Alternatives to Encipher Health
Compare Encipher Health alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to Encipher Health in 2026. Compare features, ratings, user reviews, pricing, and more from Encipher Health competitors and alternatives in order to make an informed decision for your business.
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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. -
2
Healthicity Audit Manager
Healthicity
For medical auditing, Audit Manager streamlines the way you manage audits by merging audit workflow, management, education, and reporting into one easy-to-use, web-based solution. Audit Manager brings simplicity by helping you: Identify Revenue Evaluate financial impact. Minimize denials and identify up to 10%, per provider, in missed revenue with extensive reporting and analytics tools. Increase Efficiency Improve your auditing efficiency by up to 40%. Reduce the amount of time you spend completing audits with our user-friendly interface. Improve Accuracy Customize your audit templates. Include your own standards, MAC carrier guidelines, and claim scrubber tech for ideal results. Audit Manager features: Built-in Tableau integration for in-depth analytics and reporting. Flexible Audit Management: View the status, and each associated status, of every audit, by any auditor. E/M Calculator Automatically calculate E/M codes with a built-in calculator.Starting Price: $670/mo for 3 users -
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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. -
4
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. -
5
Arintra
Arintra
Arintra is a GenAI-native autonomous medical coding platform that uses advanced artificial intelligence, deep learning, natural language processing, and clinical large language models to process entire patient charts and instantly generate precise billing codes, including E/M levels, CPT, ICD-10, HCC, HCPCS with correct modifiers and units, without human intervention, helping providers capture revenue more accurately and efficiently while reducing manual coding workloads and bottlenecks. It integrates bi-directionally and seamlessly with major electronic health record systems such as Epic and Athena, so coding happens within existing workflows with zero IT lift or workflow disruption. Arintra provides a detailed, explainable audit trail for every coding decision to improve compliance, reduce risk, and support clinical documentation improvement, and it includes a powerful analytics dashboard to track coding volume, accuracy, turnaround times, and trends. -
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RapidClaims
RapidClaims
Reduce administrative costs and improve reimbursements, all while maintaining compliance. Supercharge your RCM process with RapidClaims AI-driven magic. Slash admin costs, boost reimbursements, and stay compliant effortlessly. Streamline your coding process, and automate or empower your coders with our personalized solutions. Code thousands of charts with speed and precision while catering to unique client requirements. Our Large language model can interpret unstructured data, creating a longitudinal patient record by converting notes into structured codes and disease patterns. Never make the same mistakes twice. Create mass-level coding-related rules with plain English and easily apply them to your charts at scale, segregated by specialty, code type, and coders. Gain a deeper understanding of code-level trends for different sites and take action to improve the revenue cycle. Our platform analyzes charts to identify claim denial patterns and helps you capture them. -
7
Context 4 Health Plans Suite
Context4 Healthcare
Protect the integrity of your health plan and determine accurate pricing with the Context4 Health Plans Suite, our modular, cloud‑based technology platform. Immediate, actionable, and defensible Fraud, Waste, and Abuse (FWA) detection built by our team of certified clinical, dental, and health benefits experts. Accurate data and cutting-edge cloud technology combine to create a proven and defensible medicare reference-based pricing (RBP) solution. More than 100 healthcare data sets, with professional support to optimize efficiency and compliance. Advanced medical coding software designed to expedite claim submission and minimize denials. Our cloud based Payment Integrity Platform utilizes our proprietary analytics engine to identify coding errors, medical necessity, unbundling, fraud-waste-abuse, audit risks, pricing and other aberrations that can impact your business. -
8
HCC Coding Engine
Aptarro
Aptarro’s HCC Coding Engine is an AI‑powered solution that integrates seamlessly with electronic medical records and practice management systems to scan every patient encounter in real time, automatically identifying and closing coding gaps to ensure all Hierarchical Condition Category (HCC) diagnoses are accurately captured for optimal risk adjustment and revenue. By applying industry‑proven rules and machine learning models, it prioritizes high‑value encounters for coder review, boosts productivity up to 300% per coder without adding provider workload, and reduces denials through real‑time validation and compliance updates. With exception‑based workflows, clear dashboards for RAF score trends, built‑in audit trails and logging, and fast implementation within existing workflows, organizations see immediate ROI in their first billing cycle and unlock millions in missed revenue while maintaining clinical focus and documentation integrity. -
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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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Fathom
Fathom Health
