End-to-End Revenue Cycle Management
Product Usage: NexGen was purchased to automate claims processing and to reduce manual efforts.
Strengths: The robust feature set was a standout, including automation capabilities and complex billing rules.
Weaknesses: The software’s reliability and customer support were both heavily criticized.
Overall Judgment: Despite early signs of improving the billing rate, disappointments in system reliability and low-quality customer support made the reviewer reconsider their choice.
Product Usage: The product is used by healthcare providers for scheduling, consultations, telehealth appointments, claims billing, and member data management.Strengths: The strength is its API that performed well with 700 endpoints, enabling customization and enhancement by the company’s engineering team.Weaknesses: Weaknesses include problems with Careequality integration and occasional errors in API documentation that do not match returned data. Overall Judgement: Despite minor issues, the product is seen as a good fit for the company’s needs, providing the flexibility required for a unique digital healthcare model.
Product Usage: Candid is mainly used for post-visit claims adjudication, including claim submission, payment posting, denial management, accounts receivable, and reporting.
Strengths: The product offers a clear user interface, sufficient denial management functionality, responsive customer service and is more cost-effective compared to competitors.
Weaknesses: The product lacks the ability to bulk edit claims and some configuration options are not available to end users but must be done by their engineering team.
Overall Judgment: Despite minor areas for improvement, the product is a valuable, cost-effective solution to revenue cycle management, with excellent customer service and a straightforward user interface.
Product Usage: The product is used for back-end revenue cycle processes, from claim submission to payer and patient payment reconciliation.
Strengths: The product is flexible, accepts APIs, and works with a variety of claim formats.
Weaknesses: The product is a startup, meaning they are still building and developing certain features that established products already have.
Overall Judgment: The reviewer deemed their choice of Candid Health to be the right one as it provides flexibility and partnership that other mature products might not offer.
Product Usage: The team mainly uses the Adonis for claims processing, with Adonis taking full control of the RCM process.
Strengths: Adonis’ RCM services require minimal involvement from the user’s team, making them appear like an extension of the user’s team; the alignment of incentives was also praised.
Weaknesses: The absence of a medical coder for accurate representation of the user’s care and flow with the right CPT codes was noted as a weakness; the late availability to the dashboard was also seen as a negative.
Overall Judgment: The reviewer has been happy with Adonis, relishing the minimal involvement their team needs to have and praising the customer service and the strong connection the company tries to establish with its customers.
Product Usage: Enter functions as the claims submission provider, handling insurance responses, verifying eligibility, and informing us of any claims denials.
Strengths: Enter offers transparency, allowing the reviewer to see actions taken on a claim, are specific in what needs to be done to resolve a given claim, and are responsive to operational feedback.
Weaknesses: Enter sometimes does not respond to messages quickly enough, and they sometimes fail to keep track of changes, resulting in redundancy in communication.
Overall Judgment: Despite some communication issues, Enter provides a very good service offering transparency, support, and guidance. The reviewer feels their decision was correct.
Product Usage: Canvas’s EHR is used for scheduling patient appointments, logging activities such as phone calls, visits, changes to a patient’s profile, condition and history, and it is also used for telehealth appointments and claims generation and management.
Strengths: Canvas’s strengths lie in its flexibility and customization capabilities, its functionality that allows users to create automations based on actions or notes in a patient’s chart and its robust API documentation and integration features.
Weaknesses: Areas where Canvas falls short include the management and generation of claims, tracking patient risk adjustment and quality measures, and also navigating their backend data for reporting purposes; additionally, the system sometimes experiences bugs and freezes.
Overall Judgment: Despite some limitations and issues, Canvas is a generally stable Electronic Health Record system that provides a higher degree of customization and flexibility than other comparable systems, and it is well suited to those with technical know-how who are comfortable with configuring a system to suit their needs.
Product Usage: Canvas used for recording chart notes, storing lab information, prescribing medications, conducting lab orders when available, and executing billing tasks.
Strengths: The product offers a reliable platform with automation functionality, the ability to easily identify the correct pharmacies for medication orders, and a flexible tasking feature.
Weaknesses: There are limitations with the invoicing system, reporting capabilities, communication tools among providers, medication history tracking, and tasking functionality is still basic.
Overall Judgment: The reviewers are generally positive towards the product, praising its reliability, automations, and customizable tooling; despite recognizing improvements could be made in the billing, reporting, and task features.
Product Usage: Canvas is being used as the company’s electronic medical record for charts and billing, recent usage of its task management feature has been introduced, and scheduling feature is being considered.
Strengths: The interface is user-friendly, the task management feature is effective for managing workload and workflow, and the autosave feature is appreciated.
