Without the necessary cash flow, medical practices can’t properly care for their patients. That’s why, although the focus of healthcare organizations is to serve patients, finances are an important element that can’t be overlooked.
Medical finances contain a lot of moving parts, from accepting patient co-pays to billing insurance agencies. It’s essential to assess your revenue cycle as a whole and invest in solutions that make revenue cycle management (RCM) easier. By doing so, you’ll reduce the administrative burden on your staff and improve your medical practice’s financial health.
In this guide, we’ll look at RCM companies that deliver solutions you need for better financial health. We’ll cover:
Revenue cycle management is as important to a medical practice as lungs are to a patient. By implementing the right software and practices now, you can set up your medical organization for a stronger financial future.
Top RCM Companies
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1.
PracticeSuite
If you’re looking for comprehensive software that covers RCM, practice management, EHR, and more, PracticeSuite is the right choice for you. We’ve delivered secure, cloud-based solutions to small to mid-sized medical practices and billing service groups for over 20 years, serving 61+ clinical specialties.
Our mission is to help doctors practice profitably by providing exceptional RCM software. Our RCM tools include:
- Medical billing: Streamline and accelerate your entire revenue cycle, from patient payments to final insurance reimbursement. Navigate billing accounts for all patients across multiple practices to ensure you get paid.
- Insurance verification: Verify patient insurance eligibility immediately so you always know how much to charge for co-pay and other fees. Obtain prior authorization for services that need it so you can treat patients knowing that their insurance will cover them.
- Patient collections: Establish a straightforward and convenient payment process to promote timely patient collections for their portion of the medical bill.
- Enterprise claims management: Handle rejections, denials, payment posting, and mass claims corrections in a single dashboard.
- KPI dashboard: Monitor your RCM performance in real time with a single centralized dashboard that shows everything from key performance indicators to claim denials to payments.
- Financial reporting: Access all the data you need to make informed decisions about RCM, enabling you to achieve long-term financial stability.
- Customer support: Our RCM billing tools come with reliable customer support that’s there for you 24/7.
PracticeSuite brings decades of medical billing and revenue cycle experience to your medical practice, supplying you with all the tools you need to handle RCM. With our RCM software and services, you’ll gain deep insight into your revenue cycle, enabling you to achieve maximum profitability.
Practice profitably with PracticeSuite.
We offer revenue cycle management software and services to ensure you get paid for patient care. Click to book a demo.
2.
Oracle
Oracle offers technological solutions for various industries, helping businesses transform their operations and adopt a data-driven approach. For healthcare clients, this RCM company’s tools provide actionable health insights that automate processes and optimize resources.
A few of their standout features include:
- Financial clearance: Evaluate whether existing data is accurate and up to date to minimize the amount of information patients are asked to verify during preregistration or on arrival.
- Contract management: Manage payer contracts by viewing net receivables upon charge posting, offering detailed patient responsibility breakdowns, and supporting real-time reimbursement calculations.
- Insurance management: Enable healthcare insurers to offer a transparent member experience with better policy administration, faster premium calculations, and quicker benefits adjudication.
Best for: Hospitals, healthcare payers, and insurance groups
3.
Greenway Health
Greenway Health provides healthcare technology to over 10,000 ambulatory practices, including RCM software. Its RCM tools empower healthcare providers to optimize revenue and better manage their practice’s finances, delivering a personalized approach to revenue cycle partnership that supports its clients’ unique practice goals.
This RCM company’s standout features include:
- Specialty-specific financial care team: Work with a certified financial care team that aligns with your specialty to ensure your staff members are supported.
- Code auditing: Greenway Health’s team of experts can audit your medical practice’s coding practices. This RCM company also offers a range of coding services from full-service coding to targeted support for complex cases.
- Expedited implementation: Greenway Health works with you to optimize your system configuration and implement your new RCM software as soon as possible to quickly elevate your RCM success.
Best for: Ambulatory medical practices
4.
