AI RCM

The AI RCM (Revenue Cycle Management)category focuses on using artificial intelligence to streamline financial and administrative processes in healthcare. These tools optimize critical aspects of the revenue cycle, reducing manual workloads, improving accuracy, and accelerating cash flow. AI Medical Codingsolutions ensure the accurate assignment of billing codes, minimizing errors and enhancing compliance. AI Prior Authorization for Payersand AI Prior Authorization for Providersautomate the approval process, reducing delays in care and administrative burdens. AI Clinical Documentation Integrity (CDI)ensures that documentation accurately reflects patient care, improving coding precision and supporting reimbursement.

AI Denials Managementidentifies, tracks, and resolves claim denials, helping healthcare organizations recover revenue efficiently. Revenue Cycle Automationleverages AI to automate repetitive tasks across the RCM workflow, enhancing productivity and reducing bottlenecks. Finally, AI Patient Billingsolutions improve the patient financial experience with automated payment plans, reminders, and personalized payment options, fostering better patient engagement and reducing bad debt. Together, these AI-driven solutions transform revenue cycle operations, enabling healthcare organizations to operate more efficiently and focus more on patient care.

Market Map
95 Results
Sort
Filter
Customers Served
Headcount
Security Certifications
Want to see a product listed?
Ambience Healthcare logo
Ambience Healthcare
Claimed

Ambience Healthcare

Company Info
Founded: 2020
Headcount: 11-50
Customers
Verified Customers: 12
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
4 Reviews
Security and Compliance Certifications: HIPAA
Ambience Healthcare offers a suite of AI-driven tools designed to enhance clinical documentation and workflow. AutoScribe serves as an AI medical scribe that generates comprehensive documentation during patient visits across various specialties. Other tools include AutoCDI for real-time coding and compliance, AutoAVS for sending patients personalized after-visit summaries to reduce in-basket messages, and AutoRefer for managing specialist referrals. These solutions integrate with existing EHR systems and support multi-lingual environments and complex workflows.
Candid Health logo
Candid Health
Claimed

Candid Health

Company Info
Founded: 2019
Headcount: 11-50
Customers
Verified Customers: 21
Customers Served: Digital Health Provider, Ambulatory Practice
Product Overview
4 Reviews
Security and Compliance Certifications: HIPAA
Candid Health is an end-to-end revenue cycle management platform. It enables claims submission, detects and resolves billing issues, integrates with existing healthcare infrastructure via API, and provides real-time analytics for tracking and improving financial performance.
Adonis Intelligence logo
Adonis
Claimed

Adonis Intelligence

Company Info
Founded: 2022
Headcount: 51-200
Customers
Verified Customers: 6
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Adonis Intelligence provides actionable alerts, predictive analytics, and real-time reports to optimize revenue outcomes. The system integrates with EHR, billing, and practice management systems to enhance insights on collections, accounts receivable, claim denials, and payer performance. The platform helps healthcare organizations identify revenue roadblocks, prevent denials with real-time alerts, and improve cash flow with smart prioritization and comprehensive KPI tracking.
Company Info
Founded: 2018
Headcount: 201-500
Customers
Verified Customers: 4
Customers Served: Hospital / Health System
Product Overview
Security and Compliance Certifications: HITRUST CSF, SOC 2 Type 2, HIPAA
AKASA Authorization Advisor is an AI-enabled prior authorization tool for streamlining the submission, tracking, and follow-up of medical authorization requests for procedures. It is integrated with Epic and Cerner, and focuses on health system-specific use cases.
Company Info
Founded: 2022
Headcount: 11-50
Customers
Customers Served: Digital Health Provider, Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
AutonomizeAI's Prior Auth Copilot extracts and summarizes member authorization requests, links clinical data to internal sources, and assesses compliance with clinical guidelines. It generates decision summaries that help reduce administrative burdens and speed up approvals.
Banjo Health logo
Banjo Health
Claimed

Banjo Health

Company Info
Founded: 2019
Headcount: 11-50
Customers
Verified Customers: 4
Customers Served: Health Plan, Pharmacy Benefit Managers
Product Overview
Security and Compliance Certifications: HITRUST CSF, HIPAA
Banjo Health streamlines the prior authorization process for health plans and pharmacy benefit managers. BanjoPA is their prior authorization platform for health plans that consolidates prior authorization requests, provides decision recommendation based on predefined clinical decisions trees, and creates documentation to support appeal processes. Banjo Composer takes clinical criteria as inputs and creates clinical decision trees by automatically identifying decisions points and delivering in a platform that supports editing and testing.
CloudCruise logo
CloudCruise
Claimed

CloudCruise

Company Info
Founded: 2024
Headcount: 1-10
Customers
Customers Served: Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
CloudCruise offers an automation platform that creates APIs for automating healthcare tasks typically done through a user interface, such as filling out forms, data extraction, and document downloads. CloudCruise leverages AI to maintain and monitor workflows, providing automatic error correction and alerting. It supports deployment on virtual machines or local environments.
Cofactor logo
Cofactor
Claimed

Cofactor

Company Info
Founded: 2023
Headcount: 1-10
Customers
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Cofactor AI Denials Suite is an AI-driven platform designed to automate the insurance denial appeal process for healthcare providers, especially for retroactive denials and audits. The system integrates with the EHR to extract relevant data and generate appeal letters tailored to each case, significantly reducing the time and manual effort required for denial management. By leveraging AI to analyze clinical notes, legal requirements, and past appeal outcomes, Cofactor AI helps hospitals and clinics improve their revenue cycle by recovering payments.
Fathom logo
Fathom
Claimed

Fathom

Company Info
Founded: 2016
Headcount: 51-200
Customers
Verified Customers: 12
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System, Health Plan
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Fathom is an autonomous medical coding platform that uses deep learning and LLMs to provide accurate, complete coding for ED, radiology, primary care, surgery, hospitalist, and other high-volume specialties. Fathom provides automated coding that submits directly to billing, and for any charts that cannot be fully processed, they are routed to a manual coding team. Similarly, Fathom can be set up to audit in-house coders, finding potential denials or inaccurate coding.
Infinitus logo
Infinitus Systems, Inc.
Claimed

