Alternatives to Rhyme
Compare Rhyme alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to Rhyme in 2026. Compare features, ratings, user reviews, pricing, and more from Rhyme competitors and alternatives in order to make an informed decision for your business.
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RXNT
RXNT
RXNT is an ambulatory healthcare technology pioneer that empowers medical practices and healthcare organizations to succeed and scale through innovative, data-backed, AI-powered software. Our fully-integrated, ONC-certified suite of medical software—like Clinical EHRs, Practice Management, Medical Billing and RCM, E-Prescribing, Practice Scheduling, Patient Portal, and more—optimizes clinical outcomes and RCM for your practice. Used by tens of thousands of medical professionals—from large physician practices to medical billing companies—to drive growth, streamline business operations, and improve patient care across all 50 U.S. states. Our unified “Full Suite” system employs a secure, central database so your data passes through every product in real-time from anywhere, and more than 125 million prescriptions have been transmitted and over $7 billion in claims have been processed using RXNT. -
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Service Center
Office Ally
Service Center by Office Ally is a trusted Revenue Cycle Management and patient payments platform used by more than 80,000 healthcare providers and health services organizations, which process more than 950 million transactions annually. Service Center is a cost-effective solution enabling providers to control their revenue cycle. With a user-friendly interface, Service Center helps providers check and verify patients’ eligibility and benefits, submit, correct, and check the status of their claims online, and receive remittance advice. Accepting standard ANSI formats, data entry and pipe-delimited formats, Service Center helps streamline administrative tasks and create more efficient workflows for providers. -
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Azalea EHR
Azalea Health
Azalea Health Innovations (Azalea) is changing the way health IT platforms connect community-based healthcare providers and patients across the care continuum. Offering a 100% cloud-based, interoperable solution, Azalea delivers an electronic health record that is fully integrated with telehealth, revenue cycle management, and analytic solutions designed for rural, community, and urban practices and hospitals. Quick to deploy and intuitive to use, Azalea's EHR ensures better care coordination and communication, and the “one patient, one record” approach provides care teams the agility to achieve better outcomes. The Azalea platform also delivers tools and resources to help providers meet their Meaningful Use requirements, and informs their strategies to navigate accountable care and alternative payment models. -
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Valer
Valer
Valer’s technology speeds and simplifies prior authorization and referral management by automating submissions, status checking, verification, reporting, and EHR synchronization across all mid-to-large-sized healthcare settings, specialties, and payers from one platform and portal. Valer is the all-specialty, all-payer technology solution designed around your needs, not ours. Unlike off-the-shelf products that limit specialties, service lines, and payer mix (that don’t even automate submissions), Valer is explicitly customized to fit your needs. Because Valer is so easy to use, the dashboard increases staff productivity, simplifies staff training, and measures staff and payer performance across all service lines to enable continuous improvement. Valer doesn’t just connect to some of your payers for some of what you need. We link to all payers for all specialties, service lines, and care settings with real-time payer rule updates. -
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Infinx
Infinx Healthcare
Leverage automation and intelligence to overcome patient access and revenue cycle challenges and increase reimbursements for patient care delivered. Despite the progress AI and automation is making in automating patient access and revenue cycle processes, there still remains a need for staff with RCM, clinical and compliance expertise to ensure patients seen were financially cleared and services rendered are accurately billed and reimbursed. We provide our clients with complete technology plus team coverage with deep knowledge of the complicated reimbursement landscape. Our technology and team learn from billions of transactions processed for leading healthcare providers and 1400 payers across the United States. Get quicker financial clearance for patients before care with our patient access plus a platform that provides complete coverage for obtaining eligibility verifications, benefit checks, patient pay estimates, and prior authorization approvals, all in one system. -
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Myndshft
Myndshft
Experience a seamless workflow by having real-time transactions driven within existing technology platforms. Providers and Payers reduce time and effort by up to 90% for benefits and utilization management. Eliminate the current benefits and utilization management black box – eliminating confusion for patients, providers and payers. Self-learning automation and fewer clicks mean more time for patients, providers and payers to focus on care. Myndshft eliminates the quagmire of point solutions by providing a unified, end-to-end platform for in the moment payer-provider-patient interactions. Myndshft dynamically updates automated workflow and rules engines based on the actual responses and results from provider-payer interactions. Our technology continuously adapts to the rules in use by payers. The more you use it, the smarter it gets. A library of continuously-updated thousands of rules for national, state and regional payers. -
