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Revenue Cycle Solutions for Hospitals and Health Systems

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Revenue Cycle Solutions for Hospitals and Health Systems Alternatives

Revenue Cycle Solutions for Hospitals and Health Systems

Top 10 Revenue Cycle Solutions for Hospitals and Health Systems Alternatives & Competitors

Consumer-Centric Healthcare: Rising costs of healthcare means patients are more financially responsible for their healthcare costs than ever before. Desiring a more retail-like healthcare experience, patients are seeking providers who offer better opportunities to engage in their overall care. As a result, providers are focused on improving the patient experience and communicating with patients about their financial responsibility. Change Healthcare offers services and technologies that help providers improve the capture of patient financial data, increase collections, and improve the patient experience through better communication strategies at all points of service. Financial Clearance Solutions -Ahi QA: Helps providers improve the accuracy of patient registration data with real-time quality assurance and management tools. -Ahi LobbyTM: Helps providers track patient flow, wait time, and patient service levels at registration. -Clearance Patient Access Suite: Helps providers increase registration data accuracy, validate patients’ identity, complete insurance eligibility verification, secure preauthorization, estimate patients’ financial responsibility, accept point-of-service collections, and assist patients who are unable to pay as they consider financial assistance programs. -Coverage InsightTM: Helps providers screen all patients, service types, and balance levels to identify missed or undisclosed reimbursement sources for patient accounts via advanced analytics. Financial Clearance Services: Onsite and remote teams help hospitals improve collections by determining patient eligibility for insurance or other funding sources and assisting with enrollment. Our Eligibility & Enrollment Services and Financial Counseling help identify coverage and charity care and assists patients with setting up payment plans. Third Party Coverage helps identify reimbursement from motor vehicle accident and workers’ compensation claims. Patient Experience Solutions -Clearance Estimator: Helps hospitals and health systems create better patient estimates at or before the point of service to help increase collections and improve patient satisfaction. -Clearance Price Transparency: Engages patients seeking price transparency with an interactive, easy-to-use portal. -Patient Access Center Services: Patient access and call center services help hospitals and medical practices drive patient engagement, improve patient satisfaction, and optimize revenue. Optimize Revenue and Reduce Risk: Mid-cycle solutions from Change Healthcare help you optimize reimbursement by ensuring care is medically necessary and defensible, capturing all charges, supporting accurate claim coding, and maintaining coding compliance without adding pressure to your billing departments. -Charge Capture Advisor: Combines artificial intelligence with an efficient workflow to predict missing charges prior to claim submission, automatically and proactively creating a more complete claim to help increase and accelerate revenue. -InterQual®: An evidence-based clinical decision support solution to help ensure clinically appropriate medical utilization. The objective, comprehensive criteria enables defensible, consistent decision-making and an efficient way to proactively manage patient care to reduce length of stay, inappropriate admissions and readmissions, unneeded interventions and, in turn, denials. -InterQual AutoReview™: A robotic process automation solution that pulls clinical data from your EHR to complete InterQual medical reviews automatically, instantly, and accurately, saving case management time. The automated reviews are enriched with real-time clinical data, increasing trust with your payers. Revenue Integrity Services: These customer-centric services cover every specialty, meet virtually any volume need, and include care provided in both inpatient and outpatient facilities. -Physician and Hospital Coding Services: Helps providers strengthen reimbursement and reduce risk by outsourcing or augmenting facility and professional fee-coding functions. -Clinical Documentation Improvement Services: Helps improve the quality of clinical documentation and facilitates an accurate representation of healthcare services. -Coding Quality and Audit Services: Helps mitigate risk by implementing quality review programs that verify accuracy and identify potential coding and compliance issues. -Charge Capture Compliance Audit Services: Identifies missing charges to help optimize revenue and reduce the impact of negative cash flow. Improve Revenue Performance Our proven, end-to-end revenue cycle solutions can be customized to fit your organization’s specific needs. Leverage our 40+ years of physician and hospital billing and claims management experience to transform your revenue cycle and positively impact your organization’s financial health. -Assurance Reimbursement Management™: Helps hospitals and health systems speed reimbursement and reduce costs by applying comprehensive business rules to claims, and by pairing automation and advanced workflow with meaningful reporting. This software solution helps to increase first-pass claim acceptance rates and utilizes artificial intelligence to identify claims at risk for denial so providers can address these claims before submission. -Revenue Performance Advisor: Helps practices, labs, and other non-acute medical organizations get claims right the first time to avoid costly resubmissions and minimize denials. Revenue Performance Advisor software is integrated with practices’ existing workflows, enabling you to submit claims directly from your practice management or billing system. Hospital and Physician Revenue Cycle Management Services End-to-end revenue cycle management and medical billing