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Best Revenue Cycle Management (RCM) Products

Best Revenue Cycle Management (RCM) Products

Optimizing revenue cycle processes equals a $9.5B total opportunity.

Revenue cycle management is integral to creating a financially solvent health system. However, embedded in the current process for managing the healthcare revenue cycle are many time-consuming manual processes that contribute to high administrative costs. Revenue cycle stages of securing prior authorization and financial clearance, improving clinical documentation, assigning proper codes, and managing denied claims require substantial labor resourcing. Doing these tasks manually can result in staff burnout and costly errors throughout a patient's care.

Additionally, today’s market presents many challenges—higher costs and deductibles, decreasing reimbursements, more regulatory complexity, shifting payment models, and increasing consumerism. To deal with these financial pressures, health systems are being forced to innovate.

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Revenue Cycle Management (RCM): Products


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10 products
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Rated In Top 10%
Rated In Top 10%
Versatile platform
Versatile platform
5+ years in business
5+ years in business
Rated In Top 10%
Rated In Top 10%
Versatile platform
Versatile platform
5+ years in business
5+ years in business

Caregility Cloud™ connects patients and care teams everywhere on a secure, versatile virtual care platform that brings remote care support and AI capabilities to the patient's bedside, from the hospital to the patient's home. Reduce operational costs while keeping clinical teams and patients more connected and engaged. Intelligent telehealth edge devices integrate with clinically designed care applications to offer one-on-one and one-to-many remote patient engagement and care team support. Seamlessly integrate with leading EHRs, Clinical Decision Support (CDS) tools, connected digital health devices, interpreter services, and interactive patient consoles to modernize care models. Native and integrated AI tools enhance the art of what's possible in remote clinical workflows. 

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product capabilities
Virtual Encounter
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Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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Versatile platform
Versatile platform
  • Advanced analysis for Spirometry and Oximetry
  • EMR/EHR Integration: HL7, FHIR (Json), GDT, DICOM, eXchange Protocol, and many others
  • Compliant with the latest ATS/ERS guidelines, NIOSH, OSHA
  • Anonymization functionality of patient list, printing, data import/export, etc.
  • Comprehensive and customizable prints
  • Available for desktop and laptop
  • MacOS and Windows
  • Pediatric incentive with real-time animation
  • Multilingual: supports up to 22 languages

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key clients
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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Versatile platform
Versatile platform
5+ years in business
5+ years in business
Versatile platform
Versatile platform
5+ years in business
5+ years in business
HQP's unique system of Advanced Preventive Care (APC) uses community-based nurse care managers ("Preventionists") to better control chronic conditions, avoid complications, and improve the quality of life. APC is a unique system of care for older adults with chronic conditions to identify and mitigate as many risks to health as possible, especially focusing on risks that are important, but not as readily recognized or addressed by our existing health system. When reliably delivered and replicated to appropriately selected populations it saves lives and reduces overall health care costs significantly.
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Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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Versatile platform
Versatile platform
5+ years in business
5+ years in business
Versatile platform
Versatile platform
5+ years in business
5+ years in business
Our Measure product provides continuous objective measurement of mental health and the option of engaging feedback to patients and a clinical dashboard to clinicians. Our Cue platform provides measurement-driven personalized mental health interventions.
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key clients
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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Versatile platform
Versatile platform
5+ years in business
5+ years in business
Versatile platform
Versatile platform
5+ years in business
5+ years in business

Sidekick's digital solutions use consumer and life science-grade medical technology to create a user experience like no other. Each solution is a unique blend of CBT principles and gamification strategies, and users are offered altruistic rewards as part of their experience.

Our platform combines strong clinical validation with gamification, behavioral economics and artificial intelligence (A.I.) to deliver a truly engaging and personalized patient experience that removes barriers to health behavior change.

Our A.I. technology, developed by trailblazers in the field and leading experts from the gaming industry, reads and rewards positive behavior and serves relevant content and programs, triggering a continuity of positive behavior.