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AuthParency
Oncospark
Prior Authorization with AuthParency Prior authorization is a growing administrative burden for healthcare providers. Our automated prior authorization solution, AuthParency™, is powered by AI and machine learning (ML). This advanced system can cut your team’s prior authorization time in half. It is also compatible with all EHR and practice management systems AuthParency helps: Analyze payers’ tendencies Reduce patients’ days to care Improve patient outcomes Stop losses from non-reimbursable services Identify financial toxicity burdens Analyze population health data Track disparities Pharmaceutical companies -
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Veradigm AccelRx
Veradigm
Veradigm AccelRx delivers a free, automated, comprehensive solution to help you streamline specialty medication fulfillment for your patients. With faster time to therapy comes better odds for medication adherence and positive outcomes, as well as fewer phone calls and faxes for your staff. Combining electronic enrollment, consent, prior authorization, and script into an all-in-one system, AccelRx can help your practice significantly cut time-to-fulfillment for all specialty drugs, with any payer. Automatically populate patient data on enrollment and other forms with the click of a button. A single user-friendly platform to help you transform specialty medication management. Enhance your management of most specialty drugs all in one place, including electronic prior authorization (ePA). Access your enhanced specialty medication management as part of your existing electronic health record (EHR) workflow. -
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Silna Health
Silna Health
Silna Health’s Care Readiness Platform handles all prior authorizations, benefit checks, and insurance monitoring upfront to make sure patients are clear to receive care while providers gain capacity to focus on treatment. Its AI‑powered engine manages the entire prior authorization workflow, from tracking upcoming authorizations and sending weekly reminders to submissions and follow‑ups, automatically applying industry‑proven rules and escalating exceptions for human review. Specialty‑specific benefit checks verify coverage, accumulations, authorization requirements, and visit limits in real time, delivering accurate quotes at intake. Continuous insurance monitoring flags lost coverage, detects new plans, and safeguards against eligibility lapses. Designed for zero extra headcount, Silna ingests data directly from EMRs and practice management systems, offers configurable rule sets and strategic guidelines, and presents clear dashboards with incremental revenue insights. -
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NeuralRev
NeuralRev
NeuralRev is an AI-powered Revenue Cycle Management (RCM) platform that automates and accelerates end-to-end financial workflows in healthcare, reducing manual effort and errors while improving cash flow and operational efficiency. It automates insurance eligibility verification by connecting to clearinghouse networks in real time so patient intake and coverage checks happen instantly, and it handles prior authorization by assembling clinical and payer requirements, submitting requests electronically, and tracking approvals to reduce denials and delays. It also delivers real-time patient cost estimates by combining eligibility data with payer rules to improve transparency and upfront collections, and it streamlines medical coding, claim submission, claims processing, post-claim follow-up, and recovery, so teams spend less time chasing paperwork. -
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ABN Assistant
Vālenz
For providers, medical necessity denials cost thousands to millions of dollars every year in write-offs, plus costly staff time researching and appealing denials and responding to patient concerns. For payers, the same is true on the other end of the claim management spectrum: Paying for medically unnecessary procedures and treatments – and time spent working on denial appeals – raises costs without improving outcomes. And of course, for the patient, there can be unnecessary copays and other out-of-pocket costs, not to mention a poor patient experience involving costs and moments of care they did not need. ABN Assistant™ from Vālenz® Assurance delivers the prior authorization tools providers need to validate medical necessity, print Medicare-compliant ABNs with estimated cost, and stop over 90 percent of medical necessity denials by verifying necessity before care is delivered to the patient.Starting Price: $1039.00/one-time/user -
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Cohere PaaS Intelligent Prior Authorization
Cohere Health
Cohere helps health plans digitize the process and apply clinical intelligence to enable in-house, end-to-end automation of prior authorization. Health plans can directly license Cohere’s PaaS intelligent prior authorization for use by the plan’s internal utilization management staff. As a result, our client health plans achieve both significant administrative efficiencies and faster, better patient outcomes. Cohere delivers a tailored, modular, and configurable solution suite for health plans. Digitizes all prior authorization requests into a single automated workflow. Automates prior authorization decisions using health plan-preferred policies and accelerates manual review. Helps clinical reviewers adjudicate complex requests, using responsible AI/ML and automated capabilities. Leverages clinical intelligence with AI/ML and advanced analytics to improve utilization management performance. Improves patient and population outcomes with innovative, specialty-specific programs. -
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PracticeAdmin
PracticeAdmin
