Revenue Cycle Management Software
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Simplex HIMES is a cloud-based medical practice management solution, which helps hospitals, clinics, pharmacies and diagnostic labs manage patients' medical records, book appointments, monitor drug inventory and plan treatment pro...Read more about SIMPLEX HIMES
CGM APRIMA, previously known as Aprima EHR, is a market leading, award-winning EHR loved by physicians and office staff. CGM APRIMA is designed to take advantage of multiple hardware forms including the CGM APRIMA mobile app whic...Read more about CGM APRIMA
Allscripts Practice Management
Allscripts Practice Management
Allscripts® Practice Management is a comprehensive revenue cycle management solution for physician practices of all sizes and specialties, including those associated with health systems as provider-based practices. It boosts pract...Read more about Allscripts Practice Management
CareCloud Inc. offers an integrated electronic health recording (EHR) solution–Charts–that provides collective benefits of EMR, practice management and medical billing services. Charts helps physicians to streamline clinical opera...Read more about CareCloud
DrChrono’s iPad and iPhone compatible EHR and medical billing platform allows medical practices and healthcare providers to manage patient intake, patient care, clinical charting, billing and revenue cycle management. It includes ...Read more about DrChrono
ModMed, also known as Modernizing Medicine, offers an integrated telehealth platform within its specialty-specific EHR system, EMA. Called modmed Telehealth, it offers synchronous audio and video telemedicine capabilities for spec...Read more about ModMed
Founded in 2004, Curve Dental provides cloud-based practice management software to over 50,000 dental professionals in the United States and Canada. Dental offices use Curve Hero to schedule, invoice, manage recall, manage insuran...Read more about Curve Dental
TotalMD is an extremely affordable, extremely intuitive Practice Management solution that offers small and growing practices the latest billing technologies and techniques at a fraction of the cost of their competitors. TotalMD pr...Read more about TotalMD
Nexus is an ONC 2015 Edition certified cloud-based ambulatory EHR and PM platform. It is designed for small to midsize practices and a variety of specialties including orthopedics, neurology, podiatry, cardiology, general surgery,...Read more about Nexus
ModuleMD is a leading physician-designed SaaS solution for Allergy and Pulmonary specialists. For over two decades, practices across the nation have trusted us to improve clinical performance and increase their efficiency and ROI ...Read more about Module MD
MedClarity is Medusind's cloud-based practice management solution suitable for practices of any specialty and any size. It is offered as either a technology-only solution for in-house billers or as a fully outsourced solution.Key ...Read more about MedClarity
Practice Harmony (formally known as SurgicalCloud) is a cloud-based EHR and practice management solution for billing services, surgery centers and anesthesiology practices of all sizes. The solution can also be accessed on mobile ...Read more about SurgicalCloud
PatientNow provides the most comprehensive EMR, practice management, and patient engagement software solution in the elective medical industry. Streamline practice operations, improve efficiency, and drive revenue with one softwar...Read more about PatientNow
AdvancedMD Billing Services
AdvancedMD Billing Services
AdvancedMD is a medical office software suite with cloud-based, integrated physician-patient workflow solutions including: practice management/medical billing, electronic health records, telemedicine, patient engagement, practice ...Read more about AdvancedMD Billing Services
Designed in collaboration with practicing physicians, UnifiMD is an electronic health records (EHR) solution that was developed to meet the requirements of independent practices of varying size and specialty. UnifiMD provides...Read more about UnifiMD EMR
NextGen® Office is an award-winning, cloud-based, clinical and billing solution designed for smaller, independent practices (≤ 10 providers). This all-in-one, turnkey solution includes specialty-specific EHR content, an easy-to-us...Read more about NextGen Office
Forcura is a cloud-based health care workflow and care coordination solution. Key features include intake and referral management, document management, scan captures, customized reporting and messaging. Users can customize re...Read more about Forcura
Waystar is a cloud-based revenue cycle management platform for healthcare systems. The solution is used by organizations of all sizes to manage administrative and clinical functions. Key features include insurance verification, co...Read more about Waystar
Next gen software and services for hospital and facility-based physician practices. Award-winning smart solutions for hospitalists and rounding doctors on the go. Product Offerings: 1. Mobile Charge Capture App 2. AI-Enhanced Pr...Read more about Claimocity
Euclid is a medical management solution that helps hospitals and healthcare providers streamline various clinical operations such as claims processing, scheduling, billing and more. With its administrative dashboard, professionals...Read more about Euclid
Popular Revenue Cycle Management Software Comparisons
Buyers GuideLast Updated: November 22, 2022
Health care revenue cycle management is the central foundation of hospitals and all other health care practices. Successful management processes enable medical practices to maintain profitability while dealing with timely claims and payment processes.
