Top 10 Revenue Cycle Management Companies
Managing a successful revenue cycle for a healthcare business can be incredibly complex. With a lot of coding standards, compliance regulations, and protocols to follow, choosing the right Revenue Cycle Management (RCM) company is critical to ensure success. Healthcare organizations utilize technology to enable the RCM process that spans patient scheduling, appointment management, medical coding services, claims submission, patient invoicing, collection, and remittance processing. With a lot of RCM companies in the market, it can be challenging to decide which one to partner with. In this blog post, we will provide an in-depth analysis of the top 10 RCM companies in the US today, highlighting their unique offerings, to help you make informed decisions regarding managing your revenue cycle.
So, let us dive in!
Revenue Cycle Management and Healthcare
Persistent revenue losses due to claim failures and rejections are putting increasing pressure on hospitals and healthcare service providers to reduce costs. This has led to the expansion of the healthcare revenue cycle management data provider industry, which provides specialized services to healthcare providers. Managing claims denial services has become more reliant on third-party service providers for many hospitals for last several years. To make matters worse, the industry lacks the knowledge and skills to handle the time-consuming reimbursement process effectively. As a result, hospitals often have problems with reimbursement due to incorrect claims, improper insurance verification, lack of documentation, missed deadlines, and inaccurate coding. Despite these challenges, the global healthcare revenue cycle management market is expected to grow at a CAGR of 11% between 2015 and 2025, reaching $104,396,000,000 by the end of the decade. This growth is fueled by factors such as rising healthcare costs, rapid technological developments, and constant regulatory changes.
Here are the Top 10 Revenue Cycle Management Companies in the US:
1. Access Healthcare
Healthcare organizations may benefit from Access Healthcare, which is the leading provider of healthcare revenue cycle services and process automation solutions. They help healthcare organizations improve administrative, clinical, and financial outcomes. Since its inception in 2011, Access Healthcare is privately held, having 20 global delivery centers in 9 cities in India, the Philippines, and the USA. With approximately 20,000 employees, supporting 500K physicians, and processing over 400 million transactions covering 80+ specialties, Access Healthcare has become a significant player in the healthcare industry.
Abeo, incorporated in 2007, is a revenue cycle management company built from their in-depth experience in one of the most difficult specialties to bill for – Anesthesiology. It is a nationