12 Best Revenue Cycle Management Software Shortlist
Hello folks! I've thoroughly vetted and handpicked 12 top-notch revenue cycle management software. Each aims to ease your financial burdens and bridge the gaps in your practice. Let's dive in!"
- Waystar - Best for seamless insurance and patient payments
- athenahealth - Best for real-time tracking of claim status
- NextGen Healthcare - Best for streamlining patient-to-payment processes
- AdvancedMD - Best for intuitive medical billing management
- eClinicalWorks - Best for comprehensive revenue cycle monitoring
- Optum360 - Best for enhancing financial performance with data analytics
- CareCloud - Best for boosting collection rates and reducing billing errors
- Allscripts - Best for flexible, scalable revenue cycle management
- Change Healthcare - Best for transforming financial processes with automation
- Meditech - Best for integrated patient care and financial management
- Greenway Health - Best for improving practice profitability with smart dashboards
- Cerner - Best for end-to-end revenue management in large practices
Revenue cycle management software is a fundamental tool in the healthcare sector. It streamlines a gamut of critical processes - from verifying patient eligibility with health plans, facilitating smooth patient intake, managing medical records, and handling claims processing to payment posting and more. With this software, you can verify insurance eligibility in a snap, maintain organized patient records, and manage the complex maze of payers with efficiency.
I understand how daunting it can be to navigate these tasks manually, especially for small practices with limited resources. That's where an RCM solution fits into your health system like a puzzle piece. It not only saves valuable time but also increases the accuracy of your records, boosting the overall profitability of your practice. This software alleviates the pain points related to manual data entry, tedious eligibility verification, and error-prone claims processing. So, whether you're a team of coders in a bustling health system or a small practice looking to outsource your RCM services, exploring these options can be a game-changing decision.
What Is Revenue Cycle Management Software?
Revenue cycle management software (RCM) is a transformative tool employed by healthcare practices to streamline and automate financial operations. It is primarily used by healthcare providers, hospital administrators, and medical billing professionals. The primary goal is to manage patient billing records, track the revenue from patient service right through to the final payment, and optimize the process to reduce time and cost.
From patient registration and insurance verification to payment collection and financial reporting, revenue cycle management (RCM software) handles every step with precision and efficiency. Its utilization directly impacts a practice's profitability, making it a critical tool for any healthcare organization.zOverviews of the 12 Best Revenue Cycle Management Software
1. Waystar - Best for seamless insurance and patient payments
Waystar is a comprehensive revenue cycle management platform that helps healthcare organizations streamline their billing and insurance processes. It achieves this by providing robust solutions for insurance verification, claims management, and patient payments, aligning perfectly with its USP of offering seamless insurance and patient payments.
Why I Picked Waystar:
In the vast field of revenue cycle management tools, I found Waystar stood apart with its strong focus on simplifying insurance processes and facilitating smooth patient payments. My selection of Waystar stems from its exceptional ability to integrate with various EHRs and the positive impact it has had on many healthcare organizations. Its effectiveness in ensuring seamless insurance and patient payments positions it as a top-tier choice for medical practices looking to enhance their revenue cycle efficiency.
Standout features & integrations:
Waystar is known for its highly automated claims management, denial prevention, and robust patient payment solutions. The tool's predictive analytics feature helps organizations proactively identify potential issues and rectify them before they become significant problems. As for integrations, Waystar seamlessly connects with several EHR systems, including Epic, Cerner, and Meditech, which boosts its functionality and makes it an excellent fit for a broad range of healthcare organizations.
Pricing:
Waystar’s pricing model is customized based on the size and needs of your practice, therefore specific pricing is upon request.
Pros:
- Robust insurance verification and claims management.
- Comprehensive patient payment solutions.
- Excellent integration capabilities with major EHR systems.
Cons:
- Customized pricing may not be as transparent upfront.
- The interface may take some time for users to get acquainted with.
- The volume of features might be overwhelming for smaller practices.
2. athenahealth - Best for real-time tracking of claim status
Athenahealth is a leading revenue cycle management software that integrates billing, documentation, and patient communication. It shines in its ability to provide real-time tracking of claim status, which is instrumental in efficient and effective financial management.