Infinitus

Company Info
Founded: 2019
Headcount: 51-200
Customers
Verified Customers: 2
Customers Served: Ambulatory Practice, Hospital / Health System, Health Plan, Life Sciences
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Infinitus provides an AI-driven platform designed to automate complex healthcare communications, particularly those traditionally conducted via manual phone calls. Their solutions include AI agents and copilots that handle tasks such as benefit verification, prior authorization, and prescription follow-ups by interacting directly with payors and pharmacy benefit managers (PBMs). This automation aims to reduce administrative burdens, enhance data accuracy, and expedite patient access to care.
Luminai logo
Luminai
Claimed

Luminai

Company Info
Founded: 2020
Headcount: 11-50
Customers
Verified Customers: 7
Customers Served: Ambulatory Practice, Hospital / Health System, Health Plan, Digital Health Provider, Employers
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, SOC 2 Type 1, HIPAA
Luminai is a healthcare automation platform for RCM and Clinical Operations that uses a trained language to task execution ML model that can read documentation and execute tasks with a keyboard and mouse. Luminai's technology converts standard operating procedures into executable actions, handling complex logic without PHI leaving the system. Key RCM applications include registration, eligibility, coverage discovery, prior authorization, billing edits, and denials management. Additionally, it incorporates an LLM-oriented "Think" function to infer and summarize data, making clinical operation recommendations, such as processing lab reviews and suggesting next steps based on pre-programmed logic.
MarianaAI logo
MarianaAI
Claimed

MarianaAI

Company Info
Founded: 2023
Headcount: 11-50
Customers
Customers Served: Digital Health Provider, Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: SOC 2 Type 1, HIPAA
MarianaAI's CARE platform automates clinical workflows with AI tools like the AI Medical Scribe, which transcribes multi-lingual medical encounters in real-time and generates clinical notes and codes. The platform also creates detailed Patient Portraits, summarizes patient histories to improve care and optimize HCC/RAF scores, and automates medical coding. Additionally, it auto-drafts responses and triaging messages for patient communication.
Milagro logo
Milagro
Claimed

Milagro

Company Info
Founded: 2015
Headcount: 11-50
Customers
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Milagro offers an autonomous medical coding solution that provides real-time coding capabilities and compliance with coding guidelines. Milagro can handle multiple specialties, including cardiology, anesthesia, and orthopedics, and integrates into existing workflows within four weeks.
Notable Authorizations logo
Notable
Claimed

Notable Authorizations

Company Info
Founded: 2017
Headcount: 201-500
Customers
Verified Customers: 1
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HITRUST CSF, HIPAA, PCI DSS
Notable's Intelligent Authorizations automates the prior authorization process, reducing manual tasks for healthcare providers. It integrates with EHRs to identify authorization needs, submit requests, and track statuses directly within patient records. The platform aims to reduce denials and administrative workload, supporting faster patient care by automating interactions with payer portals.
Nym logo
Nym
Claimed

Nym

Company Info
Founded: 2018
Headcount: 51-200
Customers
Verified Customers: 6
Customers Served: Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Nym is an AI medical coding product that deciphers clinical language in patient charts and assigns ICD-10 and CPT codes to them using advanced machine learning and semantic technologies. They offer services for outpatient coding for both professional and facility charges, as well as inpatient coding for professional charges. Nym’s semantic and contextual understanding enables the product to generate accurate and compliant coding with detailed audit trails for further validation. This allows them to handle a range of medical coding scenarios from ancillary procedures like radiology and pathology to more complex situations such as emergency care and ambulatory procedures with minimal human intervention.
PayZen logo
PayZen
Claimed

PayZen

Company Info
Founded: 2019
Headcount: 51-200
Customers
Verified Customers: 12
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
PayZen is a healthcare payments platform that pays health systems on behalf of patients, then uses AI to create personalized, interest-free payment plans based on patients' ability to pay. It integrates with EHRs and financial systems to ingest relevant patient data, and works with patients to identify the right payment schedule for them.
RapidClaims logo
RapidClaims
Claimed

RapidClaims

Company Info
Founded: 2023
Headcount: 11-50
Customers
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA, ISO 27001
RapidClaims offers an AI-driven platform for medical coding, integrating autonomous coding, coder assistance, and code auditing to enhance accuracy and reduce costs. The system supports various coding types like ICD, CPT, E&M, HCPCS, and HCC, applicable across multiple specialties from its inception. It provides these services through an API, facilitating easy integration with other platforms.
Silna logo
Silna Health
Claimed

Silna

Company Info
Founded: 2023
Headcount: 11-50
Customers
Verified Customers: 10
Customers Served: Ambulatory Practice, Digital Health Provider
Product Overview
Security and Compliance Certifications: HIPAA
Silna Health focuses on helping specialty healthcare providers manage prior authorizations, benefits, and eligibility checks. It is designed for use in physical therapy, speech therapy, and behavioral health. Silna automates the authorization process using AI, provides regular benefit and eligibility checks, and sends reminders for expiring authorizations to prevent lapses in care.
SmarterDx logo
SmarterDx
Claimed

SmarterDx

Company Info
Founded: 2020
Headcount: 51-200
Customers
Verified Customers: 12
Customers Served: Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
SmarterDx is a clinical AI tool that performs detailed second-pass reviews of patient discharge data, analyzing chart notes, labs, medications, and vital signs, to identify missed differential diagnoses, clinical documentation, and other coding opportunities. This enables more accurate revenue capture and better patient outcomes.
Synthpop logo
Synthpop
Claimed

Synthpop

Company Info
Founded: 2023
Headcount: 1-10
Customers
Verified Customers: 9
Customers Served: Digital Health Provider, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 1, HIPAA
Synthpop provides AI-enabled tooling for automating referral intake, handling incoming faxes, analyzing patient records to evaluate treatment eligibility, and transcribing patient conversations to optimize around payer guidelines for claims submission.
Tennr logo
Tennr
Claimed

