Alternatives to BillingBench
Compare BillingBench alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to BillingBench in 2026. Compare features, ratings, user reviews, pricing, and more from BillingBench competitors and alternatives in order to make an informed decision for your business.
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InvisaClaim
InvisaClaim
InvisaClaim is the most advanced all in one revenue platform. An AI-powered Revenue Cycle Management platform that automates denial management, appeals, prior authorizations, and No Surprises Act compliance for billing companies and RCM teams. Upload or Live Feed a denial letter or 835 ERA and AI extracts patient data, CARC/RARC codes, CPT/ICD-10, amounts, and deadlines, then generates payer-specific appeal letters in 60 seconds across 30+ payers. Modules: Denial Workbench, NSA/IDR (eligibility checks, QPA capture, GFE & IDR letters), Prior Authorization, Pre-Check AI, A/R aging, NPPES NPI verification, deadline alerts, and full audit trail. Connects directly to your clearinghouse and EHR. Integration partners: Change Healthcare/Optum (ERA, eligibility, claim status, prior auth), Availity (in progress), Waystar (Provider Access Request). EHR partnerships with Athenahealth in the marketplace pipeline, plus a FHIR R4 layer for Epic/Cerner. HIPAA Compliant, SOC2 & 25kStarting Price: $349 -
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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. -
3
ABN Assistant
Vālenz
For providers, medical necessity denials cost thousands to millions of dollars every year in write-offs, plus costly staff time researching and appealing denials and responding to patient concerns. For payers, the same is true on the other end of the claim management spectrum: Paying for medically unnecessary procedures and treatments – and time spent working on denial appeals – raises costs without improving outcomes. And of course, for the patient, there can be unnecessary copays and other out-of-pocket costs, not to mention a poor patient experience involving costs and moments of care they did not need. ABN Assistant™ from Vālenz® Assurance delivers the prior authorization tools providers need to validate medical necessity, print Medicare-compliant ABNs with estimated cost, and stop over 90 percent of medical necessity denials by verifying necessity before care is delivered to the patient.Starting Price: $1039.00/one-time/user -
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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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Arrow
Arrow
Arrow is a healthcare revenue cycle management platform that modernizes and streamlines healthcare payments by automating billing, claim operations, and predictive analytics to help providers and payers reduce administrative burden, minimize denials, and accelerate collections. It brings workflows, data, and AI together so teams can detect errors in claims before submission, manage denials with root-cause analysis and one-click fixes, and get detailed real-time claim status updates directly from payers. It simplifies the ingestion of Explanation of Benefits (EOB) and Electronic Remittance Advice (ERA) data into a centralized, user-friendly format, provides revenue intelligence with actionable insights into the revenue cycle, and monitors payment integrity to highlight underpayments or overpayments according to payer contracts. -
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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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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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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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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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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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ESO Billing
ESO
Automate your workflow and integrations, and put an end to the repetitive manual work associated with revenue cycle management. ESO Billing frees your team to focus on what they do best. In today’s reimbursement world, efficiency counts. ESO Billing was built to save you time at every possible point in the billing process. Even its interface has been freshly redesigned for the ultimate in speed and ease of use. Customize your workflow based on your business process, task-based workflow moves each claim through its stages with minimal touches. It even alerts you automatically when payments aren’t on time, for the ultimate peace of mind. Our payer-specific proprietary audit process ensures that each claim contains all critical billing information prior to claim submission. The result? The lowest clearinghouse and payer rejection rate in the industry. Pair billing with ESO Health Data Exchange (HDE) and ESO Payer Insights to tap into hospital-generated billing information with one click. -
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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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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. -
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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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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. -
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PrognoCIS Practice Management
Bizmatics
Seamlessly integrating with, our cloud-based Practice Management solution allows for quick and easy billing management, which enables your practice to quickly identify and confirm patient insurance benefit eligibility level and copay. Work with many different clearinghouses. Efficiently manage your accounting books. Easily reconcile patient accounting and insurance billing. Quick and easy online patient payments and EOB/ERA processing. Our healthcare practice management system has a very robust tasking system. You can quickly find and assign claims to work on using a filter-based search function. You can filter and search outstanding claims by around 100 different parameters, including patient vs. insurance responsibility, primary/secondary/tertiary payer or payer grouping, provider, date of service, aging bucket, and denial reason. Filters can be saved and reused later.Starting Price: $250 per month -