Weaknesses: The knowledge center is not as helpful as it could be, locating specific settings can be challenging for administrators, command-driven entries can slow down workflow for providers, and the limitation in dashboard field customizations obstructs quick information access.
Overall Judgment: Despite identified areas for improvement, majority feedback has been positive, particularly when considering a shift from their previous EMR system, Athena, and would recommend Canvas with noted considerations.
Product Usage: Canvas is primarily used for managing patients’ clinical charts, creating claims, and dealing with patients’ claims and profiles.
Strengths: Canvas offers more visibility and a clearer workflow when dealing with patients’ claims and profiles compared to previous product.
Weaknesses: Canvas has some issues with system setup, such as wrong population of multiple locations in script ordering and missing data fields when using the claim edit feature. However, these issues are believed to be due to user error and not Canvas itself.
Overall Judgment: Overall, the product is praised for its ease of use and customization options, with a recommendation from the review to take full advantage of its capabilities.
Product Usage: Candid Health is used to submit claims, handle EFT/ERA and EDI enrollments, perform preliminary checks on claims, and manage the claims process through an integrated workflow.
Strengths: Candid Health’s key strengths include a highly responsive team, a tech-focused approach, and a flexible rules engine.
Weaknesses: Ambiguity in service scope was a challenge initially which led to some confusion about responsibilities, the CSV export feature has been less reliable, and larger-scale operations may want to bring certain services in-house to handle higher complexity.
Overall Judgment: Candid Health comes highly recommended for its high-quality sales process, support, and account management, with particularly positive remarks on its ability to improve workflows and its desire to grow with customer base.
Product Usage: Canvas is used for charting, patient management, claims tracking, scheduling and sending reminders and integrates with telehealth through Doxy.me for video appointments.
Strengths: Canvas offers real-time access to data, flexible configurations, protocols for tracking patient needs, and a robust FHIR API which allows extensive customization and integration capabilities.
Weaknesses: Areas for improvement include high user interface sophistication, limited revenue cycle management functionality, and a more structured approach to tasking.
Overall Judgment: Canvas, described as the Salesforce of EMRs, is highly appreciated for its emphasis on allowing users to build their features and regular performance improvements, despite a few bug encounters.
Product Usage: The medical group uses athenahealth’s Revenue Cycle Management (RCM) tool for billing CPT codes, claim review, and claim submissions.
Strengths: athenahealth is a well-known platform with an automated claims processing system, compliance updates, easy usability, and integrated EMR.
Weaknesses: It is not customizable to complex billing nuances, not ideal for concierge practices or non-CMS billing guidelines followers, and it is relatively costly.
Overall Judgment: The medical group is satisfied with its decision to retain athenahealth due to its familiarity, CMS compliance and integrations, despite its high cost and inflexibility to complex billing routines.
Product Usage: Canvas is primarily used by the customer’s care coordination team, social workers, and nurses, as well as insurance navigation staff and genetic counselors for structured and unstructured documentation.
Strengths: Canvas’s strengths lie in its customization and flexibility, Canvas’s attentive responses to customer feedback, and impressive ongoing efforts to improve features and customer experience.
Weaknesses: Despite its strengths, Canvas has some limitations, such as its handling of reporting features, integration with Claim.MD, a not fully-featured scheduling and messaging platform, and a manual provider directory feature.
Overall Judgment: Overall, Canvas has been a good choice for the company, providing valuable features and demonstrating strong product growth over time.
Product Usage: This reviewer uses Canvas for managing detailed documentation and maintaining clinical records for patients in a virtual specialty clinic.
Strengths: Canvas’s simplicity, efficient clinical notes, and modern UI are highlighted strengths of the product.
Weaknesses: The reviewer pointed out the limited and unreliable API functionality and the product’s presumption of a standard clinical model as weaknesses.
Overall Judgment: Despite its limitations, the reviewer believes that Canvas may be a suitable tool for organizations with basic clinical documentation needs.
Product Usage: The product has been used for about a year and a half for revenue cycle management and it is adapted for scaling up operations, including new features like remote patient monitoring-based billing.
Strengths: Its expertise, understanding of venture-backed companies, scalability, and tech focus made it stand out from the competition; it also provides proactive services and handles issues effectively, even offering support for troubleshooting.
Weaknesses: The product had minor issues which were promptly addressed with transparency; there were also some gaps in functionality which, though identified and prioritized by the company, led to delays in delivery.
Overall Judgment: The reviewer has had a positive experience with the product and its performance, communication, and support from the vendors, considering it to be one of the best vendors in delivering value from their product.
Product Usage: The product, Canvas, was used as an Electronic Health Record (EHR) and a care management system for non-clinicians and nurse practitioners in a tech-enabled service provider for chronic care management.