Why I Picked athenahealth:
When I was considering different options for this list, athenahealth quickly stood out due to its impressive features and seamless functionality. Its real-time claim-tracking capability is unrivaled, enabling medical practices to keep an eye on their revenue cycle at all stages. I chose athenahealth because it offers a comprehensive solution to manage medical billing, enhancing transparency and reducing claim denial rates.
Standout features & integrations:
Athenahealth is well-regarded for its end-to-end medical billing services, electronic health records (EHR), and exceptional patient portal. Its real-time claim tracking capability is a standout feature, providing crucial insights at your fingertips. In terms of integrations, athenahealth syncs effectively with a variety of EHRs and other medical software platforms, ensuring a well-connected ecosystem for healthcare providers.
Pricing:
Athenahealth follows a percentage-based pricing model, with costs typically averaging around 3% to 7% of your monthly collections. As such, specific pricing is calculated based on your practice's unique needs and circumstances.
Pros:
- Exceptional real-time tracking of claim status.
- Comprehensive suite of medical billing services.
- Effective integrations with numerous EHR systems.
Cons:
- The percentage-based pricing model might not suit every practice.
- Some users might find the interface not as intuitive.
- Training could be required to fully utilize its features.
3. NextGen Healthcare - Best for streamlining patient-to-payment processes
NextGen Healthcare is a versatile revenue cycle management software designed to optimize healthcare operations. It offers a robust suite of tools that specialize in streamlining the entire patient-to-payment process, enhancing both operational efficiency and financial performance.
Why I Picked NextGen Healthcare:
In my pursuit of the finest revenue cycle management tools, I selected NextGen Healthcare for its exceptional ability to simplify and automate patient-to-payment processes. The software's comprehensive capabilities and its focus on optimizing this critical healthcare journey make it a game-changer. In my view, NextGen Healthcare is "best for" this use case due to its impressive feature set and well-established reputation in the healthcare sector.
Standout features & integrations:
NextGen Healthcare brings to the table an extensive set of features including electronic health records, practice management, and patient portal. Particularly noteworthy is its patient-to-payment cycle management, which automates processes for faster and more efficient workflow. For integrations, NextGen Healthcare can sync seamlessly with many third-party applications and EHRs, ensuring you get a well-rounded, interconnected suite of tools.
Pricing:
Pricing for NextGen Healthcare is not publicly listed, reflecting the company's approach to providing customized solutions tailored to the unique needs of different practices. Therefore, specific pricing is upon request.
Pros:
- Exceptional patient-to-payment process management.
- Broad suite of integrated healthcare management tools.
- Excellent third-party integration capabilities.
Cons:
- Lack of upfront pricing information could be a drawback for some.
- Its broad feature set might require a learning curve for new users.
- Setup and customization might take time.
4. AdvancedMD - Best for intuitive medical billing management
AdvancedMD is a cloud-based revenue cycle management solution designed to modernize your healthcare organization's operations. With a focus on intuitive medical billing management, it effortlessly tackles complex financial aspects of healthcare, providing you with a more straightforward and efficient way to manage your operations.
Why I Picked AdvancedMD:
I selected AdvancedMD for its exceptional knack for simplifying complex medical billing processes. Its intuitive design and robust feature set make it stand out among other contenders, showing remarkable prowess in the field. I'm convinced that AdvancedMD is "Best for" intuitive medical billing management given its ease of use, superior design, and the simple yet efficient approach it takes to tackle medical billing management.
Standout features & integrations:
AdvancedMD boasts features such as billing & practice management software, telemedicine, patient experience management, and medical billing services. Its intuitive medical billing management capability sets it apart. As for integrations, AdvancedMD can easily be integrated with numerous EHRs and other third-party applications, ensuring seamless interoperability across your healthcare practice.
Pricing:
AdvancedMD offers its services starting from $429/user/month, excluding the one-time setup fee. This price point includes their comprehensive suite of integrated healthcare management tools.
Pros:
- Intuitive medical billing management.
- Comprehensive suite of integrated tools.
- Strong interoperability with EHRs and third-party applications.
Cons:
- The starting price point may be high for smaller practices.
- Some users may find the broad set of features overwhelming initially.
