Alternatives to Arrow
Compare Arrow alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to Arrow in 2026. Compare features, ratings, user reviews, pricing, and more from Arrow competitors and alternatives in order to make an informed decision for your business.
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1
Service Center
Office Ally
Service Center by Office Ally is a trusted Revenue Cycle Management and patient payments platform used by more than 80,000 healthcare providers and health services organizations, which process more than 950 million transactions annually. Service Center is a cost-effective solution enabling providers to control their revenue cycle. With a user-friendly interface, Service Center helps providers check and verify patients’ eligibility and benefits, submit, correct, and check the status of their claims online, and receive remittance advice. Accepting standard ANSI formats, data entry and pipe-delimited formats, Service Center helps streamline administrative tasks and create more efficient workflows for providers. -
2
XpertCoding
XpertDox
XpertCoding is an AI-powered medical coding software by XpertDox that uses advanced AI, natural language processing (NLP), and machine learning to code medical claims automatically within 24 hours. It automates the coding process, enabling faster and more accurate claims submissions to maximize financial gains for healthcare organizations. Features include minimal human supervision, easy EHR connectivity, flexible cost structure, a significant reduction in denials and coding costs, a HIPAA-compliant business intelligence platform, risk-free implementation with no initial fee and a free first month, and higher coding accuracy. XpertCoding's autonomous coding solution helps healthcare providers and organizations get paid faster, accelerating the revenue cycle and allowing them to focus on patient care. Opt for XpertCoding for a reliable and accurate medical coding software solution for your practice. -
3
MDaudit
MDaudit
MDaudit is a cloud-based platform that unifies billing compliance, coding audits, and revenue-integrity workflows for healthcare providers, hospitals, physician networks, ambulatory surgical centers, and the like. It supports all types of audits, scheduled, risk-based, retrospective, and denial-focused. MDaudit automates data ingestion from pre-bill charges, claims, and remittance data; triggers audit workflows; flags anomalies and high-risk patterns; and delivers real-time dashboards and drill-down analytics revealing root causes of billing errors, denials, and revenue leakage. Its modules, including a “Denials Predictor” for pre-submission claim validation and a “Revenue Optimizer” for continuous risk monitoring, help organizations prevent claim denials, reduce recoupments, and capture more legitimate revenue. MDaudit also provides payer-audit management: a secure, centralized workflow to respond to external audit requests and manage documentation exchange. -
4
Athelas
Athelas
Athelas is an AI-driven RCM, EHR, and ambient AI platform built to grow modern healthcare organizations. It brings revenue cycle management, clinical documentation, EHR workflows, and healthcare AI agents into one practice platform designed to accelerate payments, reduce administrative work, and help providers focus on patients. Athelas RCM transforms claim management, denial defense, remittance reconciliation, and reimbursement tracking with AI-powered tools that identify the right approach for each claim, automate portal information retrieval, extract payer decisions from the web or phone calls, and surface insights into practice financial health. Ambient AI works as more than a scribe, adapting to each clinician’s documentation style, automatically syncing chart notes to the EMR, generating CPT and ICD-10 codes, supporting parallel scribing, answering questions, retrieving data, running tasks, and providing compliance nudges during encounters.Starting Price: Free -
5
Droidal
Droidal LLC
Droidal is an AI-powered revenue cycle management platform that helps healthcare organizations reduce costs, increase revenue, and improve patient experiences. By leveraging Generative AI and large language models (LLMs), Droidal automates complex billing, claims, and payment workflows with precision and speed. The platform processes over 2 million claims monthly across 1,800+ locations while maintaining coverage for 3,500+ payers. Its AI agents streamline operations for hospitals, clinics, and care providers — cutting denials, accelerating payments, and boosting cash flow. Designed for seamless integration, Droidal enhances productivity without replacing existing systems or workflows. With enterprise-grade compliance and a subscription-based model, Droidal delivers measurable ROI while freeing up staff to focus on patient care. -
6
InvisaClaim
InvisaClaim, LLC
InvisaClaim AI Revenue Cycle Management that prevents denials and wins the ones that slip through. The most advanced all-in-one platform for billing companies and RCM teams. Before claims go out, Pre-Submission Check and Pre-Check AI scrub them against NCCI edits, coding conflicts, and payer rules stopping denials at the source. When one slips through, upload or live-feed a denial letter or 835 ERA and AI extracts patient data, CARC/RARC, CPT/ICD-10, amounts, and deadlines then drafts a payer-specific appeal in 60 seconds across 30+ payers. Modules: Pre-Submission Check, Denial Workbench, NSA/IDR (eligibility, QPA, GFE & IDR letters), Prior Auth, A/R aging, NPI verification, deadline alerts, full audit trail. Connects to your clearinghouse and EHR: Change Healthcare/Optum, Waystar, Availity, Athenahealth (pipeline), plus a FHIR R4 layer for EPIC/Cerner. HIPAA Compliant · SOC 2 · 256 EncryptionStarting Price: $349 -
7
Anomaly
Anomaly