services can provide as much—or as little— outsourcing help as you need. Our domain expertise in both physician and hospital billing and claims management, combined with decades of revenue cycle experience, can help your organization reduce operating costs, optimize cash flow and net patient revenue, and improve billing and collection efficiency. -A/R Management: Revenue cycle and A/R management services for hospitals and health systems that want to become more operationally efficient and improve financial performance. -Patient Responsibility Management: Self-pay patient collection services for hospitals and health systems that want to increase patient collections and shorten billing collection cycles. -Business Office Outsourcing: A single-vendor resource for hospitals and health systems that want to drive incremental revenue improvement and lower cost-to-collect percentages. -Denials and Appeals Management: Denials and appeals management services for hospitals that want to improve their clean-claims rate, better manage denied claims, and have expert assistance in handling appeals. -Underpayment Audit and Recovery: Underpayment recovery services for hospitals that want to better manage denied claims and quickly correct healthcare underpayments. Improve Consumer Payment Collection -Build an Effective Payment Management Strategy To increase patient collections, update your payment management strategy to reflect industry trends: Nearly one-third of all insured consumers are covered by high-deductible health plans (HDHPs)2, which means more of your patients are paying a larger portion of their healthcare expenses. With this increased financial responsibility comes a desire for more information and improved engagement. The shift to HDHPs parallels the rise in consumerism. As patients are taking an active role in purchasing and paying for healthcare services, we can assist this transition by providing more of a retail experience with convenient choices for both billing communications and payments, including online options. -Communication and Payment Solutions Change Healthcare helps providers build an effective payment management approach encompassing three key strategies: SmartPay™: Helps simplify the payment process with multiple, patient-friendly payment options to help drive collections. You can accept payments in-person, through the mail, online, and by phone. -Patient Billing and Statements: Successful providers consider their print strategy as a way to send personalized communications designed to engage with consumers. We incorporate input from focus groups to maximize the effectiveness of your patient bills and statements, driving patient engagement, faster payments, patient satisfaction, and reduced print and mail costs. -Payment Automation: Reduce the complexity and cost of processing both paper-based and electronic transactions by expediting and automating back-office payment processing and posting activities. Acquire a Consumer- Centric Focus • More than half of healthcare stakeholders surveyed consider patient engagement tools and services to be strategic necessities.3 • Accepting virtually all payment types during the patient visit (or via phone, online, or mail) can increase collections up to 224%.4 • Change Healthcare has industry-leading scale and capabilities, delivering 2.5 billion images per year, with 800 million documents mailed annually.5 To be competitive, your organization needs to understand the drivers of performance, the impact of quality on financial outcomes, and the benefits of potential efficiency gains. These insights can be obtained with a more comprehensive view of your patient, population, network, revenue cycle, and organizational health. We help you connect and transform disparate data points into actionable insights and help you benchmark with your peers, so you can make more informed decisions across your organization. Our Financial Analytics Solutions Include: -Acuity Revenue Cycle AnalyticsTM: Analyze historical revenue cycle trends within and across facilities, and drill down to identify root causes of issues and drive corrective action. We help providers analyze financial performance and operational results in minutes, without burdening IT resources. -Pulse Revenue Cycle Benchmarking TM: We help hospitals and health systems analyze timely, equitable data from hospitals across the country and from relevant payers to help leaders establish benchmarks, compare performance support negotiations, and justify decisions with supporting data. -Enterprise Business Insight: We help healthcare organizations develop custom solutions designed to centralize organizational data for easy access and reporting. -Performance Analytics: A healthcare analytics solution for providers that want to leverage financial, clinical, and operational data to improve quality, reduce cost and risk, and diagnose current issues with interactive analytics. Provides financial and clinical stakeholders with a strategic understanding of financial risk in relation to care quality—in real time. 2“Employer Health Benefits, 2018 Annual Survey” Kaiser Family Foundation, October 2018 3“The 9th Annual Industry Pulse Survey” A national survey of leading health plans and other healthcare stakeholders commissioned and conducted by the HealthCare Executive Group and Change Healthcare, 2019 4Internal Change Healthcare data; results are not guaranteed.
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Revenue Cycle Solutions for Hospitals and Health Systems
Top 10 Revenue Cycle Solutions for Hospitals and Health Systems Alternatives & Competitors

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Overall Top 10 Revenue Cycle Solutions for Hospitals and Health Systems Alternatives & Competitors for Small Health Systems

Browse options below. Based on data from AVIA reviews and gathered information about the vendor's clients, you can see how Revenue Cycle Solutions for Hospitals and Health Systems stacks up to the competition. Check reviews from current & previous users at other small hospitals and health systems to find the best product for your you organization.