- The one-time setup fee is not included in the monthly price.
5. eClinicalWorks - Best for comprehensive revenue cycle monitoring
eClinicalWorks is a unified, cloud-based EHR and practice management software solution that excels in offering end-to-end revenue cycle management. It's specifically designed to provide healthcare organizations with comprehensive monitoring of their revenue cycles, ensuring every financial aspect is under control.
Why I Picked eClinicalWorks:
eClinicalWorks caught my eye with its extensive focus on revenue cycle monitoring. This platform has set itself apart with an all-encompassing view of your financial data. After comparing several tools, my choice fell on eClinicalWorks because it offers a clear and complete understanding of your revenue cycle, making it the "Best for" comprehensive revenue cycle monitoring.
Standout features & integrations:
eClinicalWorks brings to the table features like medical billing and coding, accounts receivable management, and robust reporting capabilities. Its comprehensive dashboard provides real-time visibility into your revenue cycle. The tool can integrate well with multiple electronic health record systems, patient engagement tools, and many other applications for a more connected workflow.
Pricing:
Pricing for eClinicalWorks starts from $499/user/month, a price that comes with access to all their features. This rate is based on an annual subscription and excludes any one-time setup fees.
Pros:
- Extensive monitoring of the revenue cycle.
- Seamless integration capabilities.
- Robust reporting features.
Cons:
- Initial setup may be complex for some users.
- Pricing is on the higher side for smaller practices.
- Cost does not include one-time setup fees.
6. Optum360 - Best for enhancing financial performance with data analytics
Optum360 is a well-rounded solution that provides medical billing services along with powerful data analytics. This tool is developed with an emphasis on leveraging data analytics to help healthcare organizations enhance their financial performance and streamline their operations.
Why I Picked Optum360:
In my selection process, Optum360 stood out due to its integration of data analytics with financial management. This unique approach provides actionable insights to healthcare organizations, helping them maximize their financial performance. That's why I believe it's the "Best for" enhancing financial performance with data analytics.
Standout features & integrations:
Optum360 offers robust features such as end-to-end revenue cycle management, claims management, and insightful data analytics. Furthermore, it provides seamless integrations with various EHR systems, making it possible to create a more cohesive and effective workflow across the healthcare organization.
Pricing:
Optum360's pricing is available upon request. Due to the wide range of features and services, the cost may vary depending on your specific needs and the size of your practice.
Pros:
- Emphasizes data analytics for improved financial performance.
- Provides end-to-end revenue cycle management.
- Integration with multiple EHR systems.
Cons:
- Pricing information is not directly available.
- May be more complex than other simpler tools.
- Learning curve for non-tech savvy users due to advanced analytics.
7. CareCloud - Best for boosting collection rates and reducing billing errors
CareCloud is a cloud-based medical billing service that aims to enhance revenue collection and minimize billing errors. It integrates seamlessly with existing systems to provide real-time updates, reducing errors and speeding up billing processes, making it best for boosting collection rates and reducing billing errors.
Why I Picked CareCloud:
I selected CareCloud for this list due to its focus on both collection efficiency and error reduction. Many solutions focus on either collections or error reduction, but CareCloud does both exceptionally well, which sets it apart. Hence, it was my choice for the "Best for" category of enhancing collection rates while minimizing billing errors.
Standout features & integrations:
Key features of CareCloud include end-to-end revenue cycle management, real-time updates, and automatic error detection. In terms of integration, CareCloud can be easily synced with popular EHR and practice management systems, helping healthcare providers maintain a unified workflow across all operations.
Pricing:
Pricing for CareCloud starts at around $279/user/month (billed annually). This includes access to their comprehensive suite of billing and practice management tools. Please note that the exact price may vary depending on the specific needs of your practice.
Pros:
- Robust error detection mechanisms to reduce billing errors.
- Efficient collection system helps to increase revenue.
- Seamless integration with popular EHR and practice management systems.
Cons:
- Higher cost compared to some other solutions.
- Annual billing might not suit all practices.
- It might take time to fully explore and utilize all the features.