These health care systems monitor the entirety of each patient experience, from initial scheduling and registration through the visit and finally to post-visit statuses and final retribution. Medical practices adopt these systems to offload and automate this tedious tracking endeavor. And in doing so, they are able to spend more time focusing on treating patients and providing great experiences.
But not all revenue cycle management (RCM) software is created equally. That's why we've created this guide to give you an idea of what the must-have capabilities are. Use this as a jumping off point for reaching out to vendors and doing some demos. From there, you'll be able to make the best selection for your unique needs.
In this guide, we'll cover:
- What Is Revenue Cycle Management Software
- Common Features of Revenue Cycle Management Software
- What Type of Buyer Are You?
- Benefits of Adopting Revenue Cycle Management Software
- Market Trends to Understand in Revenue Cycle Management Software
What Is Revenue Cycle Management Software?
As we explained before, revenue cycle management software is the financial workhorse of medical practices, tracking each billable patient interaction from scheduling through to payment completion.
That sounds easy enough, but there's a ton of tools and capabilities within RCM software. They include the ability to verify insurance eligibility when scheduling appointments, creating claims submissions with the most correct codes and patient payment notice and collection.
Revenue cycle management software operates along all points of the patient/billing journey, including:
Typical Revenue Management Cycle for Medical Practices
Given its operational importance and breadth of functionality, choosing the best RCM software for your unique needs is all the more critical.
Common Features of Revenue Cycle Management Software
Revenue cycle management software provides users with the tools necessary to manage all stages of the medical practice. Key features include:
|Scheduling and registration||Record the initial outreach and track any scheduled appointments.|
|Insurance verification/validation||Gather patient insurance information and verify its eligibility.|
|Copay management||Validate the copayment amount covered by insurers and adjust the remainder owed accordingly.|
|Patient visit documentation||Manage the proper code output based on the type of visit and the services that took place during the visit.|
|Claim management||Maintain an organized database of current and past claims. Accurately send and file bills and keep claims updated.|
|ICD-10 compliance||Manage the intricacies of ICD-10 cataloging and keep your practice compliant.|
|Payment processing||Securely and reliably accept credit, debit and other electronic forms of payment.|
|Denial management||Organize denials based on critical signifiers such as source of denial and reason for denial.|
|Accounts receivable||Keep track and provide a filterable snapshot of the money still owed to your medical practice.|
|Patient statements||Send detailed statements to patients highlighting what's still owed, what insurance has covered and available payment methods.|
What Type of Buyer Are You?
Moving from paper to automated systems. These buyers want to automate their medical processes, cutting back on paper-based organization and unnecessary exposure to human error. These buyers want to improve office efficiency and provide a more consistent patient experience.
Replacing legacy systems. These buyers have gotten everything they can out of their current system, and it's become a hinderance to their operational efficiency. Regardless of whether they have a mixed together system, something built in-house or just old software, they need greater reliability, federal compliance and more transparency into the financial well-being of the practice.
Centralizing capabilities into one RCM system. These buyers come from practices that have pieced together disparate applications to get what they need. This approach might work for a while, but it very likely will begin to impede growth, as it makes it difficult to scale operations. Moving to a single RCM system enables practices to have a clear view of the status of the organization and also drill down to see critical information at the patient level.
Benefits of Adopting Revenue Cycle Management Software
There are different benefits that revenue cycle management software offers based on what you're replacing. However, there are also similar benefits shared by all new RCM adopters. These include:
Increased operational efficiency. Revenue cycle management systems enable health care practices of all types and sizes to define optimized processes for managing each step in the revenue cycle. These processes and newfound automations are certain to increase operational efficiencies for users.
Maintain financial health. Easily track and explore critical financial metrics to gauge the financial health of the organization. Drill down to see specific components of the payment process that might be stalling final retribution.
Ensure federal compliance. Lean on an ICD-10 coding catalog to not only ensure medical codes are compliant but also give time to employees who would otherwise be inundated with coding edits.
Market Trends to Understand in Revenue Cycle Management
Mobile. More and more medical practices are leveraging mobile technologies such as smartphones, tablets and wearable devices to improve operations. We're increasingly seeing medical vendors providing support for patient information access as well as payment processing on mobile.
Cloud-based software. Cloud-based revenue cycle management software gives providers and patients the ability to easily (but still securely) access patient data, billing and payment statuses from any compatible device with internet access. Cloud-based RCM platforms most often operate on a subscription basis, making them more affordable for smaller practices looking to get a new system in place.
Patient portals. Mobile, SaaS and other digitalization in the health care space isn't reserved for providers. Patients now expect communications and access to their medical information through online and mobile portals. If that's something you're interested in, take a look at our guide on patient portal software.