PracticeAdmin Scheduling reduces no-shows and improves your patient interactions by providing the data you need on demand. Using our proprietary rules-based architecture, you can set up your own preferences — whether you’re a solo provider, small to medium sized organization or a provider with multiple locations. Create your own scheduling templates for an unlimited number of locations and set up automated patient reminders. Billing is your one stop tool to manage patient registration, claims and payment. You can track all of your patient information and prior authorizations. It integrates easily with your EHR and helps keep track of your Meaningful Use certification. Billing lets you know if your claim has an error before it’s sent. Quickly re-submit your claim with no penalty, and monitor all of your EDI rejections. -
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Cohere Unify
Cohere Health
The Cohere Unify platform supports all of our intelligent prior authorization solutions with touchless and predictive technologies, evidence-based clinical content, and other advanced capabilities. Our technologies reduce or eliminate manual steps toward creating an end-to-end fully automated prior authorization process. This predictive capability enables health plans to virtually eliminate prior authorization workflow steps. Instead, the system can automatically craft specific care plans based on patient and population auth and claims data, including multiple services that can all be pre-approved upfront before they are even requested. Evidence-based clinical criteria for select specialties that inform our touchless and predictive technologies. Proven single sign-on capabilities with Availity, NaviNet, and other common portal technologies. Rules configuration and deployment proven to scale over multi-million+ transactions. -
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Availity
Availity
Collaborating for patient care requires constant connectivity and up-to-date information. Simplifying how you exchange that information with your payers is more important than ever. Availity makes it easy to work with payers, from the first check of a patient’s eligibility through final resolution of your reimbursement. You want fast, easy access to health plan information. With Availity Essentials, a free, health-plan-sponsored solution, providers can enjoy real-time information exchange with many of the payers they work with every day. Availity also offers providers a premium, all-payer solution called Availity Essentials Pro. Essentials Pro can help enhance revenue cycle performance, reduce claim denials, and capture patient payments. Availity remains your trusted source of payer information, so you can focus on patient care. Our electronic data interchange (EDI) clearinghouse and API products allow providers to integrate HIPAA transactions and other features into their PMS. -
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PAHub
Agadia Systems
As Prior Authorization volumes continue to rise, and as specialty drugs create additional clinical complexities, Health Plans, Pharmacy Benefit Managers (PBMs) and Third-Party Administrators (TPAs) are challenged to adapt while maintaining or improving operational and clinical efficiencies. PAHub, is a HITRUST certified solution that puts the tools at your fingertips to streamline and control all clinical, compliance and administrative aspects of Prior Authorization at the point-of-care to improve compliance, reduce turn-around times and costs. By leveraging the latest technologies for data mining, data analytics, content management and advanced decision support trees, PAHub, enables customers to automate the end-to-end prior authorization process. -
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Optum AI Marketplace
Optum
Optum AI Marketplace is a curated ecosystem of AI-powered solutions designed to transform healthcare by providing payers, providers, and partners with tools to deliver better outcomes efficiently. It offers a diverse range of products and services across categories such as patient & member engagement, eligibility & claims, care operations & management, payment & reimbursement, and analytics & insights. Notable offerings include the prior authorization inquiry API, which enables payers to check a patient's prior authorization status in real-time, and SmartPay Plus, an e-cashiering payment platform that simplifies patient payments and streamlines the collection process. Additionally, Optum Advisory Technology Services provides expert support for digital transformation initiatives, offering system selection, procurement, implementation, and AI tools. It also features partnerships with trusted resellers, such as ServiceNow, to offer cutting-edge healthcare solutions. -
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Arrow
Arrow
Arrow is a healthcare revenue cycle management platform that modernizes and streamlines healthcare payments by automating billing, claim operations, and predictive analytics to help providers and payers reduce administrative burden, minimize denials, and accelerate collections. It brings workflows, data, and AI together so teams can detect errors in claims before submission, manage denials with root-cause analysis and one-click fixes, and get detailed real-time claim status updates directly from payers. It simplifies the ingestion of Explanation of Benefits (EOB) and Electronic Remittance Advice (ERA) data into a centralized, user-friendly format, provides revenue intelligence with actionable insights into the revenue cycle, and monitors payment integrity to highlight underpayments or overpayments according to payer contracts. -
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ESO Billing
ESO