Anomaly is an AI-powered payer management platform built for healthcare revenue teams to “know your payers as well as they know you.” It surfaces hidden payer behaviors by decoding complex rules and detecting payment patterns across hundreds of millions of healthcare encounters. The core engine, Smart Response, continuously analyzes payer logic, adapts to shifting policies, and embeds learnings directly into existing revenue cycle workflows to provide real-time denial prediction, assisted claims correction, and alerts to revenue risks. By integrating payer-specific insights into existing systems, users can anticipate revenue loss, negotiate payer contracts from a stronger position, and proactively correct or reverse denials before they impact cash flow. The system helps level the playing field between providers and payers by turning opaque billing logic into actionable intelligence and embedding it into day-to-day financial operations. -
8
Axora
Axora.AI
Axora AI is an intelligent, end-to-end claims engine that blends AI-powered automation with billing expertise - managing everything from eligibility to payment posting. But it’s more than automation. Axora AI prevents denials before they happen, adapts to payer rule changes, and prioritizes what matters - so you recover more revenue with less effort. 1. Manages your full claims cycle from start to finish 2. Flags denial risks before submission 3. Prioritizes actions that improve cash flow 4. Seamlessly fits into your EHR, payer, and finance systems 5. No migrations. No disruption. Just faster, cleaner paymentsStarting Price: $30/month -
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Altair
Altair Health
Insurance companies run AI to review, adjust, and deny claims. Most practices still work them by hand. Altair closes that gap: an AI-native, done-for-you medical billing service that runs your full revenue cycle, from eligibility and prior authorization to claims, denials, and appeals, backed by a US-based team of expert billers. It is a service that does the work, not software your staff operates. Altair scrubs claims against payer edits and medical-necessity policies, works denials to root cause, files appeals, and learns how each payer behaves. It also runs patient billing and collections for you: statements, payment reminders, payment plans, follow-up on unpaid balances, and aged patient A/R, so the patient share is collected in full. Coding and charge capture stay with your practice; Altair runs everything else. It works with every EHR, and a live view shows what is billed, paid, and at risk. Payers built their AI to pay you less. Altair gets you paid in full.Starting Price: 5% -
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NeuralRev
NeuralRev
NeuralRev is an AI-powered Revenue Cycle Management (RCM) platform that automates and accelerates end-to-end financial workflows in healthcare, reducing manual effort and errors while improving cash flow and operational efficiency. It automates insurance eligibility verification by connecting to clearinghouse networks in real time so patient intake and coverage checks happen instantly, and it handles prior authorization by assembling clinical and payer requirements, submitting requests electronically, and tracking approvals to reduce denials and delays. It also delivers real-time patient cost estimates by combining eligibility data with payer rules to improve transparency and upfront collections, and it streamlines medical coding, claim submission, claims processing, post-claim follow-up, and recovery, so teams spend less time chasing paperwork. -
11
CureAR
TechMatter
CureAR is an AI-powered medical billing and revenue cycle management software designed for in-house billers, billing companies managed-service providers and DME companies. The software consolidates eligibility verification, charge capture, AI-assisted coding suggestions, claim scrubbing, electronic claim submission, ERA ingestion, and automated payment posting into a single cloud-hosted system. It is configurable for specialty billing rules and supports multi-tenant operations for practices that handle multiple client accounts. Key Features: AI-assisted coding and claim scrubbing: Machine learning highlights likely coding errors and applies payer-specific validation rules before submission. Real-time claim status and alerts: Tracks claims from submission to adjudication and surfaces exceptions for prioritized follow-up. ERA ingestion and automated posting: Electronic remittance advice handling with configurable reconciliation workflows reduces manual posting effort.Starting Price: $129/month/user -
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QuickIntell
QuickIntell
QuickIntell provides AI agents for healthcare revenue-cycle operations. Its software supports medical coding, eligibility checks, prior authorizations, payer calls, claim-status follow-up, denial prevention and management, appeals, payment-posting exceptions, accounts-receivable follow-up, and patient communication. The platform combines automated workflows with human approvals, audit trails, and writebacks to electronic health record and practice-management systems. It serves hospitals, provider groups, and revenue-cycle management organizations seeking to reduce repetitive administrative work. -
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BHRev
BHRev
BHRev is a specialized revenue cycle management service and automation platform built for behavioral health providers that helps practices streamline and optimize their entire financial workflow from claims submission to payment collection with AI-powered automation, expert oversight, and industry-specific expertise. It focuses on the unique challenges behavioral health organizations face, including complex payer rules, documentation requirements, high denial rates, and evolving compliance standards, by automating up to 80% of RCM tasks while human experts handle exceptions, compliance checks, and more nuanced billing functions to ensure faster reimbursement and fewer administrative errors. It combines advanced automation with human review to handle critical steps such as insurance eligibility verification, claims processing and scrubbing, denial management and follow-up, and patient payment posting so clinics can reduce operational burden and increase cash flow. -