#1

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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

XpertCoding is an AI enabled autonomous medical coding platform that automates over 90% of medical coding with 99% accuracy within 24 hours. XpertCoding also includes a Business Intelligence suite with a Clinical Documentation Improvement (CDI) Dashboard and a Comprehensive Data Analytics Dashboard, providing essential insights for healthcare leaders and teams to optimize operations.

What organizations can expect from XpertDox:

Unmatched Automation and Accuracy

  • Fully Automated Medical Coding: Automates 94% of claims without human review, ensuring speed, accuracy, and efficiency with minimal supervision.
  • Performance-Based Coding: Tracks quality and performance metrics effectively with support for Category II CPT codes.
  • Reduces Coding Errors to Less Than 1%: Ensures compliance and minimizes claim denials, delivering precise and consistent coding outcomes with >99% coding accuracy
  • Faster Claim Processing in less than 24 Hours: Accelerates claim submission timelines, ensuring faster reimbursements and reduced backlogs.
  • Smart Claim Scrubber: Customizable to align with payor-specific rules, reducing denials and rejections for smoother claim submissions.
  • EMR or EHR-Agnostic Solution: Enables easy data extraction and Fully Automated Claim Submission, ensuring uninterrupted workflows with any EMR or EHR system.
  • Modifies and Improves 80% of Claims: Streamlines workflows, eliminating bottlenecks and enhancing operational efficiency.

Enhanced Financial Outcomes for Clients

  • Flexible Pricing Model: Offers transparent, per-claim pricing for scalable and cost-effective solutions tailored to your needs.
  • Delivers a 15% Increase in Charge Capture: Optimizes revenue generation and ensures accurate billing practices.
  • Reduces Claim Denials by 22%: Strengthens the revenue cycle and minimizes payment delays.
  • Drives 23% Growth in PMPM Payments: Boosts practice revenue by up to 19%, significantly enhancing financial performance.

Revenue Cycle Optimization and Advanced Insights

  • Revenue Cycle Dashboard: Provides real-time visibility into key performance metrics and financial health, empowering data-driven decisions.
  • Clinical Documentation Improvement (CDI): Optimizes compliance and documentation accuracy for improved financial outcomes and streamlined workflows.
  • Advanced Analytics Suite: Benchmarks provider and clinic performance with actionable insights, helping healthcare teams make informed, strategic decisions.
  • Proactively Recovers Missed Charges: Identifies and retrieves overlooked charges from previously submitted claims, enhancing revenue integrity.

Secure and Risk-Free Implementation

  • HIPAA-Compliant Infrastructure: Ensures secure data privacy and full regulatory compliance, offering peace of mind for healthcare organizations.
  • Risk-Free Implementation: Includes zero upfront fees and a complimentary first month, allowing you to experience the benefits without risk.
  • ISO 27001, ISO 22301, SOC2 Type II compliant

Proven Results

  • Reduces charge entry lag by 40%, ensuring timely claim submissions. Achieves less than 1% coding errors, significantly improving compliance and reducing denials.
  • Enhances efficiency and accuracy, enabling healthcare teams to focus more on delivering high-quality patient care.

XpertCoding by XpertDox

XpertCoding is XpertDox's premier autonomous medical coding platform, designed to accelerate the revenue cycle with unmatched accuracy and efficiency. With risk-free implementation, zero upfront fees, and a complimentary first month, healthcare organizations can experience the transformative benefits of XpertCoding firsthand.

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product capabilities
Intelligent Automation
Advanced Analytics and Reporting
Compliance and Security
Continuous Performance Improvement
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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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#2

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Rated In Top 10%
Rated In Top 10%
Versatile platform
Versatile platform
svg iconGreat fit for AMC
svg iconGreat fit for AMC
Rated In Top 10%
Rated In Top 10%
Versatile platform
Versatile platform
svg iconGreat fit for AMC
svg iconGreat fit for AMC

There is a different way to work. If you were to reimagine the way you run your business, what would you do differently? What if you could save up to 80% of your operational costs by reimagining the way business outcomes are delivered?

Through the power of automation emerging technologies, we challenge you to think differently about how you work and how you use your people to full effective.

We can help you across the automation journey from thinking through your strategy to implementing and executing robotic process automation, machine learning and other emerging technologies across the enterprise.  