Fathom is an autonomous medical-coding platform powered by deep learning and natural-language processing that enables health systems to code patient encounters at scale with enterprise-grade speed, accuracy, and security. It supports fully automated production coding, processing millions of charts per day, with no human intervention required; handles backlog processing to accommodate staffing fluctuations or seasonal surges; and offers real-time auditing to review and flag coding for quality assurance. It is integrated with major EHRs and has achieved industry certifications (including HITRUST i1) to protect PHI and support compliance. It delivers measurable value by reducing total coding operations cost by up to 50 percent, cutting turnaround time by days rather than hours or minutes, and achieving automation rates above 90 percent for complete encounters, thereby increasing revenue capture, lowering denials, and enabling health systems to redeploy coding staff. -
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ARIA Coding Services
CompuGroup Medical US
ARIA Coding Services is designed to assist healthcare providers in navigating the complexities of medical coding, ensuring accurate documentation and timely reimbursements. The service offers three customizable levels to meet varying practice needs. Experts conduct monthly reviews of coding denials and rejections, providing recommendations to improve standard operating procedures and offering optional baseline evaluations of Evaluation and Management (E&M) documentation. Specialists review documentation to confirm coding accuracy, examining superbills, invoices, claims, E&M visits, surgeries, procedures, tests, modifiers, and ICD-10 usage. They deliver regular reports and address discrepancies to enhance coding procedures. A comprehensive service where specialists handle coding directly from provided documentation, ensuring proper entry of charges, thorough documentation in patient notes, and correction of coding rejections or denials as needed. -
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MedSuite
Abeo Management
abeo’s MedSuite software is the most widely used anesthesia billing solution in the nation. Purpose-built with an unparalleled understanding of the unique complexities of anesthesia billing, MedSuite helps both practices and billing services protect rightful reimbursement. Fully optimized for anesthesia, MedSuite’s cloud-based platform supports integrated workflows that make the most of vital coding and billing staff resources. As their needs evolve, so does MedSuite. The reason is simple: MedSuite isn’t just a system we sell, it’s also the system we use every day to code and bill for our own anesthesia practice clients. MedSuite is the only software solution that allows you to cross-reference the surgery schedule against billing to be certain you bill and collect for every one of your cases. Because it’s built from the ground up for anesthesia, MedSuite’s anesthesia specific database offers clear views into valuable metrics through robust, flexible reporting. -
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Charta
Charta
Charta Health offers an AI-powered platform that automates chart review by analyzing every medical chart (pre-bill, pre-visit, or post-bill) to capture missed revenue opportunities, ensure coding accuracy, and support payer-compliance needs. Its proprietary AI engine reviews 100% of patient charts, surfacing under-coding, missed billable services, coding errors, and documentation gaps, with evidence-based justifications and dashboards for auditing and tracking. For revenue integrity, the platform can increase RVUs per patient by up to 15.2% and average revenue uplift of 11%, while enabling full audit coverage at one hundred percent for a fraction of the typical audit cost. It also addresses clinical-quality workflows by validating documentation against standards such as HEDIS/STARS, integrating with clinical-decision support tools, and generating provider feedback loops, which help improve patient outcomes and reimbursement tied to quality. -
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Clarus RCM
Clarus
Transform your revenue cycle with Clarus RCM. Clarus RCM specializes in risk adjustment coding solutions namely retrospective & prospective HCC coding, commercial risk adjustment coding, HEDIS abstraction, RADV audits, chart review & data validation, and revenue cycle management services. Our certified coders guarantee 95%+ accuracy & faster turn around time. Clarus RCM Inc provides comprehensive revenue cycle management (RCM) services through a robust, innovative technology suite. By integrating RCM services with healthcare consulting services, Clarus RCM can help hospitals and physicians increase their existing revenue stream, uncover new payment opportunities and elevate RCM performance. Clarus is certified with ISO/IEC 27001:2013 industry laurels. Our operations are 100% HIPAA and ISMS (information security management system) compliant. We have been assessed by UL-DQS (American accreditation) to deliver the highest quality of healthcare services. -
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EncoderPro.com
Optum
EncoderPro Spotlight by OptumCoding is a web-based medical coding reference application designed to help ambulatory coding, billing, and reimbursement professionals manage critical coding tasks with accurate, real-time access to CPT, HCPCS Level II, ICD-10-CM/PCS, and ICD-9-CM code sets and associated regulatory guidance; the software includes powerful search and reference capabilities that combine thousands of procedure, service, supply, and diagnosis codes with descriptive and cross-coding information so users can find the right codes quickly and reduce errors in claim submission. It provides proprietary content and tools that go beyond basic code lists to include deeper insights into regulatory compliance topics such as National Correct Coding Initiative (NCCI) edits, Hierarchical Condition Categories (HCCs), and coverage determination policies, automated edit review options for proper unbundling and modifier use, and a historical content database for adjudication reference. -