Tennr

Company Info
Founded: 2021
Headcount: 11-50
Customers
Verified Customers: 8
Customers Served: Ambulatory Practice, Hospital / Health System, Digital Health Provider
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Tennr is an automation platform designed for healthcare operations, using its proprietary RaeLM™ machine learning model to process medical documents and optimize administrative workflows. The platform automates tasks such as processing referrals, patient intake, eligibility checks, and prior authorizations by classifying and extracting data from incoming documents like faxes. Tennr integrates with existing EHR systems, minimizing manual data entry and reducing errors, while maintaining human oversight for approvals when needed.
XpertCoding logo
XpertDox
Claimed

XpertCoding

Company Info
Founded: 2015
Headcount: 11-50
Customers
Verified Customers: 8
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA, ISO 27001, ISO22301
XpertCoding is an AI-enabled medical coding solution that uses machine learning to automate the coding of medical claims. It supports claims submission within 24 hours, and offers a HIPAA-compliant dashboard for performance tracking as well as a data analytics module for optimizing operations across facilities.
Anterior logo
Anterior

Anterior

Company Info
Founded: 2022
Headcount: 51-200
Customers
Customers Served: Health Plan
Product Overview
Security and Compliance Certifications: HITRUST CSF, HIPAA
Anterior is a generative AI platform for payer organizations, providing a co-pilot dashboard to empower UM nurses to get all of the right data summarized and presented so they can make the right decision faster.
Arintra logo
Arintra

Arintra

Company Info
Founded: 2020
Headcount: 11-50
Customers
Customers Served: Ambulatory Practice, Digital Health Provider, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Arintra's autonomous coding solution emphasizes support for primary care along with other clinical specialties. It automates the coding of patient charts from outpatient, inpatient, and urgent care settings, with a particular focus on high-volume environments like primary care and emergency departments. The platform integrates with EHRs to provide direct-to-billing codes without altering existing workflows, enabling primary care providers to reduce manual workload and improve accuracy in coding and reimbursement processes.
Arrow logo
Arrow

Arrow

Company Info
Founded: 2020
Headcount: 11-50
Customers
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: HIPAA
Arrow is a healthcare payment platform that provides solutions for both healthcare providers and health plans. Its key features include claims acceleration, predictive analytics, real-time claim status updates, and denial management for providers, allowing faster and more accurate payments. For health plans, Arrow offers automated claim adjudication, real-time payment facilitation, and enhanced payment integrity.
Ascertain logo
Ascertain

Ascertain

Company Info
Founded: 2022
Headcount: 11-50
Customers
Customers Served: Ambulatory Practice, Hospital / Health System, Digital Health Provider
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Ascertain is a joint venture between Northwell Health and Aegis Ventures, designed to create and accelerate AI-driven healthcare companies. The platform focuses on addressing significant healthcare challenges such as quality, equity, and cost by leveraging advanced AI technology and data analytics. Ascertain's initial projects include improving maternal health through predictive analytics for preeclampsia and developing tools for chronic disease management. The partnership brings together clinical expertise from Northwell Health and the startup creation capabilities of Aegis Ventures, supported by $100 million in seed capital to foster innovation in healthcare.
Automat logo
Automat

Automat

Company Info
Founded: 2022
Headcount: 1-10
Customers
Customers Served: Ambulatory Practice, Digital Health Provider, Hospital / Health System, Health Plan, Life Sciences
Product Overview
Automat uses AI-driven RPA to streamline tasks in healthcare administration, including EHR data entry and migration, billing and insurance verification, and lab and pharmacy integration, with customized workflow automations tailored to organizational needs.
Automation Anywhere logo
Automation Anywhere

Automation Anywhere

Company Info
Founded: 2003
Headcount: 1001-5000
Customers
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System, Health Plan
Product Overview
Security and Compliance Certifications: HITRUST CSF, HIPAA
Automation Anywhere leverages robotic process automation (RPA) and AI to automate and enhance various RCM processes. Key functionalities include automating patient registration, insurance verification, claims processing, and billing, which helps reduce manual data entry, minimize errors, and speed up the reimbursement cycle. The platform also supports advanced analytics for better financial decision-making and real-time compliance monitoring.
Basys.ai logo
Basys.ai

Basys.ai

Company Info
Founded: 2021
Headcount: 1-10
Customers
Verified Customers: 1
Customers Served: Health Plan
Product Overview
Security and Compliance Certifications: HIPAA
Basys.ai is an AI-powered platform that streamlines prior authorization (PA) for health plans using GenAI for policy encoding and request processing. It enables rapid payer onboarding and policy updates, automates complex policy rules and decision logic, and allows UM nurses to verify recommendations while making decisions. The platform recommends alternative care pathways when requests don’t match existing policies and records overrides for analytics and model improvement. It features a portal for direct document submission, API integration with Epic, and OCR for handling document types like fax.
Blue Prism logo
Blue Prism

Blue Prism

Company Info
Headcount: 1001-5000
Customers
Verified Customers: 8
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: ISO 27001
Blue Prism, now part of SS&C Technologies, offers an intelligent automation platform focusing on robotic process automation (RPA) for industries like healthcare, finance, and logistics. The platform enables organizations to automate repetitive tasks, integrate machine learning, and optimize business workflows. It supports cloud, on-premise, and hybrid deployments, allowing scalable automation for business processes such as finance, HR, and customer service. Blue Prism enhances operational efficiency by leveraging AI to automate decision-making and document processing.
Brellium logo
Brellium

Brellium

Company Info
Founded: 2021
Headcount: 11-50
Customers
Verified Customers: 7
Customers Served: Ambulatory Practice, Digital Health Provider, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 1, HIPAA
Brellium automates the medical chart review process. It audits clinical documentation and billing notes according to custom criteria, identifying discrepancies, errors, and gaps. The platform connects with EHR systems to provide real-time reporting, helps improve documentation quality, and allows for same-day billing validation. It is designed to reduce the workload on CDI teams, enhancing accuracy and efficiency in auditing thousands of charts.
Cedar Pay logo
Cedar

