Claims Management
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Canvas
Claimed
Canvas
Company Info
Founded: 2015
Headcount: 51-200
Customers
Verified Customers: 11
Customers Served: Digital Health Provider, Ambulatory Practice
Product Overview
8 ReviewsSecurity and Compliance Certifications: HITRUST CSF, SOC 2 Type 2, ONC Health IT (2015 Edition)
Canvas Medical is an EHR and revenue cycle management platform that focuses on providing a complete UI for clinicians while providing SDKs and APIs for extending capabilities. It provides out-of-the-box features for scheduling, charting, ordering for labs, medications, and referrals, claims and patient payments, clinical data exchange, and workflows for collaboration and results reporting. Their SDK and a FHIR-based API enable creating new workflows within the application and integrating third party applications.
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AthenaHealth
Athenahealth
Company Info
Founded: 1997
Headcount: 5001-10000
Customers
Verified Customers: 17
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
6 ReviewsSecurity and Compliance Certifications: HIPAA, PCI DSS, ISO 27001, ONC Health IT (2015 Edition)
Athenahealth provides a platform featuring integrated electronic health records, telehealth services, interoperability, revenue cycle management, and population health management, designed to streamline clinical workflows and improve patient care delivery.
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 ReviewsSecurity 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.
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Enter Health
Claimed
Enter Health
Company Info
Founded: 2013
Headcount: 1-10
Customers
Verified Customers: 9
Customers Served: Digital Health Provider, Ambulatory Practice
Product Overview
2 ReviewsSecurity and Compliance Certifications: SOC 2 Type 2, HIPAA
Enter Health provides revenue cycle management solution. Key features include claims submission to the appropriate payers, payment posting and analysis against payer contracts, and automated follow-up on underpayments and denials with necessary documentation and appeals. Additionally, Enter Health offers automated patient collections, including SMS and email communications, and real-time reporting. The platform is compatible with various EMRs like eClinicalWorks and Allscripts, or can be integrated via API.
Adonis
Claimed
Adonis Billing
Company Info
Founded: 2022
Headcount: 51-200
Customers
Verified Customers: 8
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
1 ReviewsSecurity and Compliance Certifications: SOC 2 Type 2, HIPAA
Adonis Billing is a healthcare billing platform that integrates predictive analytics and automation to streamline the billing process from pre-claim eligibility checks to patient payments. It features automated eligibility checks to prevent denials, cost estimations, a Smart Scrubber to minimize billing errors, patient payments, and real-time alerts for various billing issues. The platform also offers real-time dashboards and reports to monitor key performance indicators, helping healthcare providers manage their revenue cycle more effectively.
Apero
Claimed
Apero
Company Info
Founded: 2019
Headcount: 11-50
Customers
Verified Customers: 12
Customers Served: Digital Health Provider, Ambulatory Practice
Product Overview
1 ReviewsSecurity and Compliance Certifications: SOC 2 Type 2, HIPAA
Apero is a healthcare management platform that combines practice operations and billing. It integrates functions such as clinical note-taking, patient scheduling, revenue cycle management, and financial reporting into a single system. The platform also includes features like real-time eligibility checks, custom validation rules, e-prescriptions, and end-to-end insurance billing.
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NextGen
NextGen RCM
Company Info
Founded: 1973
Headcount: 1001-5000
Customers
Verified Customers: 11
Customers Served: Ambulatory Practice
Product Overview
1 ReviewsSecurity and Compliance Certifications: HIPAA
NextGen RCM streamlines financial processes from patient appointment scheduling to final payment, focusing on optimizing revenue and ensuring regulatory compliance.
Waystar
Waystar
Company Info
Founded: 2017
Headcount: 1001-5000
Customers
Verified Customers: 6
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
1 ReviewsSecurity and Compliance Certifications: HITRUST CSF, HIPAA
Waystar is an end-to-end revenue cycle management company, offering eligibility verification, claims submission, payment posting, denials management, and analytics.
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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.
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Athelas
Athelas RCM
Company Info
Founded: 2016
Headcount: 201-500
Customers
Verified Customers: 9
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HITRUST CSF, SOC 2 Type 2, HIPAA
Athelas RCM provides a platform for healthcare revenue cycle management with features including detailed financial reporting, end-to-end billing process management, resubmission of denials, patient payments, and workflow automation.
Availity
Availity Essentials
Company Info
Founded: 2001
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
Availity Essentials is an end-to-end RCM solution for providers. It offers a range of features aimed at improving efficiency and accuracy in tasks such as eligibility and benefits verification, claims management, and prior authorization.