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AveaOffice
Avea Solutions
Designed specifically to mirror the typical patient journey from pre-admission to post-discharge, yet flexible enough to adjust to your unique processes, every staff member is guided to push workflows forward effortlessly and capture the information needed to ensure clean claims and maximum reimbursements. From patient intake and benefit verification, across every Utilization Review, marking attendance and getting claims out the door, working denials and collecting payment, we’ve got you covered. It has never been more critical to work smarter and not harder in the industry. We’ve raised the bar when it comes to liberating your teams from the burden of manual processes and workarounds with our automation and powerful claim rules engines. Managing your revenue cycle is like watching dominoes fall in a harmonious pattern. Continuous industry changes, new payer rules, declining reimbursements, tighter margins. -
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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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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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Crosby Health Apollo
Crosby Health
Thousands of providers use Apollo by Crosby Health to generate, submit, and track appeals. Reducing the provider burden from clinical denials. Apollo has been trained to understand the clinical context and beats every other medical language model on core metrics. Apollo has been fine-tuned to handle billing tasks with high precision such as auditing, charge capture, and denial management. The fastest clinical language model with the largest context length. Outputs are generated on average at 60 words per second and can intake up to 300 pages. Our AI crafts winning appeal letters for every denial with meticulous arguments for maximum recovery. Eliminate multiple payor portals and fax numbers. One platform that submits and tracks every appeal. Eliminate the provider burden to generate appeals. AI trained to identify medical necessity within documentation. One-click submission to any insurance company. -
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Encipher Health
Encipher Health
Encipher Health is a comprehensive AI-powered healthcare technology platform that automates medical coding, risk adjustment, and revenue-cycle processes across specialties. Using Neuro-Symbolic AI, OCR, ML, and knowledge-graph logic, it converts unstructured clinical documentation into accurate, audit-ready codes (CPT, ICD-10, HCC, HCPCS) while enforcing payer, CMS and compliance rules. Its products — including GI coding automation, radiology coding (Conrad AI), anesthesia coding (Sedate AI), HCC/risk adjustment (Cogent AI / RiskGen‑Core / RAF Totalizer), E/M coding, home-health coding, ICD-10-AM support, AR follow-up and denial resolution — streamline workflows, reduce manual effort, minimize denial risk, and accelerate reimbursements. Real-time and retrospective workflows, seamless EHR integration, MEAT-criteria validation, modifier logic, and compliance guardrails ensure high accuracy, regulatory alignment and audit readiness. -
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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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EZClaim Medical Billing
EZClaim
EZClaim is a medical billing and scheduling software company that provides a feature-rich practice management system specifically tailored for small to medium-sized provider office and outsourced medical billing firms. It also includes integrations with a number of EMR/EHR vendors. Whether you are a doctor, practice manager, or billing service owner, EZClaim Billing is designed with you in mind, simplifying your claims management from data entry to payment posting, and beyond. EZClaim primarily supports the following specialties, General Practice, Therapy, Vision, Surgical, Medical Specialties, Home Health Care, and Outsourced Medical Billing Services (RCM). However, the software is very adaptable and can be used for many other billing specialties. EZClaim’s billing software allows the creation of insurance payor lists for Medicare, Medicaid, Tricare, Clearinghouse payer IDs, governmental MCO’s, auto insurance, and worker compensation groups. -
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MantraComply
MantraComply
MantraComply is a provider credentialing and enrolment platform. We deliver comprehensive services in provider credentialing, payer enrollment solutions, license verification, hospital privileging, and healthcare compliance management. Trusted by thousands of providers, health plans, payers, group practices, and digital health companies, MantraComply ensures faster provider onboarding, reduced denials, and improved regulatory compliance. Our model integrates AI-driven insights, customizable credentialing workflows, and 24/7 expert support, enabling providers and organizations to stay compliant while focusing on patient care. MantraComply is proudly backed by $15M in funding from Impanix Capital. -
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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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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 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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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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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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Valer
