Top RCM Solution Providers
Providers turn to automation as pressures mount to improve billing and payment collection processes.
As payment processes become more complex, most healthcare providers rely on more than one revenue cycle management solution. Here’s a look at some of the top RCM vendors.
Improving the revenue cycle continues to be a challenge for healthcare organizations, as pressures mount to efficiently collect payment for services. As healthcare delivery continues to evolve, provider organizations are continuing to struggle in maximizing their revenue-collection operations. That’s where revenue cycle management (RCM) technology comes in—to attempt to automate the process of requesting payment. The shift to value-based care, increased patient pay and a flurry of mergers are creating new challenges for health systems, and many organizations are looking for ways to improve their revenue cycle operations. The complex payment environment is causing providers to use multiple RCM products, according to a recent survey by HIMSS Analytics, conducted in partnership with Dimensional Insight, a developer of analytics and data management solutions. Among the findings, 68.9 percent of healthcare organizations use more than one vendor solution for RCM. What follows is a listing of some of the larger companies providing RCM solutions in the healthcare market.
AdvantEdge Healthcare Solutions
AdvantagEdge is a medical billing company that applies its billing experience to aid providers in the development of RCM software. It serves physician groups, hospitals, surgery centers and behavioral health agencies, and provides software solutions for medical billing, certified coding, analytics, practice management and compliance.
The company provides scalable healthcare RCM solutions via a cloud-based network, with real-time visibility into revenue cycle operations. The scope of its tools and services spans electronic health records, practice management and RCM software, patient engagement, care coordination and software to improve population health services.
Rebranded in 2015 from Emdeon to Change Healthcare, the company offers technology solutions for providers that include government and private payers, physicians, dentists, pharmacies and laboratories. Emdeon Payment Manager, an electronic payment and reconciliation solution, increases visibility of remittance data and facilitates electronic transfer of funds from the largest payer networks in the industry.
Conifer Health Solutions
Conifer provides technology-enabled healthcare performance improvement services. With more than 30 years of healthcare operations management experience, it offers value-based healthcare solutions to enhance consumer engagement, drive clinical alignment, manage risk and improve financial performance.
Convergent manages business process outsourcing, revenue cycle and receivables management, with 14 North American operating centers across all four time zones. The company has more than 60 years’ history serving a diverse industry customer base, including contact center solutions, receivables management outsourcing, commercial receivables management and healthcare RCM.
A provider of EHRs, practice management and RCM tools, Drchrono’s platform is built for iPad, iPhone and Apple Watch. Last year, it partnered with TriZetto Provider Solutions, a technology company that helps healthcare practices simplify business processes and improve medical billing.
The company is a provider of RCM, identity management, patient engagement and care management solutions. Experian Health provides services to some 3,100 hospitals and health systems and 7,000 other healthcare providers.
GE Healthcare Partners
GE Healthcare Partners purchased billing advisory firm the Camden Group in 2015, and now provides client problem-based solutions, long-term strategic partnerships and advanced analytic capabilities. It offers medical billing software and RCM solutions for all types of care settings.
Healthcare Resource Group
HRG specializes in medical cost containment and fraud management solutions. It offers infrastructures for utilization review, case management, discharge planning, clinical chart audit, bill review, pharmacy management, chronic disease management and fraud management implementation for use across complex healthcare systems.
Huron Consulting Group
Huron Consulting Group is a global firm that aims to help clients improve and sustain growth, performance and leadership. It provides expertise in access to care, patient engagement, liability collections, denials management and prevention, payer contracting and strategic pricing, and clinical documentation improvement.
McKesson provides resources, support and technology to help healthcare organizations strengthen their businesses, control costs, develop efficiencies and improve quality. Its interoperable health IT systems help customers scale, streamline and automate complex value-based reimbursement models such as bundled payment. The company offers end-to-end RCM solutions.
MedAssist, which offers solutions in eligibility and enrollment, accounts receivables and hospital business office management, is now partnering with Connance, a healthcare predictive analytics firm. MedAssist will use Connance’s AR Management Platform and Denial and Underpayment Analytics to enhance its insurance follow-up operations.
With more than 20 years’ experience in helping healthcare organization improve clinical, financial and operational outcomes, MedeAnalytics offers decision-making analysis via a cloud-based platform.
NextGen Healthcare’s services include assistance in improving financial and clinical performance, maximizing opportunities to increase revenue, correcting operational inefficiencies and elevating outcomes across the revenue cycle. The company’s team of more than 1,300 billing, claims and practice management experts help deliver full-service, scalable, end-to-end RCM solutions.
The company offers practice management medical billing software, cloud-based EHR and patient portal software, mobile charge capture and medical billing service, as well as on-demand claim information and custom reports.
Ontario provides software and solutions to help healthcare providers recover revenue efficiently and in compliance with market and government standards. Its Artiva HCx provides advanced data analytics and product solutions that streamline and automate insurance and self-pay operations.
The company’s 7,700 performance experts provide revenue cycle leadership, innovation and operational assistance to help eliminate inefficiencies in healthcare and prepare for value-based reimbursement. Its RCM expertise includes margin performance, payer-provider collaboration, patient experience, compliance and transparency.
Parallon is a revenue cycle company with more than 15,800 employees serving more than 600 hospitals and 3,000 physician practices. Its services include revenue cycle specialty solutions, eligibility and advocacy services, delinquent account collections and more.
Patientco is a payment technology company that brings together payment infrastructure with intuitive consumer payment tools backed by analytics. It offers easy-to-use technology that ensures that health systems maximize patient payments.
Vizient, which acquired MedAssets in 2016, is a member-based provider of performance improvement platforms. It offers advisory, clinical, operations, pharmacy and supply chain solutions.