Automate your workflow and integrations, and put an end to the repetitive manual work associated with revenue cycle management. ESO Billing frees your team to focus on what they do best. In today’s reimbursement world, efficiency counts. ESO Billing was built to save you time at every possible point in the billing process. Even its interface has been freshly redesigned for the ultimate in speed and ease of use. Customize your workflow based on your business process, task-based workflow moves each claim through its stages with minimal touches. It even alerts you automatically when payments aren’t on time, for the ultimate peace of mind. Our payer-specific proprietary audit process ensures that each claim contains all critical billing information prior to claim submission. The result? The lowest clearinghouse and payer rejection rate in the industry. Pair billing with ESO Health Data Exchange (HDE) and ESO Payer Insights to tap into hospital-generated billing information with one click. -
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Consensus Harmony
Consensus Cloud Solutions
Access numerous endpoints, securely and simply with one API connectivity and avoid developing one-offs to disparate healthcare systems. Bridge the gap between multiple systems, standards, and data sets, using a single point of access for developing interoperability. Consensus Harmony includes universal healthcare APIs, cloud fax APIs, electronic signature APIs, and connectivity to multiple participating EHR partners and other leading industry cloud marketplaces. Flexible interoperability options to programmatically integrate digital faxing, secure messaging, patient record requests, e-signatures, and more into key workflows like payments, prior authorizations, and referrals. Extend your capabilities and access new information networks by partnering and leveraging community providers already integrated. Don’t limit the network you communicate with, leave the modality of communication up to our technology. -
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Axora
Axora.AI
Axora AI is an intelligent, end-to-end claims engine that blends AI-powered automation with billing expertise - managing everything from eligibility to payment posting. But it’s more than automation. Axora AI prevents denials before they happen, adapts to payer rule changes, and prioritizes what matters - so you recover more revenue with less effort. 1. Manages your full claims cycle from start to finish 2. Flags denial risks before submission 3. Prioritizes actions that improve cash flow 4. Seamlessly fits into your EHR, payer, and finance systems 5. No migrations. No disruption. Just faster, cleaner paymentsStarting Price: $30/month -
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SSI Claims Director
SSI Group
Elevate your claims management process and decrease denials through unmatched edits and an industry-leading clean claim rate. Health systems require access to technology that facilitates accurate claim submission and rapid reimbursement. Claims Director, SSI’s claims management solution, streamlines billing practices and provides visibility by guiding users through the electronic claim submission and reconciliation process from beginning to end. As payers change or modify reimbursement criteria for services, the system actively monitors and incorporates these changes and requirements. And with a comprehensive mix of edits at the industry, payer and provider levels, the solution aids organizations in making the most of reimbursement efforts. -
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iMed e-Rx
iMedWare
iMed e-Rx electronic prescription system starts from $43/month and can be used for writing both legend and EPCS compliant prescriptions. Which is Certified for e-Prescribing in all States. Our software has Electronic prior authorization and it has Formulary support. Our key highlights are Drug-Drug, Allergy, and Disease interaction checking, Database of drug stores with frequent updates, Drug therapy monitoring, 24/7 monitoring of script delivery and so on.Starting Price: $43 per month -
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GenHealth.ai
GenHealth.ai
GenHealth.ai is a healthcare-focused generative AI platform built on a proprietary Large Medical Model (LMM) trained using data from over 100 million patient histories rather than natural language. The LMM processes medical codes and events to predict future patient trajectories, forecast costs, and simulate clinical pathways with higher accuracy and fewer hallucinations than traditional large language models. It supports a suite of purpose-built applications, including Intake Automation (PDF routing, data extraction, medical necessity), Prior Authorization Agent for automated adjudication, and G‑Mode analytics, which enables users to “chat” with historical and projected population‐health data via natural language, all without coding. This AI‑powered co‑pilot has shown 94 % accuracy in prior‑auth cases, a 120× improvement in medical loss ratio forecasting, and 110 % better cost prediction versus standard HCC scoring. -
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RCM Cloud
Medsphere Systems Corporation
The RCM Cloud® “software as a service” (SaaS) model strives to replace resource-intensive medical billing processes with digital solutions that reduce manual processes and optimize workflow thru automation. This approach significantly improves operational efficiency and further allows the business to expand service delivery capacity with only minor increases in administrative staff. Leverage your investment in technology to grow and sustain your business as opposed to increasing the headcount necessary to expand. On the administrative side, RCM Cloud® and associated services are delivered via the powerful, proven and secure medsphere cloud services platform. RCM Cloud® modules include patient/resource scheduling, enterprise registration, in-stream payer eligibility checking, contract management, medical records, billing, claims, payer and self-pay collections, POS payment posting and bad debt which enable all types of healthcare entities to truly transform their revenue cycles. -
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Claude for Healthcare
Anthropic