Cedar Pay

Company Info
Founded: 2016
Headcount: 201-500
Customers
Verified Customers: 4
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HITRUST CSF, HIPAA, PCI DSS
Cedar Pay is a patient billing and payment solution that integrates health plan data with provider billing so patients can view and resolve their medical bills, see real-time deductible statuses, and access HSA/FSA balances. For providers, Cedar Pay consolidates statements and explanations of benefits, provides tailored payment options, and automates and optimizes communications using machine learning.
Company Info
Founded: 2007
Headcount: 5001-10000
Customers
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Change Healthcare Denials and Appeals Management offers services and technology to help healthcare providers manage and reduce claim denials. It includes identifying and analyzing the root causes of denials, handling appeals with expert assistance, and managing payer audits. It features detailed reporting to provide insights into denial trends and recommendations for process improvements, aimed at enhancing clean claim rates and reducing the administrative burden on staff.
Claimable logo
Claimable

Claimable

Company Info
Founded: 2024
Headcount: 1-10
Customers
Customers Served: Hospital / Health System, Ambulatory Practice, Health Plan
Product Overview
Security and Compliance Certifications: HIPAA
Claimable is an AI-powered platform designed to help patients challenge unjust healthcare claim denials. It uses AI to generate and submit personalized appeal letters based on clinical research, policy details, and the patient’s medical history. The platform supports appeals for a wide range of treatments and accepts denials from major insurers, including Medicare and Medicaid. Claimable aims to streamline the appeals process with features like smart document scanning and real-time evidence matching.
Clearbalance logo
Clearbalance

Clearbalance

Company Info
Founded: 1992
Headcount: 51-200
Customers
Verified Customers: 6
Customers Served: Hospital / Health System, Health Plan
Product Overview
Security and Compliance Certifications: HITRUST CSF, SOC 2 Type 2, PCI DSS
ClearBalance Healthcare is a patient financing service provider that allows patients to manage their out-of-pocket medical expenses through revolving lines of credit, which can be interest-free or low-interest, making it easier for them to pay their healthcare bills over time. This approach aims to improve patient satisfaction and loyalty while helping healthcare providers accelerate cash flow and increase net collections. ClearBalance offers various solutions, including a patient financing program that helps health systems manage accounts receivable by transferring patient debt into manageable payment plans.
CodaMetrix logo
CodaMetrix

CodaMetrix

Company Info
Founded: 2019
Headcount: 51-200
Customers
Verified Customers: 10
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA, ISO 27001
CodaMetrix is an AI medical coding platform for multiple specialties, particularly in radiology and pathology, within large healthcare systems. The platform uses NLP and machine learning to translate clinical notes into accurate billing and diagnostic codes. CodaMetrix also provides real-time compliance monitoring and detailed audit trails to ensure adherence to coding standards and reduce the risk of audits
Cohere Health logo
Cohere Health

Cohere Health

Company Info
Founded: 2019
Headcount: 501-1000
Customers
Verified Customers: 2
Customers Served: Health Plan
Product Overview
Security and Compliance Certifications: HITRUST CSF, HIPAA
Cohere Health automates and optimizes the prior authorization process for health plans by integrating with EHR systems, digitizing authorization requests, and applying AI and clinical intelligence to automate decisions and improve efficiency. The platform supports real-time analytics and interoperability, facilitating faster patient care and reducing administrative costs.
CorroHealth PULSE logo
CorroHealth

CorroHealth PULSE

Company Info
Founded: 2020
Headcount: 5001-10000
Customers
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
PULSE by CorroHealth is an AI-powered medical coding platform designed to automate coding workflows with up to 97% accuracy. It integrates with any EHR system, supports both fee-for-service and value-based care coding, and provides transparent auditing. Using large language models and machine learning, it enhances productivity, processes records quickly, and offers analytics for strategic insights.
Crosby Health logo
Crosby Health

Crosby Health

Company Info
Founded: 2022
Headcount: 1-10
Customers
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: HIPAA
Crosby Health offers a platform tailored for hospitals and health systems to manage clinical denials and appeals effectively. They use advanced language models to analyze provider documentation and generate arguments for medical necessity. The platform automates appeal processes, reducing manual entry and facilitating a unified submission to insurers. Crosby Health also provides detailed reporting on clinical denials, helping organizations track the financial status and productivity related to appeals management.
Company Info
Founded: 2017
Headcount: 1001-5000
Customers
Verified Customers: 3
Customers Served: Hospital / Health System, Digital Health Provider
Product Overview
Security and Compliance Certifications: HITRUST CSF, SOC 2 Type 2, HIPAA
Datavant Denial Management offers a solution designed to help healthcare organizations reduce claim denials and optimize reimbursement, and includes tools for identifying and analyzing denial patterns, resolving denials, and submitting appeals. It offers analytics and services to provide insights for preventing future denials and improving clinical documentation and coding specificity.
Decoda Health logo
Decoda Health

Decoda Health

Company Info
Founded: 2023
Headcount: 1-10
Customers
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 1, HIPAA
Decoda Health is an AI-enabled patient billing and communications platform with a unified dashboard for centralized patient interactions and automated billing and invoicing. Key features include automated balance aging, AI-enabled messaging and calls for payment reminders and follow-ups, and integration with EHR/PMS systems.
Develop Health logo
Develop Health

Develop Health

Company Info
Founded: 2022
Headcount: 1-10
Customers
Verified Customers: 4
Customers Served: Digital Health Provider, Ambulatory Practice
Product Overview
Security and Compliance Certifications: HIPAA
Develop Health is an AI-enabled eligibility checking and prior authorization platform for medication. It automates benefit verification, clinical eligibility checks, and prior authorization form completion, and automatically calls payers to get benefit details. By integrating patient insurance data and clinical history, the platform increases first-time approval rates and reduces delays in accessing medications.
Ecton logo
Ecton

Ecton

Company Info
Founded: 2023
Headcount: 1-10
Customers
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Ecton is a patient financial engagement platform designed to enhance the payment experience with a combination of advanced payment rails and an AI-driven financial counselor that aids patients in understanding the best payment options, optimizes discounts, and can take payments directly. This AI co-pilot can work alongside existing financial counselors, addressing the significant shortage in health systems.
Element5 logo
Element5