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VoiceCare AI
VoiceCare AI
VoiceCare AI is an agentic AI platform that automates the entire healthcare revenue cycle (RCM) from patient intake to claims across payer portals, voice, SMS, web chat, and legacy systems, with native EHR integration. One AI agent, Joy, orchestrates benefit verification, prior authorization, and claims & denials management by talking to patients and payers directly and navigating payer portals autonomously. The platform is built for specialist medical practices, dental groups and DSOs, RCM enterprises, and integrated delivery networks (IDNs) and health systems. Every agent action is logged, audit-ready, and transparent, with a human-in-the-loop safety net for complex clinical exceptions. VoiceCare AI is HIPAA-compliant and SOC 2 Type II attested.Starting Price: $30000 -
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OptiPayRCM
OptiPayRCM
OptiPayRCM’s platform delivers seamless, “last-mile” revenue cycle management automation by integrating with EHRs, clearing houses, payer portals, and other systems via flexible adapters so your billing workflows can be processed end-to-end. Its unified core engine handles eligibility checks, claim submissions, payment postings, denial management, and full accounts receivable workflows using AI and robotic process automation to reduce manual effort and accelerate cash flow. Real-time dashboards and reports provide visibility into key metrics and enable predictive insights, while customizable automation supports exceptions and unique workflows. It reduces first-pass denials by up to 63%, speeds claim status checks up to 50 times faster than human processing, and reduces payment cycle time by up to 35%. It is compatible with more than 200 healthcare systems and supports direct integrations via EHRs, FHIR, EDI, and HL7. -
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elsai RCM analytics intelligence transforms fragmented revenue cycle data into actionable operational intelligence. By connecting claim, payer, authorization, charge, and financial data, it helps teams prevent denials, identify revenue leakage, prioritize recovery, and make faster revenue decisions with explainability, governance, and human oversight built in.
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Adonis
Adonis
Adonis is an AI-powered platform designed to revolutionize revenue cycle management by providing monitoring, alerting, and dynamic issue resolution capabilities. It enhances task prioritization across RCM organizations through insights into denial trends, underpayments, and performance metrics. By leveraging AI-driven insights, Adonis aims to increase first-pass acceptance rates and minimize human errors, going beyond basic automation. The platform proactively prevents denials, automating routine tasks to allow teams to focus on patient care and experience. Adonis seamlessly integrates with existing electronic health records, practice management, billing systems, and patient portals in real time, eliminating data silos and ensuring a cohesive workflow. Its solutions are tailored for various healthcare organizations, including physician group practices, hospitals, healthcare systems, digital health providers, and practice management services. -
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SSI Claims Director
SSI Group
Elevate your claims management process and decrease denials through unmatched edits and an industry-leading clean claim rate. Health systems require access to technology that facilitates accurate claim submission and rapid reimbursement. Claims Director, SSI’s claims management solution, streamlines billing practices and provides visibility by guiding users through the electronic claim submission and reconciliation process from beginning to end. As payers change or modify reimbursement criteria for services, the system actively monitors and incorporates these changes and requirements. And with a comprehensive mix of edits at the industry, payer and provider levels, the solution aids organizations in making the most of reimbursement efforts. -
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Availity
Availity
Collaborating for patient care requires constant connectivity and up-to-date information. Simplifying how you exchange that information with your payers is more important than ever. Availity makes it easy to work with payers, from the first check of a patient’s eligibility through final resolution of your reimbursement. You want fast, easy access to health plan information. With Availity Essentials, a free, health-plan-sponsored solution, providers can enjoy real-time information exchange with many of the payers they work with every day. Availity also offers providers a premium, all-payer solution called Availity Essentials Pro. Essentials Pro can help enhance revenue cycle performance, reduce claim denials, and capture patient payments. Availity remains your trusted source of payer information, so you can focus on patient care. Our electronic data interchange (EDI) clearinghouse and API products allow providers to integrate HIPAA transactions and other features into their PMS. -
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Paradigm
Paradigm