Claude for Healthcare is a HIPAA-ready AI platform built on Anthropic’s advanced Claude models that helps healthcare organizations move faster without sacrificing safety, accuracy, or compliance by connecting to trusted medical, payer, and clinical data sources. It enables use cases such as prior authorization review, insurance claims appeals, clinical documentation generation, patient message triage, care coordination, and other administrative workflows by validating provider credentials, medical codes, coverage requirements, and drafting recommendations or summaries with traceable sources for verification. Claude can integrate with industry standards and databases, including CMS coverage policies, ICD-10 codes, provider registries, and PubMed, and supports secure connection to personal health records (e.g., lab results and medical histories) with user consent so patients or clinicians can get plain-language summaries and insights.Starting Price: $17 per month -
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BHRev
BHRev
BHRev is a specialized revenue cycle management service and automation platform built for behavioral health providers that helps practices streamline and optimize their entire financial workflow from claims submission to payment collection with AI-powered automation, expert oversight, and industry-specific expertise. It focuses on the unique challenges behavioral health organizations face, including complex payer rules, documentation requirements, high denial rates, and evolving compliance standards, by automating up to 80% of RCM tasks while human experts handle exceptions, compliance checks, and more nuanced billing functions to ensure faster reimbursement and fewer administrative errors. It combines advanced automation with human review to handle critical steps such as insurance eligibility verification, claims processing and scrubbing, denial management and follow-up, and patient payment posting so clinics can reduce operational burden and increase cash flow. -
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Integra Logix
Integra
Logix works in the background to complete tedious yet important workflow tasks like refill requests, prior authorizations, refill too soons, fax escalations, and phone call documentation. Other tasks, like fax and email, can be automated too. And you can alleviate human error on repetitive tasks as well. Plus, create notifications so you don’t forget what’s needed and can redirect time to focus even more on patients. Every keystroke and click counts! With Logix processes in place, you can reduce document handling & processing times by an average of 1-4 minutes per document. Logix is designed to work with DocuTrack to reduce keystrokes for your pharmacy workforce and make them more efficient. Reduce keystrokes needed to complete a process by up to 80 for some processes. How much can Logix save you? Use the calculator and see for yourself. -
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MD Clarity
MD Clarity
Boost your bottom line by automating patient cost estimates, payer underpayment detection, and contract optimization in one place. Spot patterns of underpayment by insurance companies. Ensure you are setting your chargemaster optimally. Assign investigations/appeals to staff and see task status, all in one place. Compare performance across payer contracts and renegotiate terms from a position of strength. Project out-of-pocket costs at a high level of accuracy, giving patients the confidence to make up-front deposits. Enable patients to make up-front deposits directly from their online estimate. Hold insurers accountable for the full amount they owe. Get the upper hand in contract negotiations. Reduce bad debt, cost-to-collect, & accounts receivable days. -
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MDToolbox e-Prescribing
MDToolbox
MDToolbox-Rx is a Certified, Award-Winning, complete electronic prescription writer that can run stand-alone or synced with your other office software. The e-Prescribing Software is a highly customizable, simple to use e-prescribing system that allows you to easily select drugs, find drug information, and create and electronically send a prescription quickly and efficiently. MDToolbox-Rx is Certified for e-Prescribing, Eligibility, Formulary, EPCS (e-Prescribing of Controlled Substances), and Electronic Prior Authorization. Search for drugs by name, nickname, generic, brand, rx, OTC, class or indication in the most comprehensive drug database available. Higher productivity due to less pharmacy calls and time spent for renewal requests. -
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CoverMyMeds
McKesson
We’re accelerating innovative solutions created to benefit all stakeholders in healthcare, to help increase speed to therapy, reduce prescription abandonment and support improved health outcomes for the patient. We’re committed to removing access barriers to healthcare — whether it’s resolving prior authorization requests or raising awareness around support services. Healthcare is seemingly more expensive than ever. Assist your patients in getting their prescribed therapy with affordability solutions that help with high-deductible health plans, increasing copays and a lack of visibility. For some, staying on therapy can be the hardest part of their healthcare journey — whether it’s learning how to take their medications or simply remembering to do it at the prescribed time. Which is why these adherence challenges must be met with people-first solutions. -
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MediFusion
MediFusion