Element5

Company Info
Founded: 2019
Headcount: 51-200
Customers
Verified Customers: 9
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Element5 is a workflow automation platform for post-acute care, focusing on eligibility verification, authorization processing, and RCM with AI and RPA. Element5 integrates with existing EHR systems and clearinghouses to help manage the entire claims process from initiation to payment posting and reconciliation.
Encore Health

Encore Health DeCodeX

Company Info
Founded: 2023
Headcount: 1-10
Customers
Customers Served: Hospital / Health System, Ambulatory Practice, Digital Health Provider
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Encore Health's DeCodeX is an AI-driven enterprise case management platform designed to assist healthcare organizations in managing clinical claim denials. It provides tools for crafting targeted solutions to optimize financial performance and prepare revenue cycles for value-based care reimbursement models.
Ethermed logo
Ethermed

Ethermed

Company Info
Founded: 2021
Headcount: 11-50
Customers
Verified Customers: 1
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Ethermed offers an AI-driven solution that automates the prior authorization process in healthcare, aiming to reduce up to 90% of manual administrative tasks. Operating seamlessly within existing systems, it gathers necessary clinical data, completes authorization forms, and submits them without manual input, thereby minimizing delays in patient care. This technology benefits both healthcare providers and payers by decreasing administrative burdens and enhancing operational efficiency.
Etyon logo
Etyon

Etyon

Company Info
Founded: 2014
Headcount: 11-50
Customers
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Etyon provides AI-enabled solutions for optimizing revenue cycle management in healthcare. Their offerings include data integration, denial management, insurance payment risk prediction, patient payment risk prediction, contract management, labor optimization, and treasury management. Etyon's tools enhance performance tracking, predict and manage financial risks, and ensure accurate reimbursements through data analytics and ML capabilities.
Evidently CDI logo
Evidently

Evidently CDI

Company Info
Founded: 2020
Headcount: 11-50
Customers
Customers Served: Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Evidently CDI integrates with EHRs to improve documentation of patient care, improving data accuracy for clinical, administrative, and regulatory purposes. By ensuring that patient records are precise and up-to-date, Evidently’s CDI solution helps healthcare providers improve patient care, support compliance with industry standards, and optimize reimbursement processes.
Company Info
Founded: 1980
Headcount: 5001-10000
Customers
Verified Customers: 36
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA, GDPR
Experian Denial Management helps reduce claim denials and improve reimbursements through automation and analytics. The product uses ERA and claim status transactions to identify and manage denied, suspended, pending, or lost claims. It provides detailed insights and reporting to pinpoint root causes of denials. Customizable worklists and ANSI reason codes facilitate more efficient claims follow-up and resolution.
Flywire logo
Flywire

Flywire

Company Info
Founded: 2009
Headcount: 1001-5000
Customers
Verified Customers: 4
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, PCI DSS
Flywire's healthcare payment platform helps providers offer personalized, affordable payment options to patients. Using machine learning, it predicts patients' capacity to pay and tailors payment plans accordingly. The platform integrates with Epic and Cerner, and uses PayZen’s payment plan technology to support patient financing. It also supports cross-border payments with transparent FX rates and multi-lingual support.
Company Info
Founded: 2023
Headcount: 1-10
Customers
Customers Served: Health Plan
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, SOC 2 Type 1, HIPAA
GenHealth.ai 's Auto Prior Auth system automates the prior authorization process for healthcare providers and insurers with auditable, explainable decisions. It uses AI to extract patient data from various sources, including faxes, HL7v2, and call center transcripts. The system ingests medical policies and generates decision recommendations based on plan-specific workflows. It provides early abuse detection, individual risk assessments, and provider gold card recommendations.
Guardian logo
Guardian

Guardian

Company Info
Headcount: 1-10
Customers
Customers Served: Hospital / Health System, Ambulatory Practice, Digital Health Provider
Product Overview
Security and Compliance Certifications: HIPAA
Guardian AI provides a platform focused on automating denials management for healthcare providers. It leverages artificial intelligence to handle claim denials, integrating with electronic health records (EHR) systems, payer portals, and clearinghouses to streamline appeals and manage insurance claims end-to-end. The tool aims to reduce the administrative burden of tracking denials, improving clean claim rates by offering real-time alerts and actionable insights.
Humata Health logo
Humata Health

Humata Health

Company Info
Founded: 2023
Headcount: 51-200
Customers
Verified Customers: 8
Customers Served: Hospital / Health System, Health Plan
Product Overview
Security and Compliance Certifications: HIPAA
Humata Health provides an AI-driven platform designed to automate the prior authorization process in healthcare. It integrates with EHRs and payer systems to streamline authorizations, using machine learning for intelligent document recommendations and one-click submissions. The platform prioritizes cases, monitors for changes, and automates status updates to improve efficiency and reduce manual work.
Infinx logo
Infinx

Infinx

Company Info
Founded: 2012
Headcount: 1001-5000
Customers
Verified Customers: 7
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Infinx is a Revenue Cycle Automation platform that uses AI and RPA to automate prior authorizations, insurance eligibility checks, patient financial verifications, and billing. The platform integrates with Epic, Cerner, and athenaHealth, expediting claim submissions, managing denials, and ultimately improving cash flow and maximizing reimbursements for providers.
Iodine AwareCDI logo
Iodine Software

Iodine AwareCDI

Company Info
Founded: 2010
Headcount: 201-500
Customers
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Iodine AwareCDI enhances clinical documentation from admission through post-billing review by identifying missing elements in patient documentation based on clinical evidence, improving documentation integrity and revenue capture. The product prioritizes cases for review, increases query and response rates, spots gaps in patient documentation, reduces denials, predicts final discharge DRGs, minimizes audit risk, automates the query process, and identifies coding opportunities.
Janus AI Automation logo
Janus Health

Janus AI Automation

Company Info
Founded: 2020
Headcount: 51-200
Customers
Customers Served: Ambulatory Practice, Hospital / Health System, Digital Health Provider
Product Overview
Security and Compliance Certifications: HIPAA
Janus AI Automation provides intelligent automation solutions for revenue cycle management (RCM) in healthcare organizations. Its offerings include automating prior authorization processes, navigating payer portals, and checking claim statuses, aiming to reduce manual workloads and improve operational efficiency. The platform integrates with existing electronic health record (EHR) systems to streamline workflows and enhance financial outcomes.
Jorie AI logo
Jorie AI

