Recommendations: Sorts listings by the number of recommendations our advisors have made over the past 30 days. Our advisors assess buyers’ needs for free and only recommend products that meet buyers’ needs. Vendors pay Software Advice for these referrals. Reviews: Sorts listings by the number of user reviews we have published, greatest to least. Sponsored: Sorts listings by software vendors running active bidding campaigns, from the highest to lowest bid. Vendors who have paid for placement have a ‘Visit Website’ button, whereas unpaid vendors have a ‘Learn More’ button. Avg Rating: Sorts listings by overall star rating based on user reviews, highest to lowest. A to Z: Sorts listings by product name from A to Z.
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
CGM APRIMA, previously known as APRIMA EHR, is a market leading, award-winning EHR loved by physicians and office staff. Designed to take advantage of multiple hardware forms including the APRIMA Mobile app which is perfect for t...Read more
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
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
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
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
Founded in 2004, Curve Dental provides cloud-based practice management software to over 41,000 dental professionals in the United States and Canada. Dental offices use Curve Hero to schedule, invoice, manage recall, manage insuran...Read more
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
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
patientNOW is a hybrid integrated Practice Management (PM) and Electronic Medical Records (EMR) solution for aesthetic medical practices like plastic surgery, medical spas and cosmetic dermatology. The solution can be deployed eit...Read more
AdvancedMD is one of the leaders in web-based electronic health records and practice management systems. The company offers a range of applications, all delivered over the web, for small, medium and large organizations. ...Read more
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
NextGen Healthcare offers NextGen Office—a cloud-based EHR – specifically designed for private practices. NextGen Office is a fully integrated practice management solution that includes specialty-specific content, a claims clearin...Read more
ClaimRemedi is a cloud-based medical billing solution for hospitals, hospices, physicians, skilled nursing facilities and home health agencies. Key features let users automate the payment process, create custom reports and manage ...Read more
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
Next gen software and services for hospital and facility-based physician practices. Award-winning smart solutions for hospitalists and rounding doctors on the go.
1. Mobile Charge Capture App
2. AI-Enhanced Pr...Read more
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
ClinicalWorks, an electronic health record (EHR) and practice management solution, provides technology for every step of the patient care delivery process. Clinicians access features including patient engagement, Telehealth, custo...Read more
OpenPM is a cloud-based solution designed to help medical organizations manage billing, accounting, patient records and more via a unified portal. The platform enables institutions to streamline managements of claims, patient foll...Read more
Sage Intacct is a provider of cloud-based financial management and accounting software. Sage Intacct's software solution is suitable for small to midsize accounting firms and can provide financial reporting and operational insight...Read more
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.
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.
Gather patient insurance information and verify its eligibility.
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.
Maintain an organized database of current and past claims. Accurately send and file bills and keep claims updated.
Manage the intricacies of ICD-10 cataloging and keep your practice compliant.
Securely and reliably accept credit, debit and other electronic forms of payment.
Organize denials based on critical signifiers such as source of denial and reason for denial.
Keep track and provide a filterable snapshot of the money still owed to your medical practice.
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.