Valer
Valer’s technology speeds and simplifies prior authorization and referral management by automating submissions, status checking, verification, reporting, and EHR synchronization across all mid-to-large-sized healthcare settings, specialties, and payers from one platform and portal. Valer is the all-specialty, all-payer technology solution designed around your needs, not ours. Unlike off-the-shelf products that limit specialties, service lines, and payer mix (that don’t even automate submissions), Valer is explicitly customized to fit your needs. Because Valer is so easy to use, the dashboard increases staff productivity, simplifies staff training, and measures staff and payer performance across all service lines to enable continuous improvement. Valer doesn’t just connect to some of your payers for some of what you need. We link to all payers for all specialties, service lines, and care settings with real-time payer rule updates. -
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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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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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AppealsPlus
Etactics
AppealsPlus™ is a cloud-based solution that automatically analyzes ERAs, applies rules to place suspect payments and denials into appropriate work queues, and utilizes dashboards and key performance indicators to provide quantitative management and used to help drive decisions. The regulatory climate moves quickly and can change directions rapidly, leaving little time for providers and their patients to adjust. Providers don’t know if their patients will be able or willing to pay the bills after a procedure is performed. What most studies, vendors, and software companies fail to take into account is that the definition of denial is subjective. This definition differs by physician, biller, and institution. We'll take you and your team through a personalized four-week-long implementation phase to ensure that the solution is customized to your liking. After the initial four-week implementation phase you can continue to contact us with any questions or concerns you have. -
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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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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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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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EmpowerMax Billing
Harris Coordinated Care Solutions
More compensation from payers means more services for your clients, patients, and community. Outsourced billing services through SMART Health Claims or EmpowerMax Billing provide you with all the benefits of our technology while we do most of the work to increase your funds. Designed for behavioral and mental health, EmpowerMax Billing enables your organization to eliminate common issues with in-house billing, like key personnel absence or loss, under- or over-staffing, disorganization in the department, and inadequate billing supervision. EmpowerMax Billing provides a team of billing experts to handle medical claims billing, cash application, corrections, and follow up for you. -
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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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Claude for Healthcare
Anthropic
Claude for Healthcare is a HIPAA-ready AI platform built on Anthropic’s advanced Claude models that helps healthcare organizations move faster without sacrificing safety, accuracy, or compliance by connecting to trusted medical, payer, and clinical data sources. It enables use cases such as prior authorization review, insurance claims appeals, clinical documentation generation, patient message triage, care coordination, and other administrative workflows by validating provider credentials, medical codes, coverage requirements, and drafting recommendations or summaries with traceable sources for verification. Claude can integrate with industry standards and databases, including CMS coverage policies, ICD-10 codes, provider registries, and PubMed, and supports secure connection to personal health records (e.g., lab results and medical histories) with user consent so patients or clinicians can get plain-language summaries and insights.Starting Price: $17 per 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. -
41
Stride EMR
Stride EMR
Stride EMR is an AI-powered outpatient rehab platform built to help physical therapy, occupational therapy, and speech therapy practices run clinical and business operations on a single system. It combines a modern electronic medical record with Patient Relationship Management and revenue cycle management billing so clinics can automate documentation, scheduling, patient intake, insurance verification, claims submission, and follow-up without switching between tools. Stride’s AI significantly accelerates clinical workflows by auto-populating notes, reducing clicks and typing, ensuring medical necessity documentation is compliant, suggesting treatment goals, and minimizing claim denials through payer-rule-aware coding. The PRM suite includes intelligent online scheduling, waitlist management, automated reminders, two-way text messaging, reputation and review growth tools, and patient engagement campaigns to keep schedules full and improve retention. -
42
F1RSTAnesthesia
Anesthesia Business Consultants
F1RSTAnesthesia is the Oracle-based proprietary software platform that best distinguishes our unique approach to accounts receivable management. As the culmination of more than 40 years of experience in anesthesia billing services and practice management, F1RSTAnesthesia is designed to allow ABC staff to interface with providers, patients and their insurance plans real-time thereby ensuring that client practices are optimally and accurately paid for the valuable services they provide. Unlimited capability to enhance the retrieval of the documentation received for the most accurate coding possible. Features and functionality anticipate the complex triage of medical billing, including the monitoring of payment accuracy and compliance with governmental and payer guidelines. Web portal applications give clients access to the details of their practice and the ability to drill down on practice trends in the comfort and convenience of their own home. -