Jorie AI

Company Info
Founded: 2015
Headcount: 1001-5000
Customers
Customers Served: Hospital / Health System, Ambulatory Practice, Health Plan
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA, PCI DSS
Jorie AI is an AI-driven RCM automation platform, with use cases for eligibility verification, accounts receivable management, and denial management, offering integrated human oversight where necessary. Jorie AI employs advanced robotic process automation (RPA) that acts as virtual humans, navigating EHR systems, clearinghouses, and payer portals.
Latent logo
Latent

Latent

Company Info
Founded: 2022
Headcount: 1-10
Customers
Verified Customers: 2
Customers Served: Ambulatory Practice, Hospital / Health System, Pharmacies
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Latent Health uses generative AI to optimize healthcare operations, particularly in pharmacy workflows. The platform integrates with EHR systems using SMART on FHIR, providing functionalities like rapid patient data retrieval, AI-assisted 340B qualification, and automated prior authorizations.
Limo Health logo
Limo Health

Limo Health

Company Info
Founded: 2021
Headcount: 11-50
Customers
Customers Served: Hospital / Health System, Ambulatory Practice, Digital Health Provider
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA, GDPR
Limo Health provides an AI-driven platform that conducts autonomous pre-bill reviews of medical charts to identify revenue opportunities and coding errors. By integrating with existing electronic health record (EHR) systems, it aims to enhance revenue integrity, prevent claim denials, and ensure compliance with billing standards. The platform claims to increase relative value units (RVUs) per patient by up to 15.2% and reduce auditing costs by 98.2% compared to manual processes.
Magical logo
Magical

Magical

Company Info
Founded: 2020
Headcount: 11-50
Customers
Verified Customers: 3
Customers Served: Ambulatory Practice, Hospital / Health System, Health Plan, Digital Health Provider
Product Overview
Magical is an AI-powered automation tool designed to streamline workflows by automating repetitive tasks such as data entry, autofill, and personalized messaging across apps and websites. It helps users connect and move information between platforms without the need for complex integrations. With features like text expansion, form autofill, and custom templates, Magical improves productivity for teams in various sectors, including healthcare, customer support, and sales.
Maverick Medical AI logo
Maverick Medical AI

Maverick Medical AI

Company Info
Founded: 2018
Headcount: 11-50
Customers
Verified Customers: 3
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Maverick Medical AI offers autonomous medical coding through its mCoder platform, focusing on high accuracy and a fast Direct-to-Bill process. The platform supports ICD and CPT coding with deep learning algorithms and real-time error correction. It integrates with existing systems to automate a large portion of coding workflows, aiming to minimize reliance on human coders while maintaining compliance with payer-specific policies.
MDAudit logo
MDAudit

MDAudit

Company Info
Founded: 1993
Headcount: 51-200
Customers
Verified Customers: 6
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: HITRUST CSF, HIPAA
MDaudit is designed for healthcare organizations to manage billing compliance, auditing, and revenue integrity. It automates internal audit workflows, monitors billing risks, and offers analytics for external audit management. The system supports healthcare providers in reducing compliance risks, optimizing revenue, and mitigating denials by providing real-time insights and dashboards. It integrates data from claims, pre-bill charges, and remittances to improve financial transparency and operational efficiency.
Company Info
Founded: 2010
Headcount: 11-50
Customers
Verified Customers: 5
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
RevFind detects and recovers underpayments from payers by reading healthcare provider contracts and comparing actual payments to contract terms, automatically flagging discrepancies. RevFind also provides detailed reporting and benchmarking against national standards, and supports ongoing recovery efforts with professional resources and strategic guidance.
Company Info
Founded: 2010
Headcount: 1001-5000
Customers
Verified Customers: 1
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
MedMetrix Denials and Revenue Recovery focuses on handling claim denials and recovering lost revenue. Utilizing AI and automation technologies, MedMetrix offers pre-claim coding analysis, pre-billing reviews, and detailed case management support to prevent denials. Their system predicts the types of appeals most likely to succeed and automates these appeals. They also identify and recover underpayments and lost charges, handling both large and small dollar claims.
Myndshft logo
Myndshft

Myndshft

Company Info
Founded: 2015
Headcount: 51-200
Customers
Verified Customers: 1
Customers Served: Diagnostic Labs, Imaging Labs, Ambulatory Practice
Product Overview
Myndshft helps automate prior authorizations for acute and post-acute services, imaging labs, and diagnostics and genomics labs. The product uses a library of payer rules and an AI-enabled system that updates the workflow and rules engines based on previous prior authorization requests.
Company Info
Founded: 2011
Headcount: 10000+
Customers
Customers Served: Hospital / Health System, Ambulatory Practice, Health Plan
Product Overview
Security and Compliance Certifications: HIPAA
Optum Enterprise CAC (Computer-Assisted Coding) and CDI 3D is an integrated platform designed to enhance clinical documentation and coding accuracy through the use of NLP. The system reviews cases, identifying opportunities for documentation improvement and coding specificity, and automating workflows to reduce administrative burden. It includes modules for audit and compliance, analytics and reporting, and workflow management.
PayGround logo
PayGround

PayGround

Company Info
Founded: 2018
Headcount: 11-50
Customers
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA, PCI DSS
PayGround is a payments platform designed to automate patient billing and payment processes, with features like EHR/PM integration and automated payment reminders. It offers different pricing plans, including a free basic option, to accommodate the diverse needs of medical practices, focusing on reducing administrative burdens and improving payment efficiency
PayMedix logo
PayMedix

PayMedix

Company Info
Founded: 2021
Headcount: 11-50
Customers
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
PayMedix is a healthcare payment platform designed to help providers receive full payment for in-network services, regardless of a patient's ability to pay. It consolidates billing by issuing a single monthly statement to patients, covering all services from multiple providers. PayMedix also handles patient collections, removing financial risks for providers and eliminating the need for them to pursue unpaid balances. The platform integrates with existing systems without requiring changes to revenue cycle management or claims processes.
Penguin AI logo
Penguin AI