Patients engage with a rich user experience, earning rewards for managing their nutrition, exercise, sleep, stress and medication adherence. They also receive condition-specific education, and a connection to a community of health professionals and patients on a similar health journey. And our little helpers– your personal Sidekicks – will help you stay the course.

Valuable data sets are collected throughout the journey – we have collected over 50 million data points – providing a deep understanding of behavioral trends.

Top US payers and pharma companies use Sidekick to improve their patients quality of life, reduce ER visits and optimise care management and ultimately reducing the total cost of care. 

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product capabilities
Personalized care plans
Multimodal delivery options
Real-time data collection
Connected FDA-approved devices
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key clients
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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Versatile platform
Versatile platform
Versatile platform
Versatile platform

Welby Health offers a comprehensive remote care solution that empowers primary care providers to deliver high-quality, continuous care for patients with chronic conditions. We go beyond simple remote monitoring by integrating Chronic Care Management (CCM), Remote Patient Monitoring (RPM), and Behavioral Health into a single, seamless platform, supported by a team of licensed nurses.

**Here's how our comprehensive approach works:**

  • Chronic Care Management (CCM):** Our CCM program provides proactive, coordinated care for patients with complex conditions. Licensed nurses work closely with patients and their primary care providers to develop personalized care plans, provide education and support, and monitor progress. This includes medication management, coordinating with specialists, and addressing social determinants of health.
  • Remote Patient Monitoring (RPM):** We leverage technology to collect and analyze patient data remotely, providing real-time insights into their health status. Patients use connected devices to track metrics like blood pressure, weight, and blood glucose, allowing for early detection of potential issues and timely intervention.
  • Behavioral Health Integration:** We recognize the crucial link between physical and mental health. Our platform facilitates the integration of behavioral health services, enabling providers to address mental health concerns that can impact chronic conditions. This includes screening for depression and anxiety, providing access to behavioral health resources, and coordinating care with mental health professionals.
  • HEDIS Score Improvement:** Our platform is designed to support HEDIS quality measures, helping providers track and improve performance in areas like medication adherence, blood pressure control, and depression screening. We provide tools and resources to help practices meet HEDIS reporting requirements and enhance quality scores.

**Benefits of Welby Health's Comprehensive Remote Care Solution:**

* **Improved Patient Outcomes:** Proactive care, early intervention, and coordinated care management lead to better health outcomes, reduced hospitalizations, and improved quality of life for patients.

* **Increased Efficiency:** Our platform streamlines workflows, automates tasks, and centralizes patient information, freeing up provider time and improving practice efficiency.

* **Enhanced Patient Engagement:** We empower patients to actively participate in their care through education, self-management tools, and convenient communication channels.

* **Increased Practice Revenue:** We help practices implement CCM and RPM services and bill for reimbursable activities, creating new revenue streams.

* **Value-Based Care Success:** Our focus on proactive care, prevention, and patient outcomes aligns with the goals of value-based care models, helping practices succeed in this evolving landscape.

Welby Health's comprehensive remote care solution empowers primary care practices to deliver high-quality, patient-centered care that improves outcomes, enhances efficiency, and drives success in the era of value-based care.

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key clients
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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Rated In Top 10%
Rated In Top 10%
Versatile platform
Versatile platform
5+ years in business
5+ years in business
Rated In Top 10%
Rated In Top 10%
Versatile platform
Versatile platform
5+ years in business
5+ years in business

Our tech-enabled services for CCM extends your provider's reach, and because the platform is integrated directly into your EHR we help streamline holistic care. From medication reviews and appointment scheduling to durable medical equipment (DME) assistance and medical billing codes. TimeDoc Health gets your patients what they need and provides visibility where your providers need it.

Many organizations do not have the technology or internal staff needed to provide the care and documentation required for CCM. We can supplement your care coordination efforts by taking on any or all of the care provided to patients. You deserve a solution provider that can be flexible to your needs, that’s why our hybrid approach has made us an industry leading partner for care management.