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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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RevCycle Engine
Aptarro
RevCycle Engine applies built‑in, customizable rules and AI‑powered automation to correct coding and charge errors at the source, ensuring billing data is accurate before claims are submitted. By integrating seamlessly with EMRs and practice management systems, it ingests claims data in real time, applies industry‑proven rules tailored to each organization’s needs, and fixes errors automatically, reducing preventable denials and costly rework. Streamlined workflows prioritize and route only complex or exception claims for human review, boosting team efficiency and reducing burnout. With AI‑driven charge accuracy, the platform increases clean claim rates, lowers cost‑to‑collect, and stabilizes cash flow, all visible through clear dashboards and real‑time insights. Scalable automation handles high claim volumes without overtime or late‑night efforts, while features such as charge accuracy validation, denial prevention, coding review optimization, payment collection support, and more. -
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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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Semantic Health
Semantic Health
Next-generation medical coding & auditing with AI. Streamline your manual inpatient coding and auditing processes, improve coding and documentation quality, and unlock your team to focus on high-value work. Semantic Health drives improvement at leading hospitals. Semantic Health uses custom clinical AI and NLP algorithms, trained on millions of records by our world-class AI team, to parse through clinical and coded data which allows our coding and auditing engines to better understand nuanced clinical context, incorporate changing coding guidelines and rules, and suggest high-quality coding and auditing opportunities with clear evidence back to the clinical documentation. Save time and optimize your revenue cycle by adding AI to labor-intensive medical coding and auditing processes. Semantic Health offers hospitals and health systems a supercharged inpatient auditing platform for a 100% pre-bill review of claims data. -
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Healthicity
Healthicity
Healthicity provides user-friendly, web-based compliance and auditing solutions that simplify the complexities of healthcare operations. Its platform integrates workflow management, training, reporting, and program administration into a single, easy-to-use system. Compliance Manager offers customizable workspaces and real-time insights to streamline risk assessments, investigations, policy management, and employee education. Auditing solutions support organizations in conducting structured, accurate audits that enhance visibility and reduce administrative burden. By centralizing data and automating routine processes, Healthicity empowers healthcare teams to focus more on patient outcomes and less on regulatory complexity. Trusted by organizations nationwide, the platform helps ensure programs remain effective, compliant, and audit-ready. -
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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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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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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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Kovo RCM
Kovo RCM
Kovo RCM is a revenue cycle management and medical billing service platform that helps healthcare providers streamline billing processes, optimize reimbursements, and reduce administrative burden so clinicians can focus more on patient care. It delivers end-to-end RCM services that include insurance eligibility verification, claims submission and tracking, denial management and appeals, coding support, credentialing, patient billing and collections, and custom reporting and analytics to provide clear financial insights and improve cash flow. Kovo RCM supports a wide range of medical specialties, including cardiology, anesthesiology, radiology, mental and behavioral health, internal medicine, surgery, EMS and ambulance services, wound care, and more, offering tailored billing expertise for the unique coding and reimbursement challenges each field faces. -
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PowerMed Billing
PowerMed
PowerMed Billing has been built from the ground up to be state-of-the-art. With its powerful feature set, numerous reporting options and electronic claims processing, it will meet the needs of any busy practice. The software can be configured to each individual user's style, including screen appearance, custom navigation commands, and even individual language settings. It contains a full ICD coding library, customizable CPT, HCPCS, super codes, and enterprise-level patient demographics. Because Billing and EMR are essentially one program, all coded visits and claims are automatically pulled for electronic processing or for standard UB92 or CMS1500 printing. Complete with full search and reporting capabilities, practice managers have immediate access to an extensive library of predefined productivity and financial reports broken down by providers, payors and individual patients. -
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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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CodaMetrix
CodaMetrix