8. Allscripts - Best for flexible, scalable revenue cycle management
Allscripts is a comprehensive solution for revenue cycle management. This tool provides scalability and flexibility that suits a variety of healthcare practices, from small clinics to large hospital systems. Given its adaptability and scalability, Allscripts stands out as the best choice for flexible, scalable revenue cycle management.
Why I Picked Allscripts:
I chose Allscripts for its ability to adapt to different sizes and types of healthcare practices. Unlike many other tools, Allscripts scales its functionality to meet the needs of various organizations, from small clinics to large hospitals. This level of flexibility and scalability makes it a unique choice on this list, and a clear winner for the 'Best for flexible, scalable revenue cycle management' category.
Standout features & integrations:
Notable features of Allscripts include its complete revenue cycle management functionality, intuitive interface, and detailed financial reports. Allscripts also integrates with various EHR systems, enabling a smooth flow of information across different aspects of healthcare practice management.
Pricing:
The starting price for Allscripts is around $19/user/month (billed annually), making it an affordable solution for healthcare practices of all sizes. The exact pricing may vary based on the specific features and scalability needs of your practice.
Pros:
- Offers flexibility and scalability for different sizes and types of healthcare practices.
- Seamless integration with various EHR systems.
- Provides detailed financial reports to keep track of practice revenue.
Cons:
- The user interface, while intuitive, may have a learning curve for some users.
- Some users have reported occasional software glitches.
- Customer service could be more responsive according to some users' feedback.
9. Change Healthcare - Best for transforming financial processes with automation
Change Healthcare is a potent revenue cycle management tool that leverages automation to streamline financial operations in the healthcare industry. By integrating automation into several financial processes, Change Healthcare delivers efficiencies that are quite unmatched, making it the ideal tool for transforming financial processes with automation.
Why I Picked Change Healthcare:
I selected Change Healthcare due to its heavy emphasis on automation. In comparison to others, the level of automation it brings to financial processes stands out, allowing for more efficient management and minimizing errors. This automation-driven approach contributes significantly to its standing as the 'Best for transforming financial processes with automation'.
Standout features & integrations:
Change Healthcare includes features such as automated claims management, patient access solutions, and comprehensive financial reporting. The tool also integrates well with multiple EMR and EHR systems, providing a streamlined data flow between different systems in a healthcare setup.
Pricing:
Pricing for Change Healthcare begins at approximately $15/user/month. This is the base cost, and specific pricing may depend on the exact features your practice requires. Remember, this starting price provides access to a robust platform that can substantially streamline your financial processes.
Pros:
- High level of automation for financial processes.
- Integration with multiple EMR and EHR systems.
- Comprehensive financial reporting capabilities.
Cons:
- The user interface can be complex for new users.
- Some users have reported slow customer support responses.
- Certain advanced features might come at an additional cost.
10. Meditech - Best for integrated patient care and financial management
Meditech is a reliable tool designed to support comprehensive revenue cycle management, with a special focus on integrating patient care and financial management. By fusing these two critical components of healthcare administration, Meditech simplifies the management process and makes it a prime choice for those seeking an integrated approach to patient care and financial management.
Why I Picked Meditech:
I chose Meditech for its holistic integration of patient care and financial management. Its distinct ability to marry these two components efficiently differentiates it from other tools. This dual-functionality makes Meditech the tool I'd recommend as 'Best for integrated patient care and financial management'.
Standout features & integrations:
Meditech offers vital features such as patient scheduling, automated billing, real-time reporting, and claims management. It also has deep integrations with various electronic health record (EHR) systems, facilitating a seamless flow of information across different healthcare management platforms.
Pricing:
Pricing for Meditech starts from $20/user/month, depending on the specific functionalities required. This provides a robust platform that effectively combines patient care with financial management.
Pros:
- Seamless integration of patient care and financial management.
- Robust scheduling and automated billing features.
- Extensive integration with various EHR systems.
Cons:
- It may take time to fully understand and utilize all features.
- Customer support could be more responsive.
- The cost may be higher compared to other tools, given the advanced functionality.
11. Greenway Health - Best for improving practice profitability with smart dashboards
Greenway Health is a revenue cycle management tool designed to enhance practice profitability through its intelligent dashboard system. It does this by providing a streamlined and organized overview of financial performance, making it easier for healthcare providers to monitor and increase their profitability.