CollaborateMD
CollaborateMD
Company Info
Founded: 1999
Headcount: 11-50
Customers
Verified Customers: 2
Customers Served: Ambulatory Practice
Product Overview
Security and Compliance Certifications: HIPAA
CollaborateMD offers practice management and billing software for small to mid-sized practices.
Conifer Health Solutions
Conifer Health Solutions
Company Info
Founded: 2008
Headcount: 5001-10000
Customers
Customers Served: Ambulatory Practice, Hospital / Health System, Health Plan, Risk-Bearing Providers
Product Overview
Conifer Health Solutions provides revenue cycle management services and value-based care solutions for health systems, provider groups and employers to improve financial outcomes. Conifer’s value-based care solutions include data and analytics tools to support population health management, risk analysis and outcome measurement. They also offer care navigation, care management and utilization management services provided by registered nurses. Conifer Health Solutions is a subsidiary of Tenet Healthcare Corporation.
Docvocate
Docvocate
Company Info
Founded: 2018
Headcount: 1-10
Customers
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: HIPAA
Docvocate provides technology solutions for in-house and outsourced RCM teams, automating claims submission, tracking, and appeals, with advanced denial management workflows. The platform integrates with other billing tools, and offers unified visibility across a variety of workflows.
Ensemble Health Partners
EIQ
Company Info
Founded: 2014
Headcount: 1001-5000
Customers
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
EIQ by Ensemble Health Partners is a cloud-based, analytics-driven workflow tool for end-to-end RCM.
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EZClaim
EZClaim
Company Info
Founded: 1997
Headcount: 11-50
Customers
Customers Served: Digital Health Provider, Ambulatory Practice
Product Overview
Security and Compliance Certifications: HIPAA
EZClaim is a medical billing platform that integrates with EHR systems, with capabilities that include electronic claim submission, reporting, real-time eligibility checks, and patient and payer payment collection. The software is offers claim scrubbing and the ability to generate customized superbills and electronic patient statements.
FinThrive
Finthrive
Company Info
Founded: 2016
Headcount: 1001-5000
Customers
Verified Customers: 3
Customers Served: Hospital / Health System
Product Overview
Security and Compliance Certifications: HITRUST CSF, HIPAA
FinThrive provides a comprehensive end-to-end revenue management platform for healthcare organizations, including capabilities for patient access, revenue integrity, revenue collection, and recovery solutions. It supports claims submission to payers, integrating with EHR systems to ensure high first-pass payment rates and reduce denials through advanced claim edits and scrubbing.
Gentem
Gentem
Company Info
Founded: 2019
Headcount: 11-50
Customers
Verified Customers: 5
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Gentem is revenue cycle management software that helps automate medical billing and payment processes for providers. Key capabilities include real-time eligibility checks, a reimbursement process that minimizes insurance rejections and denials, and a blend of automation, customization, and performance tracking to enhance patient financial engagement
Imagine Software
ImagineBilling
Company Info
Founded: 2000
Customers
Customers Served: Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, SOC 2 Type 1
ImagineBilling is a medical billing software designed to enhance the efficiency and accuracy of billing processes for healthcare providers. It features automated charge and claim management, including electronic remittance, claim scrubbing, and re-filing based on specific criteria. The platform also offers tools for monitoring productivity and customizable workflows, allowing integration with various clearinghouses and vendors. Additionally, ImagineBilling includes advanced auditing capabilities to ensure coding accuracy and compliance with industry standards.
Inovalon
Inovalon Claims Management Pro
Company Info
Founded: 1998
Headcount: 1001-5000
Customers
Verified Customers: 13
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Inovalon Claims Management Pro is a revenue cycle platform for providers that manages claims across all payers. The platform offers features for automating claims submission, tracking claim statuses, and resolving denials. It provides analytics to identify issues and trends in the claims process, helping to improve efficiency and increase reimbursement rates. Additionally, it integrates with existing systems to ensure seamless data flow and comprehensive revenue management.
MedEvolve
MedEvolve
Company Info
Founded: 1998
Headcount: 51-200
Customers
Verified Customers: 1
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 1, HIPAA, ISO 27001
MedEvolve is an RCM provider, with services include medical billing, patient financial engagement, and practice management software. MedEvolve's approach, termed "Effective Intelligence," focuses on enhancing productivity and financial performance through real-time analytics and workflow automation, aiming to reduce labor dependency and increase collection rates in medical practices.