Physicians didn’t go to medical school to learn how to code. We are reimagining the future of the revenue cycle with AI-powered autonomous coding. The company’s platform is in use at more than a dozen premier provider organizations and health systems, representing over 200 hospitals, and 50K providers. CodaMetrix’s platform is a multi-specialty coding AI platform that translates clinical information into accurate sets of medical codes for patient care and revenue cycle processes, from fee-for-service to value-based care models. The automation is touchless, transparent, and completely traceable. CodaMetrix's cutting-edge, multi-specialty autonomous medical coding platform leverages AI to continuously learn from and act upon the clinical evidence in the EHR. We autonomously translate clinical notes into billing codes that satisfy coding requirements, ensuring claims consistently represent the unique and complete episode of care, reducing human coding workload. -
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ZOLL Billing
ZOLL Data Systems
Progressive revenue cycle management is, in many ways, the backbone of a thriving medical services operation. Controlling costs, increasing productivity, and accelerating reimbursements are essential activities that keep EMS agencies rolling. Yet efficiently progressing a claim through its lifecycle has traditionally been labor-intensive and prone to delays caused by documentation and coding inaccuracies. ZOLL® Billing is a cloud-based solution that enables revenue cycle professionals to turbo-charge billing performance and deliver more revenue. By automating workflows and eliminating billing errors, ZOLL Billing helps you process more claims with fewer resources and address compliance risk at the same time. Increase productivity and revenue with automated workflows that enable you to process more claims. -
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Flash Code
Flash Code Solutions
Flash Code™ is a coding product designed for the healthcare community. Our goal is to provide exceptional, simple to use, cost-effective software which is provided with unsurpassed customer service. We are a division of Practice Management Information Corporation - the leading independent publisher of coding books. Our team can provide a complete solution to meet your coding and compliance needs via our software and print products. Thanks for taking a few moments of your valuable time to explore what Flash Code can do for you. The merger creates an opportunity for MCCS to provide sophisticated electronic coding and compliance solutions to the health care industry. From the physician checking for medical necessity codes at the point of care, to the insurance manager validating diagnosis codes, or the benefits analyst reviewing health insurance claims for correct coding initiative compliance, MCCS provides a solution to facilitate the process. -
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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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Instant Chart
Instant Health Care
Instant Health Care provides online medical billing services for practitioners in multiple specialties across the country. Our software displays outstanding user-friendliness, and an intuitive workflow, showing a deep understanding of the needs of the users. We submit claims to the insurance companies electronically and process claims within 24 hours of receipt. We provide services that include accounts receivable management, medical coding review and assistance, and physician credentialing services. This unique platform empowers you and your patients to securely gather, manage, share and store health information, irrespective of time and/or geographical barriers. IHC’s personal health record provides more than just simple health history. Instant Health Care patient appointments software is a powerful and easy-to-use appointment scheduler. Designed to allow staff to manage schedules efficiency and effectively with using color-coded calendar. -
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Medipyxis
Medipyxis
Medipyxis is a mobile-first wound care operating system that replaces seven disconnected tools with one unified, secure platform purpose-built for mobile wound care clinics, home health providers, and visiting specialists, consolidating referral intake and AI-powered patient assignment, scheduling and route optimization, wound-specific EHR with built-in Medicare LCD compliance checks, inventory and graft ERP, business-development CRM with ROI tracking, billing and coding prep automation, and executive dashboards into a single workflow. It captures and verifies referral data (including fax/OCR) and schedules visits in minutes, supports offline charting that syncs automatically, tracks credentials and policy compliance with automated alerts, predicts inventory needs, and generates audit-ready documentation, all while cutting charting time, reducing denial rates, and improving revenue. -
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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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CluePoints
CluePoints
CluePoints is a cloud-based AI-driven risk-based quality management and clinical data oversight platform that leverages advanced statistics, machine learning, and deep learning to improve the integrity, accuracy, and safety of clinical trial data and processes; it provides real-time anomaly detection and centralized statistical monitoring that identifies outliers and data risks traditional methods might miss, enabling teams to manage risks proactively and accelerate issue resolution in line with FDA, EMA, and ICH guidelines. It includes specialized solutions such as Risk-Based Quality Management (RBQM) for real-time risk detection, Medical & Safety Review (MSR) for consolidated review and query workflows, Intelligent Medical Coding to automate consistent clinical coding suggestions, Intelligent Query Detection (IQD) to streamline discrepancy detection, and tools like the Site Profile & Oversight Tool (SPOT) for adaptive site monitoring. -