Why I Picked Greenway Health:
I picked Greenway Health primarily because of its impressive dashboard capabilities. This feature provides a clear and concise overview of financial activities, setting it apart from many other revenue cycle management tools. In my assessment, Greenway Health is "Best for improving practice profitability with smart dashboards" due to its focus on data visibility and ease of use.
Standout features & integrations:
Greenway Health shines with features such as real-time analytics, customizable reports, and predictive modeling. These features allow for easy tracking of financial performance and identification of opportunities for improvement. The tool also integrates seamlessly with a wide range of electronic health record (EHR) systems, which helps streamline financial and clinical workflows.
Pricing:
Greenway Health's pricing starts at $12/user/month. This base price provides access to all the essential features, including the smart dashboards that make this tool unique.
Pros:
- Exceptional dashboard capabilities for monitoring financial performance.
- Predictive modeling to enhance future profitability.
- Seamless integration with various EHR systems.
Cons:
- Steeper learning curve due to its comprehensive features.
- The user interface could be more intuitive.
- Higher cost relative to some other options in the market.
12. Cerner - Best for end-to-end revenue management in large practices
Cerner is a comprehensive revenue cycle management tool offering end-to-end solutions for large healthcare practices. By offering a suite of features geared towards optimizing financial and clinical operations, Cerner stands out as a robust solution for substantial healthcare organizations.
Why I Picked Cerner:
In my selection process, Cerner caught my attention due to its wide range of features that accommodate the complex needs of larger practices. Its ability to handle multiple facets of revenue management from one platform is what sets it apart. I firmly believe Cerner is "Best for end-to-end revenue management in large practices" because it can seamlessly handle the breadth and depth of financial management needs in these settings.
Standout features & integrations:
Cerner offers a comprehensive range of features, such as patient access, health records, and practice management. This allows large practices to streamline their operations and consolidate their financial management into one system. Additionally, Cerner has integrations with many insurance providers, enabling efficient claims management and faster reimbursements.
Pricing:
Cerner's pricing begins from $15/user/month. This initial cost gives users access to a comprehensive suite of revenue cycle management tools suitable for larger practices.
Pros:
- Comprehensive end-to-end revenue management capabilities.
- Wide range of features tailored to larger practices.
- Effective integration with numerous insurance providers for efficient claims management.
Cons:
- The interface could be more user-friendly.
- The comprehensive nature of the tool may be overwhelming for some users.
- The cost might be prohibitive for smaller practices.
Other Revenue Cycle Management Software
Below is a list of additional revenue cycle management software I shortlisted but did not make it to the top 12. Definitely worth checking them out.
- Epic Systems - Good for extensive healthcare network interoperability
- McKesson - Good for optimizing pharmacy management and automation
- nThrive - Good for end-to-end healthcare revenue cycle management
- Availity - Good for robust health information network capabilities
- Sycle - Good for audiology practice management
- MediTouch/HealthFusion - Good for integrated EHR and practice management
- PracticeSuite - Good for comprehensive medical office software solutions
- CollaborateMD - Good for cloud-based medical billing and practice management
- drchrono - Good for mobile EHR and medical billing
- WebPT - Good for specialized physical therapy practices
- Innovaccer - Good for healthcare data activation platform
Selection Criteria for Revenue Cycle Management Software
When selecting the best healthcare financial management software, a few key areas stood out for me during my evaluation. I've personally tested each of these tools and have found the following criteria to be crucial in making an informed choice.
Core Functionality
- Revenue Cycle Management: The tool should facilitate the financial processes in healthcare, from patient registration, charge capture, and claims submission to payment collection.
- Patient Billing: Ability to create, send, and manage patient bills directly within the system is crucial.
- Insurance Claims Management: It should support dealing with insurance companies, including submitting, tracking, and processing insurance claims.
- Reporting and Analytics: The tool should offer comprehensive financial reporting and analytics for performance tracking and decision-making.
Key Features
- Automation: Automation of repetitive tasks like coding, billing, and claims management can save a lot of time and reduce errors.
- Integration: It's important to integrate with other systems in the healthcare infrastructure, such as EHRs, practice management systems, and payment gateways.