No matter if you decide to leverage the TimeDoc software alone or deploy our services, you will be able to facilitate information sharing within care teams, support seamless care transitions, and make it possible to monitor adherence to comprehensive care plans.

  • 80%: Americans of Medicare age with two or more chronic conditions 1
  • $74: Reduction in cost per patient/month on average with Chronic Care Management
  • 37%: PCPs say patients with chronic conditions are in “noticeably worse health resulting from the pandemic”
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key clients
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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Versatile platform
Versatile platform
5+ years in business
5+ years in business
Versatile platform
Versatile platform
5+ years in business
5+ years in business

MaST is part of Holmusk Europe and we help Community Mental Health Services to change the way they use data and information so that they can improve the quality of life for people using services across England.

We improve caseload management and people’s flow through services by identifying those who are at greater risk of using crisis services and those who may require different services to support their recovery. Our decision support tools provide a sustainable way to stabilise and transform community mental health services.

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key clients
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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Versatile platform
Versatile platform
Versatile platform
Versatile platform

Seamlessly integrating with your existing EHR, our white-labeled, customizable platform gives you a single dashboard for managing patient care, workflows, and notifications across all the facilities you serve. This isn’t just generic software—it's tailored to be uniquely yours, branded under your URL, and designed around your specific needs and workflows

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Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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Versatile platform
Versatile platform
Versatile platform
Versatile platform
The current stroke care model, which is how even the highest and most sophisticated comprehensively certified programs operate, is too fragmented, focuses on just the first few days of care, and is extremely costly due to its reactive care setup. While patients receive top-notch emergent and initial inpatient care today at certified programs, nationally, 85% of strokes have acute care complications, readmission occurs in 13% of stroke cases, 20% of patients have a recurrent stroke within 90 days, and risk factor control for key elements (such as blood pressure, diabetes, and medication control) is at most 45% of post stroke patients. Stroke Link Health was created to address these issues and improve patient outcomes. With our model, we also save thousands of dollars in care per patient from providing coordinated, longitudinal team dynamics wrapped around the patient and family. In contrast to the current stroke model, Stroke Link Health offers an advanced model that links the care continuum, focuses on long-term patient outcomes and engagement, and reduces cost with proactive care management. We are designed as a true integrated stroke practice unit (ISPU). We engineer telehealth-enabled, collaborative teams called Stroke Central (hospital-based) and Stroke Mobile (home- and virtual-based post-acute and chronic care service). These teams unite the acute, post-acute, and chronic care continuum using a protocolized and proprietary care management and education model that wraps around the patients and families for 12 months. It is true longitudinal care.
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key clients
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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Buyer's Guide


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A Buyer's Guide to

Revenue Cycle Management (RCM)

What is digital in revenue cycle management?
Digital RCM solutions are software platforms and technologies that automate and optimize the healthcare revenue cycle. These tools leverage advanced algorithms, artificial intelligence, and data analytics to streamline financial processes, improve efficiency, reduce errors, and provide actionable insights.

Solution framework

Front-end
Credentialing Systems that verify and assess the qualifications, experience, and professional background of healthcare providers to ensure they meet the standards required to practice within a specific healthcare organization or network.
Insurance eligibility verification and prior authorization Systems that confirm a patient’s insurance coverage, benefits, and obtain approval from the insurance provider for specific medical procedures or treatments before they are performed.
Price transparency and cost estimation Systems that provide clear, accessible information about the costs of healthcare services to patients, including estimated out-of-pocket expenses, and facilitating various payment options to improve financial clarity and patient satisfaction.

*Scheduling and Pre-Registration are crucial parts of the Front-End Revenue Cycle process. Please see our Digital Front Door categories for companies in the Scheduling and Pre-Registration space.


Mid-cycle
Clinical documentation integrity Systems that ensure patient medical records are accurate, complete, and properly reflect the patient’s condition, treatments, and outcomes to support quality care, appropriate reimbursement, and regulatory compliance.
Medical coding Systems that translate medical diagnoses, procedures, and equipment into universal alphanumeric codes based on standardized coding systems (e.g., ICD-10, CPT) for accurate billing and reporting.