Med-Metrix
MedMetrix End-To-End
Company Info
Founded: 2010
Customers
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Med-Metrix provides end-to-end revenue cycle management (RCM) services and technology solutions for healthcare providers. Their offerings include denials management, patient intake, revenue integrity, and business insights.
Office Ally
Office Ally
Company Info
Founded: 2000
Headcount: 201-500
Customers
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HITRUST CSF, SOC 2 Type 2, HIPAA
Office Ally enables healthcare providers to submit electronic claims to payers, and has features like claim scrubbing, status tracking, and integration with various practice management systems.
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Optum
Optum Claims Management
Company Info
Founded: 2011
Headcount: 5001-10000
Customers
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Optum Claims Management streamlines the claims process for healthcare providers, from preparation and submission to payer response. It uses content and rules-based editing to screen and correct claims, enhancing first-pass payment rates and reducing feedback loops. The solution helps healthcare organizations minimize rework, delays, and denials, and ensures compliance with payer regulations.
Oracle
Oracle Cerner
Company Info
Headcount: 5001-10000
Customers
Verified Customers: 4
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA, ISO 27001
Oracle Cerner is a major EHR vendor and healthcare IT company offering RCM and population health management solutions. They offer solutions targeted for both fee-for-service providers and value-based care, including population health analytics services and care management services. Oracle Cerner was formed after Oracle Corporation’s acquisition of Cerner Corporation in 2022.
pMD
pMD
Company Info
Founded: 1998
Headcount: 51-200
Customers
Verified Customers: 16
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
pMD offers integrated healthcare solutions that enhance care delivery and practice efficiency, featuring mobile charge capture, telehealth, and revenue cycle management services
R1
R1
Company Info
Founded: 2003
Headcount: 5001-10000
Customers
Verified Customers: 9
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
R1 RCM offers a revenue cycle management platform for hospitals and healthcare systems across payment models, patient engagement strategies, or settings of care.
SimiTree
SimiTree
Company Info
Founded: 2011
Headcount: 201-500
Customers
Verified Customers: 3
Customers Served: Digital Health Provider, Ambulatory Practice
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
SimiTree RCM provides tech-enable medical billing for post-acute and behavioral health organizations.
SSI Group
SSI Claims Management
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.
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SSI Group
SSI Clearinghouse
Company Info
Founded: 1988
Headcount: 201-500
Customers
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
SSI Clearinghouse offers electronic healthcare transaction processing, including claims submissions, remittance advice, and eligibility verification. It features a robust editing suite with over 1 million edit combinations for claim validation and compliance. The service supports real-time and batch transactions with a large network of payers, including Medicare and Medicaid.
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Trek Health
Trek Health RCM
Company Info
Founded: 2022
Headcount: 11-50
Customers
Verified Customers: 15
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Trek Health's revenue cycle management platform automates various financial processes to enhance accuracy and efficiency. Key features include advanced data validation to reduce claim errors, real-time eligibility verification, automated patient billing, and communication via email or text. The platform integrates with EHR systems to enable workflows from patient scheduling to payment collection and denial management.
TriZetto
Trizetto
Company Info
Founded: 1994
Headcount: 5001-10000
Customers
Verified Customers: 6
Customers Served: Ambulatory Practice
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
TriZetto RCM aims to optimize financial outcomes for healthcare providers by handling billing processes and enhancing payment accuracy.
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TruBridge
TruBridge Clearinghouse
Company Info
Founded: 1979
Headcount: 1001-5000
Customers
Verified Customers: 1
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
TruBridge Clearinghouse provides electronic processing for healthcare transactions, including claims submissions, remittance advice, and eligibility verification. It validates and edits data to meet industry standards, reducing errors and ensuring compliance. The service allows providers to track claims status and offers reporting and analytics tools for insights into billing and claims processes, such as claim acceptance rates and denials.
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Trucare Billing
Trucare Billing
Company Info
Founded: 2021
Headcount: 11-50
Customers
Verified Customers: 2
Customers Served: Digital Health Provider, Ambulatory Practice
Product Overview
Security and Compliance Certifications: HIPAA
Trucare Billing provides medical billing services, including revenue cycle management, practice management, and credentialing for telehealth and private practice.
Veradigm
Veradigm Revenue Cycle
Company Info
Headcount: 1001-5000
Customers
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Veradigm Revenue Cycle Services provides end-to-end revenue cycle management solutions, including claims management, patient billing, and payer contract management. It aims to optimize financial performance for healthcare providers by reducing claim denials, shortening accounts receivable days, and increasing payment collections.
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