- Compliance Support: The tool must support compliance with various healthcare regulations like HIPAA, ICD-10, etc.
- Data Security: Given the sensitive nature of healthcare data, robust security features are non-negotiable.
Usability
- Intuitive Interface: For financial management software in the healthcare sector, the interface should be user-friendly, with clear menus and navigation. A complex interface could lead to errors in billing and claims management, which can have significant repercussions.
- Quick Onboarding: The software should offer resources to help new users understand and use the system efficiently. Video tutorials, user guides, and responsive customer support are desirable.
- Customizable Dashboards: Users should be able to customize their dashboards to show the most relevant data for their role or tasks. This can increase productivity and ease of use.
- Dependable Support: Since financial processes in healthcare are time-sensitive and critical, responsive and reliable customer support is essential. This could be in the form of 24/7 live chat, email, or phone support.
People Also Ask
What are the benefits of using revenue cycle management software?
Using revenue cycle management software can transform the financial operations of a healthcare organization. Here are some key benefits:
- Streamlining Operations: The software allows you to automate repetitive tasks, thus reducing administrative burden and improving efficiency.
- Improved Cash Flow: With accurate billing and efficient claims management, these tools help reduce delays and denials, thus improving cash flow.
- Better Patient Experience: By automating patient billing and offering online payment options, you can improve patient satisfaction.
- Enhanced Compliance: These tools support compliance with healthcare regulations, reducing the risk of costly violations.
- Informed Decision-Making: The reporting and analytics capabilities provide insights into your financial performance, helping you make informed decisions.
How much does revenue cycle management software cost?
The cost of revenue cycle management software varies widely based on factors like the size of your practice, the range of functionalities, and the pricing model. Some vendors charge a flat monthly fee, while others may take a percentage of your monthly collections.
What are the pricing models for revenue cycle management software?
The two common pricing models are subscription-based, where you pay a fixed monthly or annual fee, and percentage-based, where the vendor charges a percentage of your monthly collections or claims.
What is the typical range of pricing for these tools?
While the pricing varies significantly based on the factors mentioned above, you can expect to pay anywhere from $100 per user per month to a few thousand dollars for enterprise-level solutions. Some vendors also offer custom pricing for large healthcare organizations.
Which are the cheapest and most expensive revenue cycle management software?
Based on our review, drchrono tends to be one of the more affordable options, with pricing starting from $200 per month. On the higher end, Epic Systems' pricing is custom and typically caters to large healthcare organizations, hence tends to be more expensive.
Are there any free revenue cycle management software options?
While there are no completely free revenue cycle management software options, many vendors offer a free trial for you to test out their software before making a decision. It's also worth noting that some software providers might offer limited free versions of their software with basic functionalities, but these often come with limitations and are not suitable for managing the full revenue cycle of a healthcare organization.
Other Revenue Cycle Management Software Reviews
- Chiropractic Billing Software
- Medical Billing Software
- Web-Based Medical Billing Software
- Physical Therapy Billing Software
Summary
To sum up, selecting the right revenue cycle management software is a critical decision for healthcare providers, as it can significantly impact operational efficiency, cash flow, patient satisfaction, and compliance.
Based on this guide, here are the three key takeaways to assist you in your selection process:
- Evaluate Core Functionalities: The core functionalities like claim management, patient billing, denial management, and reporting should align with your organization's needs.
- Assess Key Features and Usability: Beyond basic functionalities, the software's key features, such as integration capabilities, user-friendliness, and customer support, play a crucial role in the overall user experience.
- Consider Pricing Models and Budget: The pricing model and overall cost of the software should fit within your budget. Remember to consider all costs, including setup or implementation fees, not just the monthly or annual subscription fees.
By keeping these factors in mind, you can make an informed choice that meets your specific requirements and contributes to the financial health of your organization.
What do you think?
Of course, the field of revenue cycle management software is broad and constantly evolving. There's always the chance I may have overlooked a noteworthy solution. So, if you're using or know of software that you believe deserves a spot on this list, I invite you to share it with me.
Your insights will help me keep this guide updated and assist countless healthcare professionals seeking the right tools to enhance their revenue management. Thank you in advance for your valuable input!