Back-end
Claims management Systems that prepare, submit, track, and resolve healthcare claims with insurance payers to ensure timely and accurate reimbursement for services provided.
Denials and appeals management Systems that identify, analyze, and address denied claims, including the process of appealing incorrect denials to maximize reimbursement and improve future claim submission accuracy.
Patient billing and payment collection Systems that generate accurate patient bills, communicate financial responsibilities, offer payment options, and collect payments for healthcare services rendered.
Revenue cycle analytics and intelligence Systems that use data analysis tools and techniques to gain insights into the revenue cycle performance, identify trends, predict outcomes, and make data-driven decisions to optimize financial performance and operational efficiency.

Transforming revenue cycle management (RCM) through digital innovation is no longer just a back-office necessity; it’s a strategic imperative for healthcare organizations. By leveraging advanced RCM solutions, organizations can not only reduce administrative burdens and improve cash flow but also elevate the patient financial experience. A seamless, data-driven revenue cycle empowers healthcare providers to reinvest in their mission, delivering higher-quality care, expanding access, and driving sustainable growth in an increasingly complex environment.
Amberly Diets
— Beth Konczakowski
Director of Strategic Advisory Services

The case for digital in revenue cycle management

Healthcare systems today face numerous challenges that impact their financial stability and operational efficiency through increasing complexity of reimbursement models, rising costs, and growing patient financial responsibility. In this landscape, digital solutions for revenue cycle management have the potential to address these issues and optimize healthcare financial operations.

Key drivers for digital in RCM

Financial performance
One of the most pressing concerns in healthcare is maintaining financial stability while delivering high-quality care. Many healthcare organizations struggle with narrow margins and financial pressures with the average operating margin for hospitals performing at a loss of 13.5% in 2022. 1 Effective RCM addresses this challenge by streamlining revenue capture, reducing claim denials, and accelerating cash flow. By implementing robust RCM solutions, healthcare organizations can improve their financial performance, ensure proper reimbursement for services rendered, and maintain the resources necessary to provide excellent patient care.
Administrative burden
Administrative costs in healthcare have reached unsustainable levels, accounting for 15-25% of total healthcare spending in the United States. 2 Much of the administrative load falls on clinical staff, contributing to burnout and job dissatisfaction. RCM solutions offer a way to alleviate this burden by automating many administrative tasks related to billing, coding, and claims processing. Through intelligent automation and workflow optimization, RCM not only improves operational efficiency but also has the potential to enhance job satisfaction and retention among healthcare professionals.
Patient financial experience
As patient financial responsibility continues to grow, with out-of-pocket costs rising exponentially year-over-year, healthcare organizations face increasing pressure to provide a transparent and consumer-friendly financial experience. 3 Traditional billing practices often lead to confusion, frustration, and ultimately, lower collection rates. RCM solutions address this by offering patient-centric billing options, unified billing, clear cost estimates, and flexible payment plans. By improving the patient’s financial journey, healthcare organizations can increase patient satisfaction, boost collection rates, and build long-term patient loyalty.
Regulatory compliance
Healthcare organizations operate in a highly regulated environment, with complex rules governing billing, coding, and reimbursement. Non-compliance can result in significant financial penalties and reputational damage. The total cost for non-compliance is currently deemed greater than $14M. 4 RCM solutions help organizations navigate this regulatory landscape by embedding compliance checks into workflows, automating documentation for audits, and staying up-to-date with changing regulations. This proactive approach to compliance not only reduces risk but also improves the accuracy and efficiency of the revenue cycle.