Paradigm Senior Services offers a full-service, AI-powered revenue cycle management platform specifically tailored to home-care agencies that bill third-party payers such as the U.S. Department of Veterans Affairs (VA), Medicaid, and other managed-care payers. It automates and streamlines every step of the billing and claims process: from eligibility/authorization verification, state- or payer-specific enrollment and credentialing, to submission of clean claims, denial handling, and payment reconciliation. It integrates with common agency management software and electronic visit verification tools to scrub shifts, verify authorizations weekly, and reconcile payments, reducing denials and minimizing administrative burden. Paradigm also supports “back-office as a service” for providers; even if they already have internal billing staff or scheduling software, Paradigm can take over claims processing as a specialized, expert billing department. -
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Thoughtful AI
Thoughtful.ai
Thoughtful AI offers a comprehensive, AI-driven solution for healthcare revenue cycle management (RCM). With its human-capable AI agents, such as EVA for eligibility verification and CAM for claims management, the platform automates the most complex and time-consuming RCM processes. Designed to boost efficiency and accuracy, it reduces operating expenses, minimizes denials, and accelerates payment posting. Trusted by leading healthcare providers, Thoughtful AI provides seamless integration, guaranteed ROI, and the ability to reduce cost-to-collect, all backed by HIPAA-compliant security and performance-based guarantees. -
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iMedX
iMedX
iMedX, Inc. provides clinical documentation and revenue-cycle solutions designed to help healthcare providers focus on patient care rather than administrative burdens. The platform supports AI medical coding, standard medical coding, clinical documentation, abstraction of core measures, and revenue-cycle-management workflows. Their AI medical coding offering, part of the ‘RCM Companion Suite’, uses advanced machine-learning to improve accuracy, reduce denials, and accelerate payments by automating case-routing, pre‐populating codes, guiding coders in real time, and surfacing documentation gaps before claims leave the organization. Users gain features such as intelligent case routing to the right coder, autonomous resolution of routine cases, in-moment assistance through an AI assistant, and embedded audit tools that identify missed reimbursement, documentation errors, and compliance risks. -
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TELCOR RCM
Telcor
Whether you are an independent reference lab, a pathology practice, an outreach lab or a public health lab, TELCOR RCM billing software provides the tools to overcome tough billing challenges and improve profitability. Perform claim submission, claim monitoring, remittance processes, AR management, client and patient billing, and much more for multiple NPIs all in a single revenue cycle management solution. Minimize billing staffing needs and maximize revenue cycle productivity by using the right tools to automate daily billing functions such as claims submission, collecting patient information, as well as generating revenue cycle management financial reports. Eliminate labor-intensive manual adjudication processes by processing electronic payments received from your payers via 835 ERAs or from your bank via lockbox payment files. Send quick and easy-to-understand billing communication to patients, simplify your patient billing process, and make it easier for patients to pay. -
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Vetriq
Vetriq
Vetriq is a healthcare revenue cycle automation platform designed to eliminate manual processing tasks involved in payment posting, remittance handling, and financial reconciliation for medical organizations. It focuses on automating the workflow around Explanation of Benefits (EOB) documents, payer correspondence, and bank lockbox deposits, converting incoming payment information into structured electronic data that can be automatically posted into revenue cycle management systems. Instead of requiring healthcare organizations to replace their bank, lockbox provider, or existing RCM infrastructure, Vetriq integrates with current banking relationships and practice management or EHR systems, layering automation on top of existing workflows. Vetriq’s automated processing engine transforms paper EOBs into standardized electronic remittance files such as 835 formats, eliminating the need for manual data entry and significantly reducing administrative workload.Starting Price: $22 per hour -
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Optimus Suite
EqualizeRCM Services
Innovative and industry-defining software solutions are at the heart of EqualizeRCM’s healthcare revenue cycle management strategy. Our RCM automation platform, Optimus Suite, seamlessly coexists with clients’ existing infrastructure (EMR, PM, Clearing House, Payer, and other systems). This platform, along with its set of intelligent applications, empowers facilities and practices to have efficient revenue cycle processes while reducing operational costs. Optimus can be tailored to integrate with your system and help bring your RCM performance to the next level. Denials and AR management system, enabling easy claim status, dashboard analytics, and root cause analysis of denials and AR. Platform to integrate 835 and 837 data into the denials and AR management process, enabling rapid claims analysis. A hosted, inexpensive, customizable contract payment calculator enabling calculation of expected payments per provider’s contracts and comparison to payments received. -
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BillingBench
BillingBench LLC