Penguin AI

Company Info
Founded: 2024
Headcount: 11-50
Customers
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Penguin AI is a healthcare-focused artificial intelligence platform designed to automate administrative tasks for payers and providers. It offers custom-built healthcare language models and digital workers to handle processes such as prior authorizations, claims adjudication, and coding. The platform integrates with over 38 systems, including EPIC, Cerner, and major cloud providers, facilitating data ingestion and interoperability. It also includes features for data governance, compliance with healthcare regulations, and bias detection.
Phare Health logo
Phare Health

Phare Health

Company Info
Founded: 2023
Headcount: 1-10
Customers
Customers Served: Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Phare Health develops AI tools to automate administrative tasks and improving coding accuracy within inpatient settings. Their solutions identify missed revenue, suggest coding improvements, and automate routine coding processes using end-to-end deep learning. Their product helps identify coding improvement opportunities to coders as well as automates coding for simpler encounters.
Plenful logo
Plenful

Plenful

Company Info
Founded: 2021
Headcount: 11-50
Customers
Verified Customers: 5
Customers Served: Pharmacies, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Plenful is an AI workflow automation platform designed for pharmacy and healthcare operations. It automates administrative tasks like 340B audits, documents processing for referrals, orders, and intake forms, contracted rates optimization & inventory planning, and pharmacy claims auditing. Plenful handles data formats including unstructured data as well as HL7v2, FHIR, REST APIs, and delimited text files.
Raxia logo
Raxia

Raxia

Company Info
Founded: 2019
Headcount: 11-50
Customers
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA, PCI DSS
Raxia is an AI patient financial engagement platform, with modules to automate patient account management, optimize patient communications, and accept payments. Raxia Orchestrate automates patient account management across different systems. Raxia Engage uses behavioral analytics to send personalized communication for payments. Raxia Pay offers interactive digital billing to clarify financial responsibilities for patients and improve payment rates.
Regard logo
Regard

Regard

Company Info
Founded: 2017
Headcount: 11-50
Customers
Verified Customers: 10
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Regard is an AI-driven tool designed to assist clinicians in analyzing patient data more efficiently. It integrates with electronic medical records (EMR) to extract insights from unstructured clinical data, suggest diagnoses, and generate clinical notes. This "medical co-pilot" helps healthcare providers make informed decisions and reduces documentation time. Key functionalities include automating administrative tasks, providing diagnostic support, and enhancing clinical practice by making patient information more accessible and actionable within the EMR system.
RISA logo
RISA Labs

RISA

Company Info
Founded: 2024
Headcount: 11-50
Customers
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA, ISO 27701, ONC Health IT (2015 Edition)
RISA Labs offers AI-powered automation solutions for managing prior authorizations in healthcare, focusing on reducing denial rates, administrative workload, and compliance risks. Its platform integrates with major EHR systems and utilizes advanced AI to optimize first-time submission success and streamline workflows. RISA’s tools include proactive denial prevention and real-time compliance monitoring, aimed at minimizing rejections and financial losses for both healthcare providers and payers.
Company Info
Founded: 2018
Headcount: 51-200
Customers
Verified Customers: 6
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Rivet Claim Resolution helps manage claim denials with customizable worklists, easy filtering, batch workflows, and tailored denial processing documentation. This platform speeds up the appeals process by providing timely filing alerts and supporting bulk appeals. Rivet integrates seamlessly with EHR and practice management systems.
Company Info
Founded: 2018
Headcount: 51-200
Customers
Verified Customers: 8
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Rivet Payer Performance centralizes payer contracts and automates the detection of payment variances. The tool offers payer rate comparisons, contract storage, and renewal management. It enables users to model contract terms for negotiation, identify underpayments quickly, and streamline recovery processes through detailed reporting and analytics.
Company Info
Founded: 2021
Headcount: 1-10
Customers
Verified Customers: 2
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Rotera Alyks is a digital assistant and revenue cycle automation platform designed to assist with call center operations, real-time insurance discovery, denials management, and knowledge management by providing actionable suggestions and automating routine tasks. The platform can integrate with EHRs and other systems via API, and supports customized workflows.
SamaCare logo
SamaCare

SamaCare

Company Info
Founded: 2018
Headcount: 51-200
Customers
Verified Customers: 10
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System, Life Sciences
Product Overview
SamaCare is a platform that simplifies prior authorizations for buy-and-bill drugs, imaging, and select procedures. It helps providers by managing forms, tracking statuses, and supporting communication with payers. It automates form recommendations, auto-fills information, and updates tracking with responses. SamaCare integrates with EHRs for patient information lookup and two-way synchronization, and supports faxes and payer portals. Built-in communication tools facilitate collaboration among revenue management and clinical staff, improving efficiency and reducing administrative tasks.
Semantic Health logo
Semantic Health

Semantic Health

Company Info
Founded: 2019
Headcount: 11-50
Customers
Verified Customers: 1
Customers Served: Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Semantic Health offers an AI-driven platform designed for real-time medical coding, auditing, and clinical documentation improvement (CDI). It performs pre-bill audits, reviewing 100% of coded charts to detect errors and identify revenue opportunities with minimal workflow disruption. The platform integrates with major EHR systems and provides insights for various healthcare providers, including acute care and pediatric hospitals.
Sift Denials logo
Sift Healthcare

Sift Denials

Company Info
Founded: 2017
Headcount: 11-50
Customers
Customers Served: Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Sift Healthcare's Denials Management uses AI to prioritize claim denials by scoring them based on the likelihood of being overturned and paid, helping focus resources on promising denials, improve denial overturn rates, and accelerate cash flow. They also offer a Claims Edit Engine that uses historical payments data to prevent future denials through payer-specific claim edit recommendations.
Sift Patient Payments logo
Sift Healthcare

