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StreamlineMD

StreamlineMD has served Radiology & Interventional Radiology practices for 45+ years with cloud-based ONC-certified EHR & Practice Management Software, Medical Coding & Billing Services for Hospital-Based Radiologists, Outpatient ...Read more about StreamlineMD

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CGM APRIMA

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

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athenaOne

The athenaOne Suite which includes athenaCollector a revenue cycle management solution and athenaClinials an EHR (electronic health records) recently ranked #1 in 2023 Best in KLAS for athenaClinials Ambulatory EMR for 11-75 physi...Read more about athenaOne

3.8 (836 reviews)

393 recommendations

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eClinicalWorks

eClinicalWorks® (eCW), a leading healthcare IT company, provides innovative software solutions to healthcare providers of all types, including health centers, ASCs, urgent care, and more. eCW has been a trusted partner in the heal...Read more about eClinicalWorks

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HARMONY Medical

Harmony e/Notes is a hybrid integrated solution that offers functionalities for electronic medical records, practice management, billing and revenue cycle management. Specialities that the solution caters to include cardiology, ge...Read more about HARMONY Medical

4.5 (25 reviews)

12 recommendations

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gGastro

Modernizing Medicine Gastroenterology offers gGastro EHR, a fully integrated platform designed for gastroenterologists. It combines the attributes of an electronic health records (EHR) system and endoscopy report writer (ERW) in o...Read more about gGastro

4.2 (19 reviews)

1 recommendations

CareCloud

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

3.5 (106 reviews)

2 recommendations

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CureMD

CureMD is a certified cloud-based EHR, practice management, patient portal and revenue cycle management. CureMD helps physicians and office staff manage their practice operations. It also helps practices adopt Meaningful Use - dri...Read more about CureMD

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DrChrono

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

4.0 (477 reviews)

261 recommendations

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ModMed

ModMed, also known as Modernizing Medicine®, is an award-winning software company that places doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. Services include electronic health...Read more about ModMed

4.3 (168 reviews)

39 recommendations

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Curve Dental

Curve Dental® makes everything easy so you can focus on what’s most important– improving the patient experience while retaining and attracting new patients. From scheduling, billing, texting, patient engagement, imaging, charting...Read more about Curve Dental

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TotalMD

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

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Kipu

The Kipu Platform Kipu is the premier cloud-based solution for multi-provider and enterprise behavioral and addiction treatment centers. Our end-to-end platform includes a collaborative EMR system for management of health records,...Read more about Kipu

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Nexus EHR

Nexus EHR is an ONC Certified 2015 Edition Cures Update cloud-based ambulatory EHR and PM platform. It is designed for small to midsize practices and various specialties including orthopedics, neurology, podiatry, cardiology, gene...Read more about Nexus EHR

4.6 (9 reviews)

18 recommendations

Module MD

ModuleMD is a leading specialty focused EMR and Practice Management software and services provider. Originally founded and designed by two Allergists, ModuleMD has been trusted by practices across the nation for over two decades. ...Read more about Module MD

4.3 (4 reviews)

MedClarity

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

4.6 (8 reviews)

Raintree Systems

Raintree is a complete business and Physical Therapy EMR/EHR software for Pediatric & Adult Therapy & Rehab PT, OT, SLP and ABA practice- regardless of size. From single providers to large multi-location groups, Raintree provides ...Read more about Raintree Systems

4.2 (9 reviews)

SurgicalCloud

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

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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

4.1 (84 reviews)

5 recommendations

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UnifiMD EMR

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

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Buyers Guide

Last Updated: March 16, 2023

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?

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

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.