BillingBench is an independent denial management and payer intelligence platform for medical billing and revenue cycle teams. It tracks published payer requirements and longitudinal adjuster patterns by combining a citation-audited policy dataset with aggregate denial data. Free core tools streamline daily billing workflows. The Denial Code Decoder translates CARC codes into plain-language definitions and root-cause analyses. To accelerate recoveries, the Appeal Letter Builder generates structured arguments with statutory citations tailored by denial type, specialty, and payer. Daily operations are supported by a Modifier Matrix with verified rulings, prior authorization checklists, a Timely Filing Calculator, and an 835 ERA Parser. A dedicated Chrome extension provides real-time support alongside major payer portals. Citations are verified against primary sources, each with a transparent changelog.Starting Price: $49/month -
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Assurance Reimbursement Management
Change Healthcare
An analytics-driven claims and remittance management solution for healthcare providers who want to automate workflows, improve resource utilization, prevent denials, and accelerate cash flow. Increase your first pass claim acceptance rate. Our comprehensive edits package helps you stay current with changing payer rules and regulations. Heighten your staff’s productivity with intuitive, exception-based workflows and automated tasks. Your staff can access our flexible, cloud-based technology from any computer. Manage your secondary claims volume through automatic generation of secondary claims and explanation of benefits (EOB) from the primary remittance advice. Focus on claims that need your attention with predictive artificial intelligence into problem claims. Resolve errors faster, and avoid denials before submittal. Process claims more efficiently. Print and deliver primary paper claims, or add collated claims and EOBs for secondary claims. -
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I-Med Claims
I-Med Claims
I-Med Claims provides top-tier medical billing and revenue cycle management (RCM) solutions, trusted by healthcare practices across the U.S. We handle all aspects of RCM, from eligibility verification to denial management, helping practices streamline operations and maximize reimbursements. With billing plans starting at just 2.95% of monthly collections, we offer affordable solutions that enhance financial workflows, maintain compliance, and improve cash flow. By outsourcing billing to us, practices can focus on patient care while benefiting from reduced claim denials and faster payments. -
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Aria RCM
eMDs
Every practice’s revenue cycle is the same. It starts when a patient sets an appointment and it ends when the practice receives payment. It sounds simple enough, but the reality is there are lots of opportunities along the way where simple mistakes can cost your practice money. At eMDs, we don’t simply process claims. That’s the easy part. Instead, we help our customers navigate the entire revenue lifecycle with our expertise understanding payer billing rules, audits, recoupments, appeals and denials, and much more. Why is this important? Your revenue cycle is like a production line. Each step has to be perfectly executed so the next one can be. One little hiccup and the production line (your revenue) comes to a screeching halt. By leveraging best practices developed over our 20+ years in business, our team of industry experts, and our proprietary technology, Aria RCM ensure your billing lifecycle is set up for maximum revenue collection. -
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Aroris360
Aroris Health
Aroris360 is a healthcare-focused contract management platform designed to digitize, organize, and analyze payer contracts to improve revenue visibility and performance. It transforms paper-based agreements into a searchable digital library, enabling instant access to contract terms, side-by-side comparisons, and automated compliance alerts that streamline renewals and strengthen negotiation strategies. It centralizes payer contracts, fee schedules, and claims data into a single system, integrating directly with clearinghouse files to process real-time payment data and maintain a comprehensive claims history. It provides advanced analytics that break down payer mix, code utilization, and revenue patterns, allowing organizations to identify discrepancies between contracted rates and actual payments, uncover underpayments, and highlight opportunities for optimization. -
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ARIA RCM Services
CompuGroup Medical US
ARIA RCM Services is an end-to-end medical billing and revenue cycle management solution designed to enhance financial operations for practices, hospitals, and laboratories. The service offers flexibility by allowing clients to leverage their existing billing technology or utilize ARIA's systems, ensuring full transparency through a dedicated RCM team. Services are tailored to address specific needs, ranging from comprehensive revenue cycle management to focused areas such as aging accounts receivable and coding oversight. ARIA's team of regulatory and payment experts assists clients in navigating the latest CMS and payer requirements, aiming to minimize denials, reduce AR, and accelerate payment processes. The service emphasizes operational efficiency by combining industry best practices with proprietary workflow technology, delivering optimal results at a lower cost. -
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Remittance360
GAFFEY Healthcare
All organizations across the healthcare revenue cycle sector can utilize Remittance360. If an entity receives standard 835, business office staff of all levels will find this tool useful in making actionable decisions regarding cash and accounts receivable workflow. Remittance360 is simple and easy to use, start-up time is minimal, and the uploading process of 835 data takes seconds. Utilizing the standard 835 data set, information upload is obtainable for all organizations, with minimal IT involvement. Remittance360 takes advantage of the data organizations have, but delivers relevant reporting of denials, trends, and individual payer activities. Gaining insights into this information can determine specific workflow needs. The ability to query data is simple in Remittance360, and common queries can be saved for easy user functionality. Querying denials by remark code and by department can assist in identifying and fixing root cause issues. -
