Alternatives to Axora
Compare Axora alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to Axora in 2026. Compare features, ratings, user reviews, pricing, and more from Axora competitors and alternatives in order to make an informed decision for your business.
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RXNT
RXNT
RXNT is an ambulatory healthcare technology pioneer that empowers medical practices and healthcare organizations to succeed and scale through innovative, data-backed, AI-powered software. Our fully-integrated, ONC-certified suite of medical software—like Clinical EHRs, Practice Management, Medical Billing and RCM, E-Prescribing, Practice Scheduling, Patient Portal, and more—optimizes clinical outcomes and RCM for your practice. Used by tens of thousands of medical professionals—from large physician practices to medical billing companies—to drive growth, streamline business operations, and improve patient care across all 50 U.S. states. Our unified “Full Suite” system employs a secure, central database so your data passes through every product in real-time from anywhere, and more than 125 million prescriptions have been transmitted and over $7 billion in claims have been processed using RXNT. -
2
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. -
3
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. -
4
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. -
5
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. -
6
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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Amazing Charts Practice Management
Amazing Charts
Amazing Charts Practice Management is a comprehensive solution designed to streamline administrative tasks and enhance the efficiency of independent medical practices. Developed by a practicing physician, this system automates processes such as capturing patient demographics, scheduling appointments, pre-registering patients with insurance eligibility checks, and generating analytical reports. It also determines patient financial responsibilities at the point of care, maintains insurance payer lists, and ensures prompt and accurate billing to assist in payment collection efforts. Key features include the ability to view unpaid claims to ensure timely resolution, a claims manager who reviews submissions to reduce denials, and an integrated secure connect clearinghouse for high-level support and quick responses to payer changes. The system offers intelligent, interactive role-based dashboards that automatically prioritize work lists across all office areas.Starting Price: $229 per month -
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Inovalon Claims Management Pro
Inovalon
Keep revenue flowing with a powerful tool that speeds up reimbursements with eligibility checks, claims status tracking, audits and appeals, and remittance management for government and commercial claims, all in a single system. Leverage an advanced rules engine that immediately scrubs claims against the most up-to-date CMS and commercial payer rules, allowing you to correct errors before claims go out the door. Verify eligibility across all payers during claim upload and see flagged errors so claims can be edited before submission. Decrease days in A/R with automated workflows for audit responses, appeal submissions, and ADR tracking. Customize staff workflow assignments based on the type of claim and action needed. Automate secondary claims submissions to stop timely filing write-offs. Increase claims revenue with automated workflows for faster, more successful audits and appeals. -
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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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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. -
11
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. -
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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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Veritable
314e Corporation
Veritable accelerates patient insurance eligibility verification and claims-status checks by providing instantaneous results in a clean, intuitive interface. It supports real-time, batch uploading of patient lists to verify eligibility across more than 1,000 payers (including national Medicare and all state Medicaid) and multiple service types. It also enables tracking of claims status, from submission through reimbursement, so practices and billing companies can proactively identify issues to reduce payment delays and denials. Key benefits include automating eligibility and claims workflows to reduce manual entry and phone calls, improving front-desk patient experience by validating coverage and copayments at check-in, and offering seamless integration for both technical and non-technical users with strong data-security controls. It includes a “Code Explorer” for instant lookup of ICD-10-CM, ICD-10-PCS, HCPCS Level II, and CPT codes.Starting Price: $50 per month -
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Rivet
Rivet Health
Patient cost estimates and upfront collection. Understand patient responsibility instantly with automatic eligibility and benefit verification checks. Hyper-accurate estimates based on your own practice data, creating better care and a healthier business. Send estimates via HIPAA-compliant text or email. It's time to treat 2020 like 2020. Collect more than ever with upfront mobile patient payments. Ditch the write offs and decrease patient AR. Run eligibility checks and provide accurate cost estimates, even for multiple payers, treatments, facilities or providers. Collect payment up front via HIPAA-compliant text or email. Reduce A/R days, collect more revenue and increase patient satisfaction all at once. Identify, analyze and resolve denials, as well as track ROI from reworked claims. Automate denial assignments to team members via Rivet, and leave notes and links along the way to resolve future denials even faster. -
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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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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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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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Quadax
Quadax
How well you manage the challenges of your revenue cycle has a direct effect on your bottom line and the success of your entire organization. It doesn’t matter how many patients seek your care if it’s taking months to receive the expected payments for the services you provide. And, you shouldn’t have to spend hours each day tracking down the payments you’ve worked hard to earn. There’s a better way to maximize healthcare reimbursement. Let Quadax be your guide to creating a comprehensive, sustainable and orderly strategic plan, and select the right technology solutions and services that best fit your business model. With us as your partner, you can achieve operational efficiency, optimize financial performance and enhance the patient experience. The goal for every claim going out the door is to avoid a denial and get paid as quickly as possible. -