MediFusion is a fully integrated suite of software designed to offer innovative EHR and medical billing solutions to healthcare practices and enhance clinical, administrative and financial operations. Our team is just a phone call away to provide ongoing EHR training and be there for you whenever you need help and support. Speed-up your clinical processes and automate your workflow with our all-in-one integrated solution. A system that manages the entire revenue cycle from Eligibility Verification to Claim Processing and getting paid. Our cloud-based Electronic Health Record (EHR) software is an integrated and scalable solution to enable your practice to improve the quality of care provided to patients. This easy to use web-based EHR platform allows you to document, access and track your Clinical and Financial information on any internet-ready device no matter where you are. -
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XIFIN RPM
XIFIN
Powered by our advanced, cloud-based technology platform, XIFIN RPM is a comprehensive, highly automated Revenue Cycle Management solution that maximizes efficiency, refines medical cycle billing, improves cash collection, and increases financial accuracy. Diagnostic providers need financial management technology that not only helps improve cash collections, but also delivers visibility and control over financial operations, and provides connectivity within and beyond the organization. With these increasingly complex needs, diagnostic providers are poorly served by traditional billing systems that lack the referential and financial integrity required to deliver accurate, auditable information. Instead, they need a technology infrastructure with a solid financial and accounting foundation that delivers full visibility to understand the financial status of every diagnostic activity a provider performs, at every stage from order submission to payment. -
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Transform your revenue cycle with Oracle Health RevElate Patient Accounting. Our EHR-agnostic solution helps you optimize financial outcomes with clinically integrated, cloud-enabled billing workflows that provide automation and extensibility. With RevElate Patient Accounting you can: Limit workflow redundancies, using dynamically connected workflows and analytics to help optimize efficiencies Prioritize and collect on outstanding accounts receivable with embedded business rules to identify and assign work efficiently Establish an open and extensible framework to support workflows that flow across Oracle Health solutions, third-party technologies, and organizations at scale Help improve compliance and maximize reimbursements with embedded payer rules RevElate Patient Accounting brings together a unified view of clinical and financial information to give you enhanced visibility into patient activity and accounts.
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Practice Fusion
Practice Fusion
Save time with templates and patient charts in the cloud-based EHR that adapt to your needs. Browse from a library of medical charting templates built by practices like yours. Efficiently manage prescriptions including controlled substances and those requiring prior authorization. Seamlessly exchange information with local pharmacies, laboratories, imaging centers and other tools integrated into the EHR platform. Choose from over 500 lab and imaging centers to order tests and share results with patient. Flexible billing options with industry-leading partners who help you get paid faster. Monitor your progress with insightful dashboards and submit reporting data to CMS directly through your EHR. Access customizable dashboards to track your progress on quality initiatives like MIPS. Explore extensive education and training materials to navigate the complexities of quality measures. -
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Oracle Health
Oracle
Connected technologies and unified data empower individuals and enable the health ecosystem to accelerate innovation and influence health outcomes. Oracle Health is building an open healthcare platform with intelligent tools for data-driven, human-centric healthcare experiences to connect consumers, healthcare providers, payers, and public health and life sciences organizations. With the largest global EHR market share, we are able to bring data together to enable clinicians, patients, and researchers to take meaningful action, advance health, and work to improve outcomes worldwide. Rated the largest revenue cycle management (RCM) leader by IDC MarketScape, we provide timely, predictive, and actionable health insights to automate processes, optimize resources, and drive efficiencies. Accelerate innovation, benefit from flexible infrastructure and platform resources, and drive clinical intelligence through our open, extensible ecosystem of partners and technologies. -
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MedicsRIS
Advanced Data Systems
MedicsRIS is a comprehensive radiology information system that empowers radiologists to seamlessly manage their practice and easily get paid for every diagnostic exam. Developed by Advanced Data Systems, MedicsRIS takes inbound orders from referring physician’s stage 2 certified electronic medical record (EMR) without any costly HL7 interfaces as well as obtain incentives and avoid penalties. Core features of MedicsRIS that help boost business productivity include a referring physicians portal, automated billing with EDI, multi-modality scheduling, insurance eligibility verification, mammography tracking, and more. Give referring physicians and radiology departments access to our qualified CDS option via the MedicsRIS portal for those who don’t have their own qCDSM. Stymied with getting prior authorizations manually? Our automated PA option gets them online without leaving MedicsRIS. -
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Southern Scripts
Southern Scripts