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Artsyl ClaimAction
Artsyl Technologies
Processing high volumes of medical claims through intelligent automation helps businesses deliver higher levels of efficiency that does more than reduce costs. For organizations that rely on manual processes, managing medical claims documents and data is labor-intensive and error-prone, injecting unnecessary risk into the process. With ClaimAction medical claims processing software from Artsyl, your organization can improve margins, minimize touch points and eliminate processing bottlenecks. Capture medical claims data without the need for custom software coding. Route claims data and documents automatically to the right claim examiner, based on your business rules. Configure complex benefits and reimbursement rules to streamline processing and reduce payment delays. Respond quickly to changing government regulations and support data, document and process compliance. -
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EZDI
EZDI, an AGS Health Company
EZDI is Acquired by AGS Health Company. We enable businesses of all sizes, from startups to large enterprises to use our revenue cycle management platform and APIs to bring insights out of their healthcare data. An integrated clinical documentation and medical coding platform. Fully integrated platform that gives you the ability to increase documentation and coding specialist productivity upto 45%, while growing revenue from improved case mix and risk scoring. Easy-to-use, modern clinical APIs that integrate seamlessly into your infrastructure. Trained on more than 7 million real clinical documents to provide cutting-edge accuracy. We leverage millions of knowledge graph records, deep learning, and machine learning to provide clear code and query suggestions. We’re prepared to lead the next wave of AI in healthcare. Built for coders and documentation specialists to work smarter and faster from day one.Starting Price: $0.15 per patient -
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P3care Medical Billing Software
P3 Healthcare Solutions
Medical billing software prices vary from company to company. As a HIPAA medical billing company, we use software that is compliant and free from bugs. Not every source code meets the requirement of medical billing and coding. Therefore, we use the one that is authentic and has faced the test of time. Medical billing software is provider-friendly, and, virtually assists with billing problems. It is designed to handle calculations of reimbursement, financial data, and revenue cycle management to an advanced level of certainty. Medical billing software has the ability to track every part of the medical billing workflow, from making appointments to processing reimbursements. The following functions define its role in essence. -
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ClinicMind
ClinicMind
A more efficient, more profitable practice is possible with ClinicMind. If you are spending too much time and energy managing small issues and not enough time on what matters for your practice, you’re not alone. It’s what we hear most from practitioners who are still struggling with inefficient software or laboring through manual processes. We’ve built our EHR software and RCM solutions based on industry best practices and real-world solutions to clinical challenges. Our teams of coding, billing, and medical compliance analysts have 20 years of experience, and we’ve served 16,000 users and counting. ClinicMind solutions work for any specialty or integrated practice, including chiropractic and mental health practices. Our software development and industry expertise is broad and flexible enough to understand and resolve the unique operational challenges in each specialty area. -
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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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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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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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DentalWriter
Nierman Practice Management
Be up and running instantly with an easy web-based EMR for dental sleep medicine, TMD, & oral surgery that gets your ducks in a row for each and every patient. DentalWriter builds your case of medical necessity with individualized SOAP reports, your golden ticket for medical reimbursement and physician referrals. DentalWriter intelligently cross-codes from dental to medical for easy and accurate medical billing. Your integrated billing service concierge will handle the rest. DentalWriter Plus+ utilizes the intake and exam data to cross-code from dental to medical and generate individualized SOAP reports of medical necessity needed for medical reimbursement and physician communication. Maximize productivity while marketing your dental sleep and TMD practice all with the click of a button. -
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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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PulsePro Practice Management
Pulse Systems
PulsePro practice management system applies automated workflow logic to join financial, clinical and administrative processes into one package. PulsePro is easy to use and implement, offering advanced scheduling, patient registration, medical billing, coding and claims processing. And because implementation is quick and PulsePro is so easy to learn, your team will be up and running in hours — not days or weeks — performing daily tasks using an industry leading practice management system. Pulse is a leading EHR/PM Company that is a part of the Amazing Charts and Harris Healthcare family. We have a long history supporting medical practices with technology and value-added services. -
