Top 10 Revenue Cycle Management Companies for Specialty Practices

Revenue is the lifeblood of any healthcare practice, and managing it effectively is crucial for long-term success. This process involves everything from patient intake to payment collection, and it can be complex, especially for specialty practices. To streamline this, many practices turn to revenue cycle management companies offering tailored solutions to improve efficiency and boost financial outcomes.

Pearl Talent is a leading service placement provider specializing in matching skilled professionals with businesses across various industries. Healthcare is one of the key sectors we serve, offering tailored solutions to meet the unique needs of medical practices. Our team includes expert medical healthcare virtual assistants (VAs) proficient in various roles, ensuring seamless support for your practice.|

Drawing from our many successful placements and healthcare industry insight, we created this guide to share with you the top revenue cycle management companies for specialty practices. We will also highlight their unique services and how they can improve the financial efficiency of your practice. In the end, you'll have the information needed to decide on the best partner for your revenue cycle needs.

Let’s get started!

Top 10 Revenue Cycle Management Companies

Efficient revenue cycle management is essential for healthcare organizations aiming to streamline operations and maximize revenue by following best practices. As the healthcare industry evolves, selecting the right company can improve financial outcomes and patient satisfaction. Let's explore the top 10 revenue cycle management companies to consider.

1. Oracle Health - Provides Secure, Flexible Solutions

Oracle Health is a global leader in healthcare technology, with over four decades of experience driving innovation across industries. This revenue cycle management company creates connected technologies and unified data platforms to empower individuals and improve health outcomes. 

Oracle Health offers a comprehensive suite of revenue cycle services to streamline healthcare operations, enhance clinical decision-making, and improve patient experience. Their revenue cycle services are recognized as industry leaders, automating billing processes, optimizing resources, and increasing efficiency for healthcare providers. 

Notable Features Offered by Oracle Health

• Self-Service Patient Access: Empowers patients with self-service tools for scheduling, registration, and appointment check-ins, reducing front-office workload.
• AI-Powered Workflow Automation: AI and machine learning, powered by advanced analytics tools, automate tasks like patient insurance verification, improving efficiency and reducing manual errors.
• Cloud-Based Security & Flexibility: Cloud-native SaaS solution with military-grade security, offering seamless integration with Oracle Health EHR for enhanced data management and flexibility.

Oracle Health Pricing Plans

Oracle Health offers customized pricing for healthcare revenue cycle management services tailored to your practice’s needs. Their solutions cater to healthcare organizations of all sizes, from small specialty practices to large hospital networks. You can contact their support team 24/7 for more details on pricing and services. Trusted by various healthcare providers, Oracle Health helps streamline revenue cycle management for clinics, hospitals, and integrated health systems.

2. Experian Health - Maximizes Revenue Through Audits

Experian Health is a leading provider of revenue cycle management (RCM) solutions that help healthcare organizations optimize their financial performance. With a focus on improving cash flow, Experian Health leverages data-driven technology to speed up reimbursement cycles. 

This revenue cycle management company helps healthcare organizations enhance patient registration, automate claim processing, and increase collections while ensuring regulatory compliance and accurate coding. The company’s technology handles over 175 million annual claims and facilitates more than $4.9 billion in collections.

Notable Features Offered by Experian Health

• Optimized Collections & Recovery: Improves collection rates on past-due accounts while lowering the collection cost and enhancing cash flow.
• Automated Claims Workflows: Streamlines healthcare claims management with integrated solutions that automate workflows and improve efficiency.
• Payer Contract Auditing: Audits payer compliance with contract terms, ensuring accurate payments and maximizing revenue by reducing underpayments.

Experian Health Pricing Plans

Like many leading revenue cycle management companies, Experian Health does not disclose specific pricing on its website. To get a tailored quote, you’ll need to contact their sales team directly. Experian Health offers customized solutions for a wide range of healthcare providers as a provider of services to hospitals, health systems, medical groups, pharmacies, and diagnostic centers.