Sift Patient Payments

Company Info
Founded: 2017
Headcount: 11-50
Customers
Customers Served: Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Sift Healthcare's Patient Payments Management system uses AI to optimize the revenue cycle by predicting patient payment behaviors. It offers advanced analytics to determine who will pay, when, and the best methods and frequency for contact. This includes structuring payment plans and identifying charity qualifications.
Company Info
Founded: 1902
Headcount: 10000+
Customers
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: HIPAA
The 3M 360 Encompass System integrates computer-assisted coding (CAC) and CDI into a single platform. It uses NLP and AI to automatically suggest medical codes based on patient documentation, improving the accuracy and efficiency of the coding process. The system prioritizes high-risk cases for review, tracks quality metrics like Hospital Acquired Conditions (HACs), and supports real-time clinical intelligence reporting. It aims to enhance compliance, optimize reimbursement, and facilitate better patient care by providing comprehensive tools for coders and CDI specialists.
Company Info
Founded: 1902
Headcount: 10000+
Customers
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: HIPAA
CDI Engage One by 3M CDI that uses AI to provide real-time clinical insights to physicians and CDI teams. It integrates into both front-end and back-end workflows, analyzing EHR notes and narrative documents to identify gaps in patient care and documentation. This helps clinicians document a complete and compliant patient story before saving notes in the EHR, thus reducing the need for retrospective queries. It also supports back-end workflows with evidence-based analysis, worklist prioritization, and a clinically driven review process.
Company Info
Founded: 1902
Headcount: 10000+
Customers
Customers Served: Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Solventum Revenue Integrity is designed to manage and prevent claim denials by analyzing clinical, coding, and payment data. Utilizing machine learning models, it predicts potential denials and provides real-time insights and recommendations throughout the patient journey. The system enhances reporting by linking clinical activities to payment outcomes and integrates workflow with denial risk alerts, guiding revenue cycle staff for timely interventions to prevent denials.
SparkChange logo
SparkChange

SparkChange

Company Info
Founded: 2019
Headcount: 11-50
Customers
Customers Served: Hospital / Health System
Product Overview
SparkChange Health's revenue cycle automation platform streamlines the billing process through integrated workflow automation. It reduces the effort required for tasks like scheduling, registration, HIM coding, billing, and collections by embedding automated actions into existing workflows.
Company Info
Founded: 2019
Headcount: 11-50
Customers
Customers Served: Hospital / Health System
Product Overview
SparkChange Authorizations offers a solution for managing prior authorization. Key features include automated identification of required authorizations, correction of authorization discrepancies post-service, retroactive authorization handling, and continuous monitoring of denials for appeals. The platform also provides custom edits to prevent claims without proper authorizations from being processed.
Company Info
Founded: 1988
Headcount: 201-500
Customers
Verified Customers: 4
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: HIPAA
SSI Claims Management is a solution designed to improve the accuracy and speed of medical claims processing for healthcare providers. It features an extensive array of billing edits, automated workflows, electronic attachments, and comprehensive denial management tools.
Synaptec Health logo
Synaptec Health

Synaptec Health

Company Info
Founded: 2018
Headcount: 11-50
Customers
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Synaptec Health offers AI-powered automated medical coding solutions that process patient charts rapidly and accurately. The platform supports ICD-10, E/M, and CPT coding, integrating with a variety of healthcare systems through standard formats like HL7 and JSON. It provides real-time auditing, helps detect downcoding and missing documentation, and offers pay-per-use pricing without setup fees.
Tandem logo
Tandem

Tandem

Company Info
Founded: 2023
Headcount: 11-50
Customers
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Tandem is a prescription concierge service that uses AI to get patients their medications as quickly and cheaply as possible. It checks prescriptions against insurance and cash prices, along with coupons and financial assistance programs, to find the best price for the patient. If prior authorization is required, Tandem will work with the patient's doctor to handle it.
Thoughtful AI logo
Thoughtful AI

Thoughtful AI

Company Info
Founded: 2020
Headcount: 51-200
Customers
Verified Customers: 10
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Thoughtful AI is an AI Revenue Cycle Automation platform that integrates with EHRs and practice management systems to automate tasks in eligibility verification, patient intake validation, claims processing, payment posting, with additional capabilities in coding, provider management, and revenue reporting.
UiPath logo
UiPath

UiPath

Company Info
Founded: 2005
Headcount: 1001-5000
Customers
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA, GDPR, ISO 27001
UiPath is a vertical-agnostic RPA platform that can be used for RCM processes like patient registration, billing, claims processing, insurance verification, and payment posting. Additionally, UiPath's analytics and reporting tools provide insights into RCM performance, helping healthcare organizations optimize their financial operations.
Vantage Health logo
Vantage Health AI

Vantage Health

Company Info
Founded: 2018
Headcount: 11-50
Customers
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA, PCI DSS
Vantage Health offers solutions to enhance the patient financial experience, with features like consolidated bills from all encounters and departments, personalized messages and timing, and modeling to determine likelihood of patient payment versus collections.
Company Info
Founded: 2017
Headcount: 1001-5000
Customers
Verified Customers: 23
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HITRUST CSF, HIPAA
Waystar Denial Management automates identification, analysis, and appeal of denied claims. It provides real-time insights into denial patterns, enabling healthcare organizations to address and prevent future denials. The system also supports streamlined workflows for submitting appeals and tracking their status, helping to recover revenue more effectively.
Company Info
Founded: 2017
Headcount: 1001-5000
Customers
Verified Customers: 4
Customers Served: Digital Health Provider, Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: HITRUST CSF, HIPAA
Waystar's Prior Authorization platform uses intelligent automation to manage the entire authorization process. It automatically verifies, initiates, tracks status, and retrieves authorization details, integrating directly with major EHR systems. The platform automates patient referral status, handles unscheduled admissions, and generates necessary medical notices. It adapts to changing payer rules and is maintained by an in-house team of experts. AI is used to verify if authorization is required, gather data, send documentation, check status, and flag potential issues.
Willow logo
Willow

Willow

Company Info
Headcount: 1-10
Customers
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Willow is an AI-powered revenue cycle automation platform designed for healthcare providers. It automates billing processes, including patient intake, eligibility verification, claim submission, denial management, and payment posting, aiming to reduce errors and expedite payments. The platform offers real-time revenue intelligence through advanced analytics, enabling users to monitor financial metrics, identify denial trends, and benchmark payer performance.