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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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Medinous
Medinous
Medinous is a fully integrated web enabled Hospital Management System for large & mid-size hospitals and clinics, specially crafted for streamlined operations, superior patient care, enhanced administration & control and improved profitability. Our goal is to completely automate and integrate your Hospital’s entire process flow covering Clinical areas, Support functions, Finance, Supply Chain, Administrative and Billing functions. For ease of use, we facilitate quick integrations with PACS, Lab/Medical equipment, Drug databases and Payer connections. -
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Dastify Solutions
Dastify Solutions
Dastify Solutions is a U.S.-based, AI-powered medical billing company trusted by 1,000+ healthcare providers nationwide. They specialize in high-accuracy RCM, leveraging advanced AI and a team of 500+ AAPC/AHIMA-certified coders to reduce errors by up to 99%. They offer end-to-end services, including coding, AR recovery, credentialing, and denial management, customised for 75+ specialities on a flexible pay-for-paid model. Their platform integrates seamlessly with 600+ EHR / EMR systems.Starting Price: $50 -
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E-COMB
KBTS Technologies
EDI Compatible Medical Billing (E-COMB) is a web based solution for generating medical claims complying with the HIPAA transaction and code set standards, regulated by the US Government following the recommendations of American National Standards Institute (ANSI). The application is designed to generate, submit and reconcile the claims to the insurance carriers, guarantors and/or patients. This is one of the most important tools for doctors in realizing their revenue by reducing the turnaround time in the claims reimbursement. All the information related to environment of the Doctor’s Office/Hospital is grouped together as Master Data. This information is frequently used for claims processing and is less likely to change quite often. Master Data contains details of the Procedures, Diagnoses, Doctors, Payers, and Billing Providers etc. This data is created as part of the initial set up and can be updated easily at any time. -
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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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FQHC RCM Management Services
Visualutions
Revenue Cycle Management. With staffing costs and overhead constantly on the rise organizations need an experienced revenue cycle partner who can not only navigate complex billing requirements, but who produces a sizable return on their investment. Our fully-managed CHC billing management services take the guesswork out of getting paid. Our experience staff deals exclusively with CHC billing so we know what it takes to keep the money flowing in your direction. Services. Revenue Cycle Services. Our team of highly trained staff members leverage many years of CHC revenue cycle management experience to accurately prepare. A Visualutions RCM Health Check includes a rich visual representation of your revenue cycle including a multi-year Transaction Analysis, multi-year payer mix review, A/R trends, E/M coding analysis, and more. An efficient RCM workflow and a sound set of policies ensures smooth, reliable billing processes and a higher rate of collection on services rendered. -
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Conexia
Conexia
Provide authorizations, claims processing and payment in real-time at the point of care. Enhance care coordination and improved outcomes to lower medical cost while streamlining administrative processes. Engage providers at the point of care to capture and share data in real-time resulting in an unparalleled exchange of health information. We partner with our clients to implement risk management strategies that result in better outcomes with lower costs. We strive to improve the user experience for everyone involved in the ecosystem. We deliver a minimum 3:1 ROI for our clients to allow them to optimize their resources. Conexia has developed a core technology platform (ONE) that is customizable to meet the diverse regulatory requirements and operational processes for each client in each geography. In most cases, our initial implementation is an overlay on the payer’s existing technology ecosystem to create real-time processes. -
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AGS Computer-Assisted Coding
AGS Health
AGS Health's Computer-Assisted Coding (CAC) software helps hospitals and physicians simplify the ICD-10, CPT, HCPCS, and E/M coding process; increases your coder productivity while cutting denials, missed charges, and low-risk scores. Computer-Assisted Coding also known as medical coding software helps to boost productivity and make critical decisions faster while reducing denials, missed charges, and low-risk scores. The AGS Computer-Assisted Coding (CAC) module enables flexible and scalable coding of professional and facility operations to increase accuracy, productivity, and flexibility. Features:- - NLP-Based ICD-10-CM, PCS, CPT, and E&M Code Automation: Leverages NLP to automatically suggest billable codes from different types of clinical documents. - One-Click Coder Validation & Acceptance: Automatically identify charts that have potential queries for seamless validation and acceptance. - Always Up to Date: Our Clinical NLP engine is always learning and improving base.