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eClaimStatus
eClaimStatus
eClaimStatus provides simple, practical, efficient and cost effective real time Medical Insurance Eligibility Verification system and Claim Status solutions that power value added healthcare environments. At a time when healthcare insurance companies are reducing reimbursement rates, medical practitioners must monitor their revenue closely and eliminate all possible leakages and payment risks. Inaccurate insurance eligibility verification causes more than 75% of claim rejections and denials by payers. Furthermore, refiling rejected claims cost an organization $50,000 to $250,000 in annual net revenue for every 1% of claims rejected (HFMA.org). To overcome the revenue leakages, you need a no-fuss, affordable and effective Health Insurance Verification and Claim Status software. eClaimStatus was designed to solve these specific challenges. -
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Sift Healthcare
Sift Healthcare
Sift demystifies healthcare payments by integrating actionable intelligence into revenue cycle workflows to help healthcare organizations optimize payment outcomes and reduce the cost to collect. Sift equips healthcare providers with actionable denials intelligence that enables them to protect their receivables and accelerate cash flow. Sift captures insurance claim and patient financial data into a HIPAA-compliant, cloud-based and normalized database, providing a single source of truth for around your healthcare payments. Sift fills the gaps between a provider’s EHR, clearinghouse, workflow tools, and patient engagement platform. Sift unifies the data points from each system to build a unique and proprietary data set and provide holistic payments oversight. By applying multiple data science techniques, Sift provides comprehensive and integrated recommendations for denials management, payer assessment, patient collections and patient acquisition. -
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DoctorMGT
Doctor Management Services
DoctorMGT is a healthcare revenue cycle and practice support company that helps medical providers improve billing performance, reduce denials, and accelerate payments. The company supports solo providers, specialty clinics, hospitals, and medical groups with services such as medical billing, coding, claims management, AR follow-up, and compliance-focused revenue support. DoctorMGT works with complex claims across areas such as pain management, orthopedics, surgery, chiropractic care, durable medical equipment, personal injury, and lien-based billing. Its services are designed to reduce administrative workload while helping providers keep cash flow steady and claims moving efficiently. DoctorMGT also offers virtual medical assistants, virtual medical scribes, appointment scheduling, credentialing, medlegal support, and lien negotiation services. -
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RCM Cloud
Medsphere Systems Corporation
The RCM Cloud® “software as a service” (SaaS) model strives to replace resource-intensive medical billing processes with digital solutions that reduce manual processes and optimize workflow thru automation. This approach significantly improves operational efficiency and further allows the business to expand service delivery capacity with only minor increases in administrative staff. Leverage your investment in technology to grow and sustain your business as opposed to increasing the headcount necessary to expand. On the administrative side, RCM Cloud® and associated services are delivered via the powerful, proven and secure medsphere cloud services platform. RCM Cloud® modules include patient/resource scheduling, enterprise registration, in-stream payer eligibility checking, contract management, medical records, billing, claims, payer and self-pay collections, POS payment posting and bad debt which enable all types of healthcare entities to truly transform their revenue cycles. -
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CombineHealth AI
CombineHealth AI
CombineHealth AI is the creator of Amy, Marc, Emily, and Diana — an advanced AI workforce designed to power end-to-end Revenue Cycle and Practice Management services for healthcare groups nationwide. These solutions are built on a proprietary foundational model that delivers 99.2% accuracy and ensures 100% compliance with coding and billing guidelines. The AI workforce helps reduce coding errors, enhance coder productivity, and address physician documentation challenges. Organizations using these solutions have seen a 35% increase in clean claim submissions and a significant reduction in denial rates. The AI employees work seamlessly alongside human teams, performing key functions such as medical coding, billing, data entry, A/R follow-up, and denial management — while providing detailed, auditable reasoning for every action taken.Starting Price: $1000/month -
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Veradigm Payerpath
Veradigm
Veradigm Payerpath is an end-to-end revenue cycle management suite of solutions built to assist organizations to improve revenue, streamlining communications with payers and patients, and boosting practice profitability for practices of all sizes and specialties. Eliminate missing information, incorrect coding, and data entry error to ensure clean claim submission. Ensure claims pre-submission are correctly coded, have no missing information, and are error-free. Compare performance against peers at the state, national, and specialty levels to optimize productivity and improve financial performance with advanced analytical reporting. Remind patients of their appointments and confirm their insurance coverage and benefits information. Automate the billing and collection of patient responsibility. Veradigm Payerpath’s integrated solutions are practice management (PM) agnostic, interfacing seamlessly with all major PM systems. -
