Revenue Cycle Automation
Revenue Cycle Automation products use AI and elements of RPA to automate key workflows in revenue cycle management, including claims processing, prior authorization, patient payment collection, eligibility verification, and denials management. These platforms generally integrate with EHRs, practice management systems, and other RCM tools, and provide agents that can accomplish key workflows. Core capabilities include:
Integration with existing systems through APIs or advanced web browsing capabilities
Ability to define key workflows for automation, with well-defined inputs and outputs
Tracking and analytics to understand effectiveness of workflow automations and identify key issues
While there are many RPA platforms, our focus with this category is on vendors who specialize in healthcare and RCM, or who have the scale to have deep expertise on healthcare workflows.
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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.
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.
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
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
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.
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.
Confido Health
Confido Health
Company Info
Founded: 2022
Headcount: 11-50
Customers
Customers Served: Hospital / Health System, Ambulatory Practice
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA, ISO 27001
Confido Health is a healthcare technology company that leverages artificial intelligence (AI) to automate administrative workflows in medical practices, thereby enhancing efficiency and patient engagement. Their AI agents handle tasks such as appointment management, payment collections, pre-operative and post-operative care coordination, chronic care management, and addressing care gaps. By integrating with existing electronic health record (EHR) systems, Confido's solutions aim to reduce staff workload, improve patient access, and optimize operational efficiency.
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.
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.
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
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.
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.
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.
Rotera
Rotera Alyks
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.
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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.
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
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.
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.
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