3. R1 RCM - Optimizes Reimbursements and Compliance

R1 RCM is a top provider of revenue cycle management solutions, offering a robust platform that helps healthcare organizations achieve peak financial performance. With decades of experience, R1 partners with leading providers to transform financial operations and patient care through advanced analytics and intelligent technologies. 

Their revenue cycle management company platform uses cutting-edge technology to enhance financial performance, streamline workflows, and increase revenue. Their solutions are designed to ensure that providers can focus on patient care. At the same time, R1 handles the complexities of the financial side of healthcare.

Notable Features Offered by R1 RCM

• Revenue Optimization Services: Identifies missed revenue opportunities with a comprehensive review of patient payment services, ensuring accurate reimbursement for services provided.
• Clinical Integrity & Coding Support: Enhances documentation and coding accuracy with tech-enabled clinical support to ensure compliance, improve billing practices, and streamline outsourced medical billing.
• Regulatory Requirements & Compliance Expertise: Optimizes government reimbursements and 340B program savings while ensuring compliance with specialized, tech-enabled services.

R1 RCM Pricing Plans

R1 RCM, a leading brand among revenue cycle management companies, offers customized pricing based on your healthcare organization's needs. They provide solutions for hospitals, health systems, physician practices, pharmacies, and specialty care providers. While specific pricing isn't disclosed on its website, R1 RCM tailors its revenue cycle services for organizations of all sizes. 

4. Athenahealth - Streamlines Billing and Productivity

Athenahealth is a trusted provider of healthcare revenue cycle management services with over 50 years of experience in healthcare. Known for its tailored approach, Athena helps practices and health systems accelerate revenue reimbursement and reduce accounts receivable days. Athenahealth’s platform is designed to improve profitability while supporting unique operational needs.

They offer RCM solutions, including athenaIDX and athenaCollector, to streamline billing and reduce costs. Their revenue cycle management company services focus on improving claim accuracy, reducing denials, and enhancing staff productivity through innovative tools like Athenahealth Gamify. These solutions help healthcare organizations increase revenue and improve financial outcomes.

Notable Features Offered by Athenahealth

• Integrated Clearinghouse Services: Reduces errors and enhances staff efficiency through integrated workflows, revenue cycle monitoring, and optimized FTE performance.
• Single-Platform Solution: Consolidated financial data across hospitals and professional services, streamlining operations and improving profitability.
• Automated Accounts Receivalbe (A/R) Follow-Up: Utilizes powerful automation tools to handle routine accounts receivable tasks, freeing up staff for more strategic work.

Athenahealth Pricing Plans

Athenahealth, a top revenue cycle management company, serves many healthcare providers, from startup practices to large enterprises and health systems. You’ll need to submit a contact form to get a customized quote. Athenahealth will reach out within 2 business hours to discuss your specific needs. Their solutions aim to unlock productivity, drive efficiency, and address challenges for practices of all sizes.

5. PwC RCM - Improves Coding and Reimbursement

PwC is one of the top revenue cycle management companies, offering clinically integrated solutions that help healthcare organizations boost financial performance. They provide custom RCM strategies by combining services, accelerators, and partnerships to connect clinical and financial platforms. 

PwC focuses on digital enablement and automation to simplify patient access and improve workflows. Their solutions help healthcare providers improve workforce productivity through virtual interactions and advanced technology. 

Notable Features Offered by PwC

• SMART Coding Quality Monitoring: PWC's SMART system offers customizable insights to improve coding accuracy, reimbursement rates, and clean claim submissions, with a potential 10:1 ROI.
• NextGen IP SMART for Cloud Transformation: Supports cloud migration with enhanced features, streamlining processes and offering flexibility for organizations transitioning to the cloud.
• KLAS-Rated Revenue Cycle Solutions: Recognized for excellence, PwC's Revenue Cycle Managed Services is rated Best in KLAS for extended business office services, ensuring high-quality support.