Revenue Cycle Management:

Prior Authorization ​

Insurance Claims - Posting

Patient Payment - Posting

Coordination of Benefits: Primary, Secondary, & Tertiary

Revenue Integrity - Payment Audits (Under & Over)

Provider: Insurance Enrollment

Revenue Integrity - Charge Description Master (CDM) Management

Revenue Integrity - IME or IMR Audits (CMS & Medicare Advantage)

Insurance Claims - Denied & Rejected Follow-Up

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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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#3

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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

Cedar Pay makes it simpler for patients to navigate the post-service financial journey and take control of their medical bills. We deliver enterprise-grade patient billing and payment solutions that leverage Cedar's cutting-edge consumer engagement technology, unique payer integrations and aligned incentives to help provider organizations increase collections, boost efficiency and deliver an exceptional patient experience. More than 55 of the nation's leading health systems and physician groups turn to Cedar to transform the patient financial experience. On average, Cedar Pay lifts patient collection rates by 30%, with 88% of patients reporting a positive experience.

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product capabilities
Self-service out-of-pocket estimator
Digital statementing
Statement consolidation
EOB reconciliation
Post-service patient payment
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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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#4

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Versatile platform
Versatile platform
Versatile platform
Versatile platform

HealthNautica’s eORders™, software is a comprehensive, easy-to-use, cloud solution for managing the entire perioperative process and surgical scheduling without changing your scheduling system. It begins with the physician’s office filling out an online surgery scheduling or procedure request.

Gone are the days of illegible, incomplete, inaccurate faxes sent back and forth between the physician’s office and the facility’s scheduling department. The cumbersome and error prone faxing process is replaced by an electronic form that is configured to each facility’s exact specifications and reacts to the user’s input thereby assisting the physician’s office in getting it right the first time.

All orders are legible, complete, screened for CMS Medical Necessity, incorporate SCIP, VTE, SSI and ACS NSQIP measures, verified for insurance eligibility, pre-certified and satisfy edits by CMS, commercial payers and the facility. Our solution ensures efficient surgery center scheduling and block time management while streamlining processes such as prior authorization.

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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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#5

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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

We are not just RPA Developers! In other words, we do not just build your automations and drop them at your door. CampTek Software is a full life cycle Managed Service provider that offers an array of Services based on your current and future requirements and can tailor hybrid solutions that you can take advantage of.

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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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#6

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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

For hospitals, it is 4x harder to collect from patients than insurance payers. Patients now make up to 30% of hospital revenue but are 4x harder to collect from than insurance payers1 due to complexity, regulation and patient means. 

Sift Healthcare provides advanced analytics and machine learning integrations to optimize patient payments. Sift combines patient payment expertise and AI-driven intelligence to equip providers with an integrated toolset to optimize patient financial engagement.

Patient collections should be a dialogue, not a solicitation. Sift integrates AI into your patient engagement platform to guide patient communications activities – maximizing collections while improving patient engagement.

  • Account Segmentation
  • Patient Contact Strategy
  • Payment Plan Provisioning
  • Improved collections, increased payment plan adoption, and reduced inbound/outbound calls

Propensity-to-pay for a person, not a number. Sift goes beyond credit scores, leveraging historical data to determine the best engagement approach for each patient.

  • Improved Patient Satisfaction
  • Pre-service patient financing and collection recommendations that help avoid surprises and set expectations
  • Lookalike predictive models, not credit scores and rule logic
  • Increased upfront collections with more empathy
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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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#7

Versatile platform
Versatile platform

Apierion Enables Regulatory Bodies, Insurance Companies & Facilities to Issue Credentials and Permits Seamlessly

Review Committee Dashboard

Fully Customizable

Payments Secured via Apierion’s Payment Technology

Secure Document Uploads into Vault

Permissioned, Secure Access can be granted upon request

Digital Identity Resides in a Data Vault Which Dynamically Updates

Bi-directional Data, Messaging and Payments

Digital Medical Twin NFTs

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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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#8

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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 Revenue Intellect™ solution is a cloud-based, guided-analytics platform that is designed to help maximize and sustain financial margin. Revenue Intellect enables users to Identify hidden or hard-to-find sources of revenue loss and access data, ranging from targeted analyses to free-form data exploration, to provide value to all levels of a health care provider's operational structure.
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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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#9

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5+ years in business
5+ years in business
5+ years in business
5+ years in business
https://www.exlservice.com/healthcare-fa-overview
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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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#10

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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
Dashboard connects your staff with the information that matters most to them. Your employees can order, view, and manage reports all from one single convenient location. We work to ensure that each department gets exactly the information they need to manage risk and increase productivity: from patient access to financial clearance to billing and collections.
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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
To see which organizations are using this product, sign in or create a free account.

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