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PayerLenz
PayerLenz
PayerLenz is a reimbursement benchmarking and eligibility verification platform for behavioral health providers, billing companies and RCM firms. It answers a question standard verification cannot: not whether a patient is covered, but what the payer is likely to allow. The benchmarks are built from more than 500,000 adjudicated claims covering 260+ payer groups across 21 states, and every figure carries its sample size and recency so users can judge how much weight it holds. The platform also provides real-time eligibility checks and full worked verifications, and gives billing teams a live view of accounts receivable. PayerLenz is the first product from Revenue Logic, a behavioral health billing firm. A benchmark is a distribution of what comparable claims have paid; it is not a prediction or guarantee for any individual claim.Starting Price: Free -
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TriZetto
TriZetto
Accelerate payment while decreasing administrative burdens. With 8,000+ payer connections and longstanding partnerships with 650+ practice management vendors, our claims management solutions can result in fewer pending claims and less manual intervention. Quickly and accurately transmit professional, institutional, dental, workers compensation claims and more for fast reimbursement. Meet the shift to healthcare consumerism head on by providing a straightforward and seamless financial experience. Our patient engagement solutions empower you to have informed conversations about eligibility and financial responsibility while reducing hurdles that may impact patient outcomes. -
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AGS AI Platform
AGS Health
AGS AI Platform is an end-to-end Revenue cycle management platform that provides a full suite of revenue cycle solutions that can be configured to meet the unique needs of any healthcare organization. AGS AI Platform is designed to improve healthcare systems' revenue cycle performance by automating repetitive tasks, simplifying coding, improving documentation, and optimizing billing practices to prevent denials and improve revenue flow. It provides a connected solution that blends artificial intelligence and automation with award-winning human-in-the-loop services and expert support to maximize the performance of the healthcare revenue cycle. The platform allows healthcare organizations to gain enhanced visibility into day-to-day operations and the overall performance of the revenue cycle, including intelligent worklists, productivity reports, customizable dashboards, root cause analyses, and executive reporting. -
42
Kovo RCM
Kovo RCM
Kovo RCM is a revenue cycle management and medical billing service platform that helps healthcare providers streamline billing processes, optimize reimbursements, and reduce administrative burden so clinicians can focus more on patient care. It delivers end-to-end RCM services that include insurance eligibility verification, claims submission and tracking, denial management and appeals, coding support, credentialing, patient billing and collections, and custom reporting and analytics to provide clear financial insights and improve cash flow. Kovo RCM supports a wide range of medical specialties, including cardiology, anesthesiology, radiology, mental and behavioral health, internal medicine, surgery, EMS and ambulance services, wound care, and more, offering tailored billing expertise for the unique coding and reimbursement challenges each field faces. -
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Experian Health
Experian Health
Patient access is the starting point for your entire revenue cycle process. Ensuring correct patient information on the front end reduces the errors that cause rework in the back office. 10 to 20 percent of a health system's revenue is forced to remediate denied medical claims and 30 to 50 percent of those occur during patient access. By adopting an automated, data-driven workflow—not only are you reducing the errors that lead to claim denials, you’re also improving access to care for your patients through capabilities like online scheduling options that are available 24/7. Access is further improved by reducing the friction around patient billing by leveraging real-time eligibility verification to deliver accurate patient estimates at registration. Increase staff efficiencies by improving registration accuracy. Correct discrepancies and errors in real time to avoid costly denials and rework. -
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Approved Admissions
Approved Admissions
Approved Admissions is a secure platform that automates tracking of coverage changes for Medicare, Medicaid, and commercial payers bundled with real-time eligibility verification and coverage discovery. The platform's primary goal is to help providers minimize the number of claim denials due to a missed insurance coverage change and accelerate the billing cycle. Approved Admissions is using the innovative RPA (Robotic Process Automation) Bridge solution to ensure patient data consistency across multiple systems, and benefit coverage search. Key Features: - Automated eligibility verifications and re-verifications - Email or API notifications if any coverage changes are detected - Real-time verifications - Batch eligibility verification - Seamless integration with RCM, EHR platforms (PointClickCare, MatrixCare, SigmaCare, DKS/Census, FacilitEase, and many others) - RPA-powered cross/platform synchronizationStarting Price: $100 per month -