PwC Pricing Plans

Like most revenue cycle management companies, PwC’s website doesn’t disclose specific pricing. PwC’s services are customized based on the size and needs of the healthcare organization. They help providers enable patients to review insurance and self-pay service prices, fostering trust and informed decision-making. 

6. CareCloud - Captures Revenue Opportunities Efficiently

CareCloud is a revenue cycle management company that offers a complete RCM solution to support healthcare providers, from patients to payers. With a flexible, consultative approach, CareCloud allows medical practices to shift the burden of collections, letting them focus on patient care. 

CareCloud’s RCM services are built to enhance front- and back-end operations, capturing every revenue opportunity. With complete transparency, timely reporting, and expert support, CareCloud ensures improved data accuracy, efficiency, and strategic guidance for healthcare organizations.

Notable Features Offered by CareCloud

• Credentialing & Re-Attestation: Assists in provider credentialing with government and commercial payers, including quarterly Council for Affordable Quality Healthcare (CAQH) re-attestation to ensure ongoing compliance.
• Comprehensive Benefits Verification: Provides full support (phone, fax, email) to verify patient benefits and procedure coverage before service is provided.
• Prior Authorization & Inpatient Call Support: Manages prior authorization requests for non-emergency procedures and offers an inbound call center for patient billing inquiries and payment collections.

CareCloud Pricing Plans

CareCloud, a trusted name among revenue cycle management companies, offers flexible pricing based on the needs of your practice. They provide no-obligation, free Revenue Cycle Assessments (RCAs) to help practices benchmark performance and identify areas for improvement. Their experienced team helps practices navigate regulatory changes like MACRA and ICD-10 while empowering growth. 

7. NextGen - Reduces A/R And Improves Experience

NextGen is a revenue cycle management company that helps healthcare practices achieve faster and more effective financial outcomes. Their RCM solutions are designed to maximize revenue integrity, prevent denials, and improve collections. NextGen focuses on reducing days in accounts receivable while enhancing the overall patient experience.

NextGen’s RCM services offer a comprehensive approach to streamline billing, reduce denials, and accelerate patient collections. With a focus on improving net collections and financial performance, NextGen ensures that practices can optimize their revenue cycle and achieve financial stability.

Notable Features Offered by NextGen

• Specialty-Based Expert Consultation: Provides specialized guidance through dedicated client managers, ensuring RCM services align with your practice's unique needs.
• Customizable Financial Insights: Offers financial analytics through customizable dashboards, tracking over 100 key performance indicators (KPIs) across all specialties.
• Optimized Revenue Cycle Management: Increases collections while allowing practices to allocate more resources to patient care, improving overall operational efficiency.

NextGen Pricing Plans

You can schedule a demo or meet with NextGen to learn more about their revenue cycle management solutions and get a customized quote. Pricing depends on the size and specific needs of your practice. Their services are designed to enhance healthcare outcomes and streamline revenue processes for practices of all sizes. While detailed pricing isn't available on their website, their sales team is ready to assist you with tailored solutions.

8. Optum - Automates Claims and Collections

Optum is a healthcare company that offers revenue cycle management services that focuses on improving staff efficiency, optimizing revenue, and enhancing patient engagement. Their revenue cycle management company solutions integrate seamlessly with Epic systems, offering a streamlined claims management and reimbursement approach. 

Optum provides end-to-end RCM services, from patient access to reimbursement management. Their solutions automate healthcare claims, reduce denials, and improve up-front collections by 45%. Their data analytics driven denials management ensures clean claims and accelerates reimbursements, enhancing provider efficiency and the patient experience.

Notable Features Offered by Optum

• Enhanced Patient Engagement: Offers seamless experiences across the care continuum, boosting satisfaction, loyalty, and revenue through convenient, patient-centered solutions.
• Financial Clearance Solutions: Provides comprehensive financial transparency and patient collection tools, reduces patient stress, and effectively accelerates reimbursements.
• Analytics-Driven Decision Making: Delivers powerful analytics to identify issues, benchmark performance, and uncover opportunities for improved financial and operational efficiency.