Key attributes of revenue cycle management solutions

Effective Revenue Cycle Management solutions share several critical attributes that enable them to optimize financial performance and enhance operational efficiency. When evaluating RCM solutions, healthcare organizations should look for the following key characteristics:

End-to-end coverage
  • Manages the entire revenue cycle from patient scheduling to final payment
  • Complements existing practice management systems to streamline financial operations
  • Provides a unified platform for all revenue cycle functions
Example: An RCM ecosystem that handles scheduling, eligibility verification, coding, billing, and collections within a single integrated platform.
Intelligent automation
  • Utilizes AI and machine learning to automate routine tasks
  • Employs robotic process automation (RPA) for repetitive, rule-based processes
  • Reduces manual data entry and associated errors
Example: An RCM solution that automatically codes encounters based on clinical documentation and updates claims in real-time.
Advanced analytics and reporting
  • Offers real-time financial dashboards and key performance indicators
  • Provides predictive analytics for denials management and cash flow forecasting
  • Enables drill-down capabilities for detailed analysis of revenue cycle performance
Example: A system that predicts which claims are likely to be denied and suggests preemptive actions to prevent denials.
Patient-centric financial experience
  • Offers clear, upfront cost estimates and explanations of benefits
  • Provides multiple payment options and flexible payment plans
  • Enables self-service portals for patients to manage their accounts
Example: A patient portal that allows individuals to view their bills, set up payment plans, and make payments online or via mobile app.
Compliance and security
  • Ensures adherence to healthcare regulations (e.g., HIPAA, HITECH)
  • Provides robust data security measures to protect sensitive financial information
  • Offers audit trails and reporting for compliance monitoring
Example: An RCM system with built-in compliance checks that flag potential regulatory issues before claims are submitted.
Real-time eligibility and benefits verification
  • Performs instant insurance eligibility checks
  • Provides detailed breakdowns of patient benefits and coverage
  • Updates patient financial responsibility in real-time
Example: An RCM tool that automatically verifies insurance coverage when appointments are scheduled and updates information at check-in.
Denial management and prevention
  • Identifies root causes of denials through pattern analysis
  • Offers workflow tools for efficient denial follow-up and appeals
  • Provides education and training to prevent future denials
Example: A denial management module that categorizes denials, assigns them to appropriate staff, and tracks appeal outcomes.
Continuous performance improvement
  • Benchmarks performance against industry standards
  • Identifies areas for process improvement and cost reduction
  • Provides ongoing training and support for optimal system utilization
Example: An RCM system that compares an organization’s key metrics to peer benchmarks and suggests improvement strategies.

Organizing for success with revenue cycle management

To successfully implement Revenue Cycle Management solutions, health systems must consider several key factors. By keeping these principles in mind, organizations can effectively optimize their revenue cycle operations and achieve financial goals.
  • Conduct a comprehensive revenue cycle assessment
    1. Analyze current performance metrics across all stages of the revenue cycle
    2. Identify pain points, inefficiencies, and opportunities for improvement
    3. Benchmark performance against industry standards and best practices
  • Optimize existing technology and processes
    1. Assess current RCM technology for underutilized features and potential upgrades
    2. Identify and address user issues regarding existing systems
    3. Explore opportunities for automation and improvement within existing systems to maximize efficiency with current and new technologies
  • Invest in staff training and change management
    1. Provide comprehensive training on new RCM systems and processes
    2. Educate all staff on the importance of accurate documentation and coding
    3. Offer ongoing education to keep staff updated on best practices and regulatory changes
    4. Encourage open communication about revenue cycle challenges and solutions
    5. Recognize and reward staff contributions to revenue cycle improvement
  • Establish key performance indicators (KPIs) and monitoring processes for continuous improvement
    1. Define clear, measurable KPIs for each stage of the revenue cycle
    2. Use analytics tools to identify trends, patterns, and opportunities for improvement
    3. Implement data-driven decision-making processes across the revenue cycle
    4. Regularly review and act on insights generated from RCM analytics
  • Optimize front-end processes
    1. Implement robust patient registration and eligibility verification processes
    2. Develop clear financial counseling protocols for patients
    3. Establish processes for accurate charge capture and coding at the point of service
  • Stay current with regulatory changes and industry trends
    1. Establish processes for monitoring and implementing regulatory updates
    2. Participate in industry associations and conferences to stay informed of best practices
    3. Regularly evaluate new technologies and solutions that could enhance RCM performance
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