Strengths: The product was easy to customize, quick and collaborative to implement, and priced competitively.
Weaknesses: The product experienced frequent performance issues, had limited capabilities, lacked robust APIs, and struggled with scheduling and patient data segregation.
Overall Judgment: Despite the ease of initial setup and customization, the persistent technical issues and a lack of certain crucial functionality led to platform migration.
Product Usage: The product is being used as a source of clinical truth for patients, documenting meaningful patient care delivered, chat encounters, and submitting $0 claims for compliance purposes in value-based contracts.
Strengths: Athenahealth’s strengths include its extensive features, built-in Revenue Cycle Management support, and certain specialty-specific capabilities.
Weaknesses: The main weaknesses of Athenahealth are poor API performance, lack of prompt support for clients on lower-priced plans, and the cumbersome and time-consuming solution validation process.
Overall Judgment: The user experiences frustration with Athenahealth’s service model, but acknowledges that some trade-offs may become worthwhile once billing through Athenahealth begins in earnest.
Product Usage: The company has incorporated Athena for over a year as an integrated EMR and RCM solution that eliminates the need for multiple vendors and is popular within independent primary care practices.
Strengths: Athena is a comprehensive system whose clinical inbox structure is effective, offers an adequate API capability, and nightly backend data syncing via Snowflake.
Weaknesses: Athena’s data migration process and its API documentation are weak points, alongside a lack of real-time event notifications on patient chart changes, and the system requires creating duplicate user accounts for clinicians working across departments.
Overall Judgment: Athena is fairly satisfactory but not exceptional, with challenges linked to building on top of it and getting approvals for API use, and would likely be used for existing clinics but might be replaced with a more manageable product for expansion into new areas.
Product Usage: The user leveraged Athena for various operations excluding patient scheduling (handled by Phreesia) and patient care management tasks (handled by ActiveCampaign).
Strengths: Athena offered an excellent sandbox environment for testing and its user interface was considered more intuitive compared to competitors like Epic.
Weaknesses: The user found it challenging to work with Athena’s APIs due to incomplete documentation, and getting support with these issues was difficult.
Overall Judgment: While Athena was suitable for the company’s needs as a brick-and-mortar practice, the user questions the additional value gained from building custom apps on top of it.
Product Usage: Waystar is used for daily automated claims submissions, ERA enrollment, and eligibility checking.
Strengths: Waystar is user-friendly and simple to navigate with a robust search functionality.
Weaknesses: Waystar’s reporting functionality is lacking, requiring extensive use of spreadsheets for data analysis and tracking; support responsiveness and issues with deeper engineering aspects were highlighted.
Overall Judgment: Despite its user-friendly interface and features, Waystar might not be the best solution for those companies seeking robust reporting capabilities and flawless engineering support.
Product Usage: Apero was primarily used to power all backend aspects of our Revenue Cycle Management (RCM) process, from claim submission to reporting.
Strengths: Apero excels in offering granular tracking and reporting on each individual claim throughout the RCM lifecycle.
Weaknesses: While offering a robust solution, Apero could further improve its product by adding higher-level summary features or more visually appealing information displays.
Overall Judgment: The company was satisfied with Apero due to its tech-forward approach, responsive customer service, and strategic partnership attitude.
Product Usage: Enter Health was used for revenue cycle management (RCM) services focused on CMS-1450 institutional billing for Medicare and Medicaid in a value-based setting.
Strengths: The strengths of Enter health include their advancement in AI and software efficiency, reasonable pricing model at smaller and larger scales, transparency in the data system, well-designed search function for outstanding or processed claims, automated functionalities, and excellent customer support.
Weaknesses: The product’s main weakness was its lack of knowledge and expertise in the user’s specialty and extensive difficulties in the integration process.
Overall Judgment: Enter Health is a robust platform with efficient and transparent processes, despite its shortcomings in handling specific specialties; better understanding of the different models between service-based and tech-based RCM could influence the decision to use it.
Product Usage: Athena’s EHR is being utilized by the medical assistants in the clinic to manage tasks such as checking patients in/out, scheduling appointments, uploading and pulling reports among others. The providers mainly use it to document patient visits and approve orders.
Strengths: Athena has a robust API, allowing system manipulations without touching the user interface, and it includes an integrated eFax system that manages the sorting and assignment of faxed documents.
Weaknesses: There is an excessive number of clicks required for charting and templates provided are not efficient as they are. The user interface for certain features also seems outdated.
Overall Judgment: Despite certain drawbacks, Athena’s EHR would likely still be in use in two years barring any major issues like price increases, large networks moving away from it, or the shutdown of core features. A significant improvement in other EHRs could also lead to a switch.