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Stedi
Stedi
Stedi is the only clearinghouse built on modern APIs, while supporting both real-time and batch EDI processes. It enables health techs and incumbents to exchange mission-critical transactions - from eligibility to claims and remits. With a security-first cloud infrastructure, built-in payer redundancy via 3,400+ route connections, and market-leading sub-10-minute support response times, Stedi provides reliability and responsiveness to avoid billing outages and reduce denials.Starting Price: $2,000 per month -
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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. -
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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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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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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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Alaffia
Alaffia Health
Alaffia’s AI-powered system uncovers fraud, waste, and abuse in the most intricate healthcare claims to prevent and recover overpayments for payers and employers. Alaffia detects and corrects errors in misbilled claims before an improper payment is made. Alaffia empowers you to recover and save on overpayments previously made on misbilled claims. Overpayments on error-filled claims could be costing you hundreds of dollars per employee each year. Work with Alaffia to eliminate overpayments and drive more savings to the bottom line. The Alaffia system detects and corrects inaccurately billed claims, preventing overpayments. We work directly with your health plan or TPA for seamless integration and no disruption to your members. Our services are entirely contingency-based, so you only pay when we deliver savings. We ensure that providers aren’t charging your employees for services not rendered. -
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AltuMED PracticeFit
AltuMED
Conducting thorough checks on the financial eligibility of the patients, running their insurance’s analysis and monitoring discrepancies, the eligibility checker covers all. If however any error does creeps in the data submitted, our scrubber working on deep AI&ML algorithms is capable of scrubbing errors be it coding errors, incomplete or wrong patient financial information. The software, at present, has 3.5 Million edits pre-loaded in its memory. To further streamline the process, automatic updates are issued by the clearing house to inform about the status of in-process claims. Covering the entire billing spectrum from verifying the patient financials to working on denied or lost claims and also has a through follow-up feature for appeals. Our intuitive systems warns if a claim could be denied, taking corrective actions to prevent it but also is capable of tracking and appealing for lost or denied claims. -
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ImagineMedMC
Imagine Software
Manage your members' healthcare and networks with a cloud-based healthcare delivery system. Automate claims processing for managed care organizations. Includes eligibility, referral and authorization processing, provider contracting, benefit administration, auto claims adjudication, capitation (PCP and Specialty), EOB/EFT check processing, and EDI transfers and reporting. Deploy as a cloud solution or an in-house system. Ideal for managed care organizations (MCOs), independent physician organizations (IPAs), third-party administrators (TPAs), preferred provider organizations (PPOs), and self-insured groups. Streamline the complexities of administrating eligibility, referral authorization and claims processing. Features and functions maximize data integrity while reducing data entry. -
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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. -
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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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Silna Health
Silna Health
Silna Health’s Care Readiness Platform handles all prior authorizations, benefit checks, and insurance monitoring upfront to make sure patients are clear to receive care while providers gain capacity to focus on treatment. Its AI‑powered engine manages the entire prior authorization workflow, from tracking upcoming authorizations and sending weekly reminders to submissions and follow‑ups, automatically applying industry‑proven rules and escalating exceptions for human review. Specialty‑specific benefit checks verify coverage, accumulations, authorization requirements, and visit limits in real time, delivering accurate quotes at intake. Continuous insurance monitoring flags lost coverage, detects new plans, and safeguards against eligibility lapses. Designed for zero extra headcount, Silna ingests data directly from EMRs and practice management systems, offers configurable rule sets and strategic guidelines, and presents clear dashboards with incremental revenue insights. -
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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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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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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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Claim Agent
EMCsoft
EMCsoft’s Claims Management Ecosystem assures that healthcare providers and billing companies deliver clean claims to insurance payers for proper claim adjudication. It is the integration of our versatile claims processing software Claim Agent and comprehensive fitting process called the Four Step Methodology into your claim adjudication process. This approach enables, supports, and automates your work process to maximize claim reimbursement. Request our free online demo for a great introduction into the functionality/features of Claim Agent and how it fits into your claim adjudication process. Claim Agent scrubs and processes your claims from the provider system to the insurance payers in a efficient, cost effective, and timely manner. The software is compatible with any system making implementation process quick and simple. We provide custom edits, bridge routines, payer lists, and work flow settings that are unique to each user. -
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Centauri Health Solutions
Centauri Health Solutions
Centauri Health Solutions is a healthcare technology and services company driven by our desire to make the healthcare system work better for our clients and to provide compassionate support for individuals in need. Our analytics-powered software enables hospitals and health plans (Medicare, Medicaid, Exchange and Commercial) to manage their variable revenue through a custom-built workflow platform. While our tailored support of their patients and members provides them with access to life-enhancing benefits. Our solutions include Risk Adjustment (Medical Record Retrieval, Medical Record Coding, Analytics and RAPS/EDPS Submissions), HEDIS® and Stars Quality Program Management, Clinical Data Exchange, Eligibility and Enrollment, Out-of-State Medicaid Account Management, Revenue Cycle Analytics, Referral Management & Analytics, and Social Determinants of Health. -