Southern Scripts simplifies the complexities of navigating through the Pharmacy Benefit Manager world by giving the employer group complete freedom, control, and choice as to how they structure their plan. Southern Scripts is a leading pharmacy benefits manager (PBM) founded by pharmacists to reinvent the traditional PBM approach. Our innovative pass-through PBM model and flexible solutions empower plan sponsors to achieve maximum cost savings, decreased risk, and optimum versatility in plan design to achieve true patient-centered clinical care at the lowest net cost. Plan sponsor is charged the exact price the pharmacy is paid. We pass all discounts and rebates that we secure at 100% to the plan sponsor. No additional fees for standard PBM services, such as prior authorizations, step therapy, and data reporting. Our robust clinical management program and high-performance drug formularies deliver the lowest net cost to protect plans from unnecessary expenses. -
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Certive Health
Certive Health
Certive’s Revenue Integrity Analytics platform is based on a unique blend of data science, clinical expertise, and administrative process knowledge. Certive Health’s experience base ensures the integrity of the hospital’s revenue and compliance of its processes. The core of Certive Health’s Revenue Solutions offering is built on its Revenue Integrity Analytics™ platform. Extended technical capabilities in analytics, workflow, and marketing automation combined with clinical and payer side experience helps our clients reduce costs, improve outcomes, and increase patient satisfaction.Starting Price: $1000.00/month -
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TriZetto
TriZetto
Accelerate payment while decreasing administrative burdens. With 8,000+ payer connections and longstanding partnerships with 650+ practice management vendors, our claims management solutions can result in fewer pending claims and less manual intervention. Quickly and accurately transmit professional, institutional, dental, workers compensation claims and more for fast reimbursement. Meet the shift to healthcare consumerism head on by providing a straightforward and seamless financial experience. Our patient engagement solutions empower you to have informed conversations about eligibility and financial responsibility while reducing hurdles that may impact patient outcomes. -
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Anomaly
Anomaly
Anomaly is an AI-powered payer management platform built for healthcare revenue teams to “know your payers as well as they know you.” It surfaces hidden payer behaviors by decoding complex rules and detecting payment patterns across hundreds of millions of healthcare encounters. The core engine, Smart Response, continuously analyzes payer logic, adapts to shifting policies, and embeds learnings directly into existing revenue cycle workflows to provide real-time denial prediction, assisted claims correction, and alerts to revenue risks. By integrating payer-specific insights into existing systems, users can anticipate revenue loss, negotiate payer contracts from a stronger position, and proactively correct or reverse denials before they impact cash flow. The system helps level the playing field between providers and payers by turning opaque billing logic into actionable intelligence and embedding it into day-to-day financial operations. -
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Paradigm
Paradigm
Paradigm Senior Services offers a full-service, AI-powered revenue cycle management platform specifically tailored to home-care agencies that bill third-party payers such as the U.S. Department of Veterans Affairs (VA), Medicaid, and other managed-care payers. It automates and streamlines every step of the billing and claims process: from eligibility/authorization verification, state- or payer-specific enrollment and credentialing, to submission of clean claims, denial handling, and payment reconciliation. It integrates with common agency management software and electronic visit verification tools to scrub shifts, verify authorizations weekly, and reconcile payments, reducing denials and minimizing administrative burden. Paradigm also supports “back-office as a service” for providers; even if they already have internal billing staff or scheduling software, Paradigm can take over claims processing as a specialized, expert billing department. -
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Droidal
Droidal LLC
Droidal is an AI-powered revenue cycle management platform that helps healthcare organizations reduce costs, increase revenue, and improve patient experiences. By leveraging Generative AI and large language models (LLMs), Droidal automates complex billing, claims, and payment workflows with precision and speed. The platform processes over 2 million claims monthly across 1,800+ locations while maintaining coverage for 3,500+ payers. Its AI agents streamline operations for hospitals, clinics, and care providers — cutting denials, accelerating payments, and boosting cash flow. Designed for seamless integration, Droidal enhances productivity without replacing existing systems or workflows. With enterprise-grade compliance and a subscription-based model, Droidal delivers measurable ROI while freeing up staff to focus on patient care. -
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Vetriq
Vetriq
Vetriq is a healthcare revenue cycle automation platform designed to eliminate manual processing tasks involved in payment posting, remittance handling, and financial reconciliation for medical organizations. It focuses on automating the workflow around Explanation of Benefits (EOB) documents, payer correspondence, and bank lockbox deposits, converting incoming payment information into structured electronic data that can be automatically posted into revenue cycle management systems. Instead of requiring healthcare organizations to replace their bank, lockbox provider, or existing RCM infrastructure, Vetriq integrates with current banking relationships and practice management or EHR systems, layering automation on top of existing workflows. Vetriq’s automated processing engine transforms paper EOBs into standardized electronic remittance files such as 835 formats, eliminating the need for manual data entry and significantly reducing administrative workload.Starting Price: $22 per hour -