Conifer Health
Conifer Health provides revenue cycle and value-based care solutions that optimize financial performance. With this RCM company’s tools, you can elevate your healthcare experience, acquire appropriate reimbursement, and improve access to care within your community.
Conifer Health’s solutions include:
- Revenue cycle outsourcing: Reshape your current revenue cycle by improving patient experience, clinical revenue integrity, and billing with technology-enabled solutions and intelligent process automation.
- A/R management: Increase cash collections and optimize yield by ensuring clean claims, compliant billing, denials management, and more.
- Financial risk management: Work with Conifer Health to create a coordinated and optimized system for claims expense and care patterns.
Best for: Hospitals, health systems, and physician groups
5.
CureMD
CureMD provides health information systems and services to healthcare organizations, covering tools from credentialing to medical billing. Its RCM tools enable medical practices to accelerate cash flow and reclaim staff time.
Its standout features include:
- Patient financial experience optimization: Give patients access to price estimations, easy-to-understand bills, online payment options, and self-service options to offer a better financial experience.
- AI automation: Automate tasks like claims processing, payment posting, and denial management to reduce staff workload and improve accuracy.
- Denial resubmissions: Resolve claims in under three days by resubmitting claims and making appeals through CureMD’s solutions.
Best for: Multispecialty groups and medium to large practices
6.
athenahealth
athenahealth offers an RCM solution that allows medical organizations to get paid faster, with less work by increasing automation, reducing redundancies, and fostering best practices.
This RCM company’s top features include:
- Automation: athenahealth provides powerful automation tools that evaluate and perform routine A/R follow-up tasks, independent of your team.
- Gamification: Boost staff productivity with this RCM company’s gamification tools, which allow billing employees to earn points for their performance and compete with other team members.
- Interoperability: athenahealth’s RCM solution integrates with all leading electronic medical record (EMR) solutions, ensuring your tools remain interoperable.
Best for: Large practices, health systems, billing services, and hospitals
7.
CorroHealth
CorroHealth provides end-to-end RCM tools that align patient care, operational efficiency, and financial health. Its tools cover front-end operations, mid-cycle processes, and end-cycle actions to redefine RCM and drive further financial resilience.
This RCM company’s top features include:
- Coding: Maximize the value of your claims by automating your coding processes or outsourcing them to CorroHealth’s expert coders.
- Claims management: Leverage CorroHealth’s tools to ensure claims are accurate, compliant, and optimized for first-pass approval.
- Denial prevention: Expertly navigate denials with the help of advanced data analytics and tailored workshops and training sessions.
Best for: Healthcare systems
RCM Company FAQs
What Does RCM Stand For?
RCM stands for revenue cycle management.
What is Revenue Cycle Management?
The revenue cycle refers to all tasks before, during, and after a patient’s visit that affect a practice’s ability to get paid. It begins when a patient calls for a medical appointment and ends when the final bill is paid.
Revenue cycle management refers to the oversight and optimization of this cycle. It can be handled by staff members of the practice itself or by a third-party company.
RCM is often confused with medical billing, which involves collecting payments from patients and health benefit payers (such as insurance companies and government programs). This makes medical billing an essential part of the revenue cycle, but the term is not interchangeable with RCM.
What is a Revenue Cycle Management Company?
An RCM company provides solutions that help medical practices optimize their financial performance. Generally, these solutions assist with:
- Managing the full lifecycle of a patient encounter: This includes pre-visit tasks (like insurance eligibility verification, prior authorizations, and patient responsibility estimates), mid-visit tasks (like medical coding), and post-visit tasks (like claim submission, denial management, and collections).
- Improving billing accuracy and reducing denials: Software minimizes human errors and automates certain parts of the revenue cycle, resulting in improved billing accuracy and fewer claim denials. For instance, an RCM company may provide coding assistance or coding reviews to ensure any claims you send out are coded correctly.