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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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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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LigoLab LIS & RCM
LigoLab
As a comprehensive enterprise-grade solution, the LigoLab LIS & RCM Laboratory Operating Platform™ includes modules for AP, CP, MDx, RCM, and Direct-to-Consumer, all on one integrated platform that supports the entire lifecycle of all cases, enabling laboratories to differentiate themselves in the marketplace, scale their operations, and become more profitable. The RCM module is deeply integrated with the LIS and automates ICD and CPT coding. Billing processes start at order inception with verification, eligibility, and scrubbing components that increase clean claim submissions and revenue, and decrease claim denials and compliance risk. TestDirectly is a patient engagement portal that enables labs and collection facilities to scale collection, testing, and reporting workflows that produce fast and accurate results, minus the friction and the errors that come with paper forms and manual labor. -
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ImagineBilling
ImagineSoftware
The industry’s first intelligent, multi-specialty medical billing software. Streamlining billing and patient collections for over 75,000 physicians across the country. Globalized data eliminates the need for duplicate entry. Visit-driven to allow for large volume and complex information. Flexible data structure accommodates requirements across multiple practices and specialties. Helping you get paid faster. Post payment manually or through electronic remittance. Automatically scrub claims for errors and missing information. Automatically refile insurance claims based on selected criteria. Fast review to evaluate and approve charges. Audit charges by modality, procedure, insurance, user, doctor or date of service. Intuitive reports for tracking the financial health of your front-end and back-end billing. Never lose another charge again. Integrates with your preferred clearinghouse or statement vendor. -
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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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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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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. -
42
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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Casamba Revenue
Casamba
Fewer denials and delays in claim submission + a dedicated team to manage follow-ups. Grow revenue by 4% and net payment per visit by 10%. Improved collection efficiency and consistent follow-up help net collection percentages grow. Reduce your DSO by 10 days or more. Claims that meet exact requirements shorten collection timelines and increase cash flow. Dashboards and metrics allow you to make informed decisions and move your business forward. The integration of Casamba and IKS Health creates a unified solution tailored for physical therapy practices and the challenges you face. By combining technology and services, we bring exponential value. We make your practice more efficient by freeing you and your therapists to focus on the delivery of excellent care. Contact us to find out how our RCM service can help you grow your business. -
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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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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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MediSYS
MediSYS
With a single sign-on solution for PM and EHR, our total clinic solution streamlines workflow, speeds cash flow and maximizes reimbursement. With our team of medical billing & revenue experts, practices typically see bottom-line improvements including fixed-cost reductions. Plus, partnering with our revenue services team gives you peace of mind knowing that you have more time to focus on patient care and patient engagement — what you do best! Empower your team with our industry-leading implementation, training, support, data migrations and interoperability. Proven tools to allow today’s patients and providers to better manage their health. Continued education and training based on industry requirements and guidelines. Connect quickly and efficiently with patients with built-in tools designed specifically for medical practices. -
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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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Infinx
Infinx Healthcare
Leverage automation and intelligence to overcome patient access and revenue cycle challenges and increase reimbursements for patient care delivered. Despite the progress AI and automation is making in automating patient access and revenue cycle processes, there still remains a need for staff with RCM, clinical and compliance expertise to ensure patients seen were financially cleared and services rendered are accurately billed and reimbursed. We provide our clients with complete technology plus team coverage with deep knowledge of the complicated reimbursement landscape. Our technology and team learn from billions of transactions processed for leading healthcare providers and 1400 payers across the United States. Get quicker financial clearance for patients before care with our patient access plus a platform that provides complete coverage for obtaining eligibility verifications, benefit checks, patient pay estimates, and prior authorization approvals, all in one system. -
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Myndshft
Myndshft
Experience a seamless workflow by having real-time transactions driven within existing technology platforms. Providers and Payers reduce time and effort by up to 90% for benefits and utilization management. Eliminate the current benefits and utilization management black box – eliminating confusion for patients, providers and payers. Self-learning automation and fewer clicks mean more time for patients, providers and payers to focus on care. Myndshft eliminates the quagmire of point solutions by providing a unified, end-to-end platform for in the moment payer-provider-patient interactions. Myndshft dynamically updates automated workflow and rules engines based on the actual responses and results from provider-payer interactions. Our technology continuously adapts to the rules in use by payers. The more you use it, the smarter it gets. A library of continuously-updated thousands of rules for national, state and regional payers.