Optum Pricing Plans

You can contact Optum to explore their revenue cycle management services. Their solutions aim to support cash flow, speed up payments, and reduce costs efficiently. Serving payers, providers, and pharmacies, Optum helps improve operational efficiency and optimize revenue processes across healthcare sectors.

9. Trizetto Provider Solutions - Ensures Fast Reimbursements and Acceptance

TriZetto, a recognized leader among revenue cycle management companies, offers comprehensive solutions to enhance financial performance and operational efficiency. With over 650 Electronic Medical Record (EMR) and Practice Management System integrations, TriZetto’s certified platform ensures seamless functionality for healthcare providers. 

TriZetto’s revenue cycle performance services include claims management, patient engagement, and denial management solutions that accelerate payments and improve revenue recovery. Their platform boasts a track record of 98% average payer acceptance rate, ensuring fewer rejections and faster reimbursements. 

Notable Features Offered by Provider

• Comprehensive Billing Services: Handles critical back-office tasks like claims submission and payment posting, ensuring smooth operations and fewer errors.
• Certified Coding Expertise: Employs AAPC- and AHIMA-certified coders to minimize coding errors, reducing the risk of claim denials or rejections.
• Revenue Recovery Specialists: Provide dedicated customer support to recover revenue loss or revenue leakage and efficiently address denied or underpaid claims.

Provider Pricing Plans

Trizetto’s pricing details are private, as costs depend on your organization's specific needs. To obtain a customized quote, connect with one of their revenue cycle specialists through their website. TriZetto serves a diverse range of healthcare providers, offering services designed to simplify the RCM process and enhance operational efficiency.

10. eClinicalWorks - Guides Financial Management Effectively

eClinicalWorks, a revenue cycle management company, offers flexible and accurate billing solutions tailored to healthcare practices. Their services include advanced reporting tools, real-time claim status updates, and a user-friendly console for managing collections and refunds. 

They provide dedicated account managers to guide practices through financial challenges, while satisfaction surveys enhance patient communication. These comprehensive features help healthcare professionals improve medical billing efficiency and maximize revenue potential.

Notable Features Offered by eClinicalWorks

• Comprehensive Reporting and Analytics: Provides tools to monitor KPIs and access real-time claim status updates, enhancing practice visibility.
• Efficient Communication Tools: Utilizes an RCM system console for managing collections, refunds, and claim alerts, streamlining communication within the practice.
• Patient Satisfaction Surveys: Facilitates the distribution of electronic satisfaction surveys, enabling practices to gather and act on patient feedback effectively.

eClinicalWorks Pricing Plans

eClinicalWorks offers two revenue cycle management options: a self-service practice management model and a full-service RCM solution managed by their team. Both options aim for a 98% or higher first-pass claims acceptance rate. These solutions cater to various healthcare providers, enhancing efficiency and financial performance. For more detail on their pricing options, visit their website to learn more.

Key Takeaway

Choosing the right healthcare revenue cycle management company can make a significant difference in the financial health of your specialty practice. With the right partner, you can streamline your operations and ensure faster payments, reducing administrative burdens. In addition, these companies offer specialized solutions tailored to the unique needs of different healthcare practices. 

Outsourcing allows you to focus more on patient care and less on administrative tasks. Many of these revenue cycle management companies also offer customizable plans to fit your practice's specific size and requirements. In the end, finding the right RCM company is vital to optimizing your practice’s revenue and overall efficiency.

Are you looking for expert healthcare support to improve your practice’s efficiency? Pearl Talent offers highly skilled medical healthcare virtual assistants (VAs) who specialize in various roles to meet your unique needs. Contact us today to learn how our medical assistant hiring services can support your practice’s success.

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