Best Revenue Cycle Management (RCM) Products

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.

CodaMetrix is a SaaS platform, hosted in the AWS Cloud environment, that uses AI and ML to interpret structured and unstructured clinical data from the Electronic Health Record (EHR) to reduce time and cost of coding while increasing the quality of claims data. It works in parallel with existing coding processes, automatically capturing chargeable billing codes and providing medical coding teams with context and suggestions for codes that require further review.

CodaMetrix currently supports Epic, GE, Meditech, and Cerner and can be expanded to other EHRs. It is available in a growing number of service lines including Radiology, Pathology, Endoscopy, Surgery, and Evaluation & Management. CMX Insights™ delivers real-time visibility into coding performance, financial impact, and compliance risks—empowering health systems to optimize operations, reduce denials, and drive continuous improvement.

Ambience Healthcare’s AI platform for documentation, CDI, and coding has been deployed at health systems such as Cleveland Clinic, UCSF Health, St. Luke’s Health System, John Muir Health, and Memorial Hermann Health System. Ambience is the only AI scribing and coding solution designed to support 100+ specialties and subspecialties, and is directly integrated with Epic, Cerner, athenahealth, and other leading EHRs. 

By partnering with Ambience, healthcare systems reduce documentation time by an average of 80%, improve clinical documentation integrity, and achieve at least a 5X return on investment with more accurate E&M coding. Ambience is also the only AI solution that provides clinicians with AI-assisted CDI support. Ambience surfaces precise diagnosis codes for clinicians to review based on patient conversations, then structures documentation to support selected codes. 

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.

Our single platform approach provides immediate visibility into revenue cycle opportunities, tackling some of today's biggest challenges with the following Productized Analytics Suite Modules:

• Workforce Quality Insights (WQI) – Links front-office actions to financial KPIs
• Patient Access Insights (PAI) – Enhances financial experience pre-service
• Revenue Integrity Suite (RI) – Reduces denials and compliance risks
• Productivity Analytics (PA) – Improves staff productivity in real-time
• Cost Insights (CI) – Targets controllable costs
• Business Office Suite (BOS) – Unifies patient accounting data

Valer’s technology speeds and simplifies prior authorization and referral management by automating submissions, status checking, verification, reporting, and EHR synchronization across all mid-to-large sized healthcare settings, specialties, and payers from one platform and portal.

All built just for you.

Patients placed in the wrong bed status with improper documentation results in massive revenue loss and patient dissatisfaction.

Physicians can’t keep up with constantly changing criteria needed to admit patients to the hospital, and hospitals spend tons of money and resources fixing bed status issues retrospectively.

AdmissionCare provides the admitting physician with automated admission criteria - such as MCG - integrated directly into the EHR workflow to help document medical necessity that increases payer reimbursements and reduce denials.

How does it work?

• Integrate into the clinician's EHR workflow
• Determine the most appropriate bed status for each patient at admission
• Synchronize payer criteria with the clinician's documentation
• Collect revenue for the care provided, while avoiding costly denials

QGenda Credentialing helps healthcare organizations complete credentialing faster and easier while improving data accuracy, transparency, and compliance. Through advanced automation and highly configurable workflows, this intuitive solution creates a predictable, repeatable, and scalable credentialing process that enables organizations to increase productivity, shorten turnaround times, and accelerate time to revenue.

Our pre built and custom revenue cycle management bots run the gamut from Pre-Visit to Accounts Receivable and all that's in between. We've automated processes in Epic, eCW, Cerner and so many more! We offer full automation lifecycle services and support. Check out our Revenue Cycle products: https://www.campteksoftware.com/healthcare-revenue-cycle-management/

Solv’s suite of features provides you with everything you need to exceed patients’ expectations the first time they ever interact with your brand, with tools that are proven to increase loyalty, reduce leakage, and accelerate revenue collection. 

Solv provides a digital presence for providers to want to offer convenient, accessible healthcare to their patients, with features including:
- Online self-scheduling
- Digital registration with insurance capture and electronic consent
- Online payment
- Video telemedicine
- Automated waitlist management and optimization
- Secure chat
- Feedback, surveys and reputation management
- New patient acquisition
- Returning patient loyalty portal