- Boosting cash flow and financial stability: When you partner with an RCM company, you access tools that result in a more streamlined revenue cycle process. This results in more revenue for your medical practice and greater long-term financial stability.
- Reducing administrative tasks for staff: Without partnering with an RCM company, all RCM tasks fall to your staff members. Depending on the size of your practice, the number of patients you see, and the number of employees you have, handling all your RCM processes can be overwhelming. Working with an RCM company allows you to outsource these tasks, reducing the workload on your staff members.
- Providing a path for improvement: Certain RCM companies offer data collection and analysis, which allow you to access strategic, actionable insights you can use to adjust your RCM approach. Through data, you can identify any revenue leaks and operational inefficiencies, providing a concrete path for improvement.
The specific solutions offered vary from company to company. As a medical staff member searching for an RCM company to work with, research top providers thoroughly to make sure that the company’s offerings align with your needs—more about this in the next section!
No matter your practice’s specialty, size, or needs, PracticeSuite has you covered.
What to Consider When Choosing an RCM Company
When choosing an RCM company for your medical practice to work with, consider the following:
- What solutions do they offer? Determine what software the RCM company provides. Assess if they align with your medical practice’s most essential needs. If they address smaller obstacles you’ve been having trouble with, that’s a bonus.
- What specialties do they serve? If your medical practice has a specialty that requires specific RCM features, consider if the provider you’re researching offers features that align with your needs. For example, behavioral health clinics may need support for telehealth billing for a high frequency of sessions.
- Do their solutions fit your budget? Your medical practice’s budgetary restrictions are an essential factor in your research. Look for RCM companies that offer scalable solutions that can be tailored to your price range and specific needs. These companies allow you to pay for the features you need and add on additional features later on, when you have the funds to do so.
- How do they support the entire revenue cycle? Some RCM companies specialize in offerings for particular stages of the revenue cycle. However, if your goal is true oversight of your entire revenue cycle, you must look for a solution that supports all tasks related to your practice’s ability to get paid.
- What data and reporting features do they provide? Determine how easily you can access real-time metrics to make informed decisions about your practice’s revenue cycle.
- How do their offerings stay compliant and secure? We don’t need to tell you that the medical industry has stringent rules regarding data security. During your research, focus on how the RCM companies stay compliant with local and federal privacy regulations, such as HIPAA.
- What level of customer support do they offer? Purchasing and using any new software solution is daunting. Ideally, you want your provider to offer onboarding and training so your employees are well-informed about using their new tools. After onboarding, having 24/7 customer support is another huge bonus, so you can contact the provider directly whenever you have questions.
- Do their solutions integrate with your other tools? If you already use certain medical software, such as an electronic health record (EHR) tool, scheduling software, or a telehealth platform, your RCM tools should be able to integrate with them. This ensures that your data flows properly from one platform to another so you can accurately understand your practice’s financial health.
If you’re unable to answer these questions from your research alone, bring them into any demos or customer calls you book with the RCM companies you’re interested in working with. The product specialists should be able to answer these questions easily and help you determine if their offerings are the right fit for your medical practice.
Additional Resources
Boosting and optimizing your medical practice’s revenue can feel overwhelming, which is why having a dedicated RCM company’s help can be extremely valuable. Look for a company with offerings that align with your goals, and go from there.
Interested in learning more about running a medical practice? Explore these resources:
- 20+ Best Medical Billing Software Solutions. Billing is a core part of the revenue cycle. Discover top solutions to streamline your medical billing processes.
- 10+ Top Medical Practice Management Software Tools. Aside from patient care, you must also take care of tasks related to management, administration, and finances. Check out our recommended tools for practice management processes.
- 9 Vital Types of Medical Office Software for Your Practice. Not sure which types of software will benefit your medical office? Explore the most essential solutions in this guide.
Practice profitably with PracticeSuite.
Maximize profit and gain deep insights into your revenue cycle with our RCM solutions.