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Kodiak Platform
Kodiak Platform
Kodiak Platform is a cloud-based healthcare finance and revenue-cycle solution designed to unify and elevate critical financial operations across hospitals, health systems, and physician practices. Built around their proprietary Revenue Cycle Analytics software, the platform aggregates over two decades of national payor and provider data to enable deep insights into net revenue trends, industry benchmarking, and risk accelerators, all aimed at generating a high return on investment. It integrates modules for charge capture, three-way cash reconciliation, uncompensated-care reimbursement, and payor market intelligence, enabling finance teams to automate key processes, gain visibility into unapplied payments, and benchmark payor performance at the payer level. With detailed dashboards, multi-step workflows, and continuous monitoring, users can standardize revenue-cycle tasks, reduce manual effort, and identify growth opportunities from one unified platform rather than siloed systems. -
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MDaudit
MDaudit
MDaudit is a cloud-based platform that unifies billing compliance, coding audits, and revenue-integrity workflows for healthcare providers, hospitals, physician networks, ambulatory surgical centers, and the like. It supports all types of audits, scheduled, risk-based, retrospective, and denial-focused. MDaudit automates data ingestion from pre-bill charges, claims, and remittance data; triggers audit workflows; flags anomalies and high-risk patterns; and delivers real-time dashboards and drill-down analytics revealing root causes of billing errors, denials, and revenue leakage. Its modules, including a “Denials Predictor” for pre-submission claim validation and a “Revenue Optimizer” for continuous risk monitoring, help organizations prevent claim denials, reduce recoupments, and capture more legitimate revenue. MDaudit also provides payer-audit management: a secure, centralized workflow to respond to external audit requests and manage documentation exchange. -
47
mDOC
Mack Software
Using our claim listing page you can quickly resolve errors and omissions prior to submitting your claims. After all information has been posted, diagnosis and modifier codes applied, you can submit a group of claims to Trizetto Provider Solutions® in one quick step to upload the claims. Trizetto Provider Solutions® will in turn perform additional claim scrubbing and then send your claims on to the payers. Post payments from insurance companies against claims indicating allowed amounts, adjustments and copay, coinsurance and deductible. Payments are entered in batches to ensure accuracy. Statements are prepared at your desired frequency - daily, weekly, monthly. These statements are presented in a simple, clear format that is easy for patients to read and understand. No more confusion!! A credit card authorization area is included on the statement for convenient payment of balances due. -
48
Benchmark PM
Benchmark Solutions
Benchmark PM enhances patient engagement from initial intake through final encounter with features such as patient onboarding, easy appointment scheduling, customizable reminders, robust reporting, and user-friendly dashboards. For billing, Benchmark PM simplifies filing, processing, and follow-up with integrated claims management, an integrated clearinghouse, electronic billing, insurance verification, and a versatile payment portal. Benchmark Solutions operates as healthcare practices’ one-stop management solution, comprising of Benchmark EHR software, Benchmark PM software, and Benchmark RCM services. Benchmark Solutions' offerings come together to form a comprehensive electronic toolset that can streamline daily internal operations and increase revenue earned all while improving the overall patient experience. Each piece of the Benchmark Solutions suite is modular so it can easily integrate with other technologies already in place. -
49
talkEHR
CareCloud
The world’s first EHR software that understands you. Interact with talkEHR by utilizing Alison an AI powered voice assistant. talkEHR is an electronic health records software that understands you. Doctor can now spend less screen time and focus on patient interaction. Whether you’re a solo practice or part of a multi-specialty group, talkEHR will work for you. Our software is ONC-ACB Certified to the latest standard, ICD-10 compliant, MACRA/MIPS Certified ready that seamlessly connects patients, payers, labs, and other members of the healthcare team. Choose from a range of integrated mobile health apps to extend the core functionality of talkEHR and remove mundane tasks from your practice. talkEHR mimics the natural workflows of physicians, which makes it incredibly intuitive and easy to use. talkEHR has been built on cutting-edge technologies and architecture, which makes it highly responsive. -
50
ARIA RCM Services
CompuGroup Medical US
ARIA RCM Services is an end-to-end medical billing and revenue cycle management solution designed to enhance financial operations for practices, hospitals, and laboratories. The service offers flexibility by allowing clients to leverage their existing billing technology or utilize ARIA's systems, ensuring full transparency through a dedicated RCM team. Services are tailored to address specific needs, ranging from comprehensive revenue cycle management to focused areas such as aging accounts receivable and coding oversight. ARIA's team of regulatory and payment experts assists clients in navigating the latest CMS and payer requirements, aiming to minimize denials, reduce AR, and accelerate payment processes. The service emphasizes operational efficiency by combining industry best practices with proprietary workflow technology, delivering optimal results at a lower cost.