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Easy Coder
Alpha II
Easy Coder includes efficient procedure and diagnosis code search, encounter editing, and compliance tools all in one easy-to-use program. The solution leverages its web-based platform to provide real-time updates to content, rule changes, and policies, with no need to install the software. Verifies medical necessity. Saves coding time. Combines all aspects of coding. Allows for corrections early in the revenue cycle workflow. For almost 15 years, our medical billing service has been a daily user of Alpha II’s EasyCoder. It has proved to be an invaluable tool, providing my staff with quick access to current, comprehensive, and reliable coding resources. The E&M Generate, the policy reviewer, supporting diagnoses lists, and access to the Medicare fee schedules by locality have developed our staff’s knowledge and confidence as we strive to serve our clients as a trusted resource.Starting Price: $84 one-time payment -
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PerioVision
Henry Schein One
PerioVision is a unique practice management solution for unique practices. Built for the surgical periodontist, it includes the exact tools and detailed reporting you need to provide excellent care and increase your profits. Based on user input and technical innovations, PerioVision is continuously improving. Its comprehensive patient records, customizable charting, and flexible platform allowing you to practice your way, flawlessly. PerioVision can help you reduce the paper in your practice. Its flexible architecture lets you choose from a number of technologies to create an office that works for you. Its comprehensive reports help you track and improve referrals, production, collections, and more. PerioVision allows your practice to go digital. Medical and dental electronic health records (EHR) are both embedded in one system. You can easily cross-code, using medical codes and dental codes as needed for billing, insurance claims, and record-keeping. -
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Elixir EHR
Mirketa Inc.
Elixir is an end-to-end patient care management solution. It simplifies healthcare operations, streamlines patient record management, and enhances the overall patient care. The Elixir Suite of Products offers four integrated modules: - Electronic Health Record (EHR) - Contact Center - Billing - Patient Portal Elixir offers key benefits, including: - Automated sales processes, from lead to patient. - Proactive reservation management with real time view of all facilities - Error-free e-prescriptions via Surescripts integration. - Streamlined medical coding. - Efficient appointment management. - Simplified medical billing Empower your healthcare facility through efficiency, compliance, and patient-centered care with Elixir!Starting Price: $50/user/month -
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ediLive!
Texas Medical Systems
ediLive! claims processing software works with any NSF, ANSI, or print file claim image, allowing the HIPAA complaint transmittal of any practice management software's claim file. Additionally, ediLive! customers benefit from real-time connectivity and claim collections workflow management. ediLive! attaches all claim status messaging from payers directly back to the claim for easy follow-up and correction, taking all incomplete claims and compiling them into a single on-screen worksheet for fast corrections and resubmittal. If you use ediLive!, we have a wonderful product call claims scrubber that can help you to get your claims paid – not only faster, but better! Call our office to schedule a free on-line demonstration. We can scrub the first 100 claims for you as a free trial. Every coding error you make costs your practice money. -
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P1 Billing LLC
P1 Billing
P1 Billing is one of most innovative medical billing companies in America. We provide Medical Billing, EHR, Transcription and Bookkeeping services to a variety of specialties, including: Internal Medicine, Emergency Medicine, Vascular, OBGYN, High risk OBGYN, Allergy Specialists, Pediatrics, Orthopedics, and more. We aim to maximize your revenue by collecting all that is due your practice, while minimizing your billing headaches and allowing you to concentrate on taking care of patients. We use the most up to date reimbursement strategies available and continuously update our procedures in order to obtain for you, the physician, the greatest legally attainable reimbursement rates. At P1, we identify the issues and make sure the carriers understand their problem, to insure you receive the maximum legal reimbursement you deserve. You and your staff spend time better suited to treating patients examining charts, reviewing contracts, analyzing coding to fight denials -
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Brellium
Brellium
Brellium is an AI-powered clinical compliance platform designed to audit clinical documentation, billing, and payor risk across every patient visit. Its core capabilities include real-time chart review using machine learning to check every note, session, and encounter for coding compliance (MDM/E/M/ICD-10), clinical quality standards, payor rules, and documentation integrity, delivering audits up to 13x faster and reducing chart-review costs by approximately 98%. Brellium integrates with any EMR, supports custom and prebuilt audit criteria, sends automatic provider-feedback emails, and provides trend-data dashboards that stack-rank clinicians based on documentation quality. It also offers a unique clawback-protection guarantee: if a payor retracts reimbursement on a Brellium-approved chart, Brellium will cover the cost. The platform serves specialties such as behavioral health, ABA, home health, chronic-care management, and telehealth.
