobile billing to improve healthcare accessibility and patient experience.

Rhyme Health streamlines prior authorization by connecting EHR systems and insurance carriers for faster submission and approval.

Rivet Health offers products for managing payer contracts, GFEs and patient responsibility estimates, and underpayment resolution.

RoyalPay Patient Payments is a patient billing solution that offers clean order receipts, instant eligibility checks to boost time-of-service collections.

SamaCare is prior authorization platform for drugs, automating and streamlining data entry and tracking.

Semantic Health is an AI CDI platform that reviews all coded data before billing, assessing and validating the accuracy and completeness of medical codes from clinical documentation.

Silna uses AI to streamline prior authorizations, benefits and eligibility checks for therapists.

SimiTree RCM provides tech-enable medical billing for post-acute and behavioral health organizations.

SmarterDx is a chart review platform that uses AI to analyze patient data for clinical documentation integrity and coding opportunities to improve revenue capture.

Sohar Health enables eligibility verification and AI-powered medical coding for behavioral health providers.

Square is a secure payment processing platform, offering both web products and APIs to enable payments, including patient payments and subscriptions.

Stripe is a secure payment processing platform, offering both web products and APIs to enable payments, including patient payments and subscriptions.

Synaptec Health is an AI-enabled medical coding product for automatically processing patient encounters.

Trek Health is a revenue cycle management provider, enabling payer enrollment and claims submission, with the ability to do instant payments for claims.

TriZetto RCM aims to optimize financial outcomes for healthcare providers by handling billing processes and enhancing payment accuracy.

Trucare Billing provides medical billing services, including revenue cycle management, practice management, and credentialing for telehealth and private practice.

Walnut is a point-of-sale lending platform that helps provide patients with interest-free payment plans for medical bills.

Wendi is an AI-powered digital assistant for patient engagement from initial contact through scheduling and eligibility checking.

Wisedocs is an AI medical records review platform that indexes, reviews and summarizes medical records for insurance, legal, and independent medical evaluation firms.