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RevCycle Engine
Aptarro
RevCycle Engine applies built‑in, customizable rules and AI‑powered automation to correct coding and charge errors at the source, ensuring billing data is accurate before claims are submitted. By integrating seamlessly with EMRs and practice management systems, it ingests claims data in real time, applies industry‑proven rules tailored to each organization’s needs, and fixes errors automatically, reducing preventable denials and costly rework. Streamlined workflows prioritize and route only complex or exception claims for human review, boosting team efficiency and reducing burnout. With AI‑driven charge accuracy, the platform increases clean claim rates, lowers cost‑to‑collect, and stabilizes cash flow, all visible through clear dashboards and real‑time insights. Scalable automation handles high claim volumes without overtime or late‑night efforts, while features such as charge accuracy validation, denial prevention, coding review optimization, payment collection support, and more. -
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Nextech
Nextech Systems
Revenue cycle management platform with payment processing, claims management, patient access, and denials management. Nextech’s specialty-focused technology solutions are personalized to meet the unique workflow requirements of specialty providers, helping practices increase efficiencies across their clinical, administrative, financial and marketing functions using a single platform. Offering all-in-one, ONC-certified electronic medical records (EMR/EHR), practice management, revenue management, and patient engagement software and services, Nextech is recognized as the top single solution provider for ophthalmology, plastic surgery and dermatology, serving a client base of more than 9,000 providers and 50,000 office staff members. Offering physicians intelligent healthcare technology, Nextech focuses on the success of its specialty practices through consultative guidance and implementation of solutions tailored to the speed and workflows of individual providers. -
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VerifyTreatment
VerifyTreatment
VerifyTreatment (formerly VerifyTX) is a healthcare insurance verification and revenue cycle management platform, purpose-built in behavioral health and expanding across healthcare. Providers get a full benefit breakdown across 1,800+ payers in seconds, 24/7/365, including the behavioral health carve-outs generic tools miss, so admissions teams answer coverage questions on the first call instead of calling back. The platform protects revenue across the patient journey. Auto-VOB monitors the active census and flags lapsed coverage. Coverage Discovery finds active coverage from partial or no insurance information. Claim Status and Claims Acknowledgement give billing teams real-time visibility without portal logins. Web forms, a mobile app, an open API, and Salesforce are included on every plan. HIPAA compliant with secure team messaging. 4,000+ facilities run on VerifyTreatment, processing over 10 million verifications since 2016. Every plan is month to month, no contracts.Starting Price: $299 -
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Precision Practice Management
Precision Practice Management
Whether you're looking to outsource all of your revenue cycle management functions or just some of them, Precision Practice Management has the experience and expertise to help you stay on top of the constantly changing landscape in this most important area. Precision can successfully address all areas of revenue cycle management, from compliance, credentialing, coding, claims processing, clearinghouse edits and electronic lockbox to claim denial management, reporting, financial analyses and more. Your in-house staff may be doing a tremendous job in managing some or most aspects of your medical billing, but your office staff has many other important clinical functions to perform. Sometimes billing matters receive lower priority and suffer as a result. Precision's medical billing experts are focused entirely on medical billing and nothing else; that's all they do. -
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Quanum RCM
Quest Diagnostics
Quanum Revenue Cycle Management (RCM) delivers a holistic solution for managing the financial component of a medical practice with a focus on increasing revenue. Created by Quest Diagnostics, a leading provider of pre-employment drugs-of-abuse screening for employers and risk assessment services for the life insurance industry, Quanum RCM offers a complete medical billing solution, from billing claims to denial management and other billing related activities and support. -
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Smarter Technologies
Smarter Technologies
Smarter Technologies is an AI-powered automation and insights platform focused on healthcare revenue cycle management that helps hospitals, health systems, and provider organizations optimize administrative and financial workflows to increase efficiency, reduce costs, and improve cash flow while letting clinical teams focus more on patient care. It combines proprietary clinical and agentic AI, human-in-the-loop virtual agents, advanced clinical ontology, and structured AI insights to automate up to 80% of revenue cycle tasks such as eligibility verification, documentation integrity, coding accuracy, claims processing, and denial management without replacing existing systems. Its solutions include modular RCM automation blended with skilled operational support, clinical AI tools like SmarterDx that understand tens of thousands of diagnoses and procedures to improve reimbursement and prevent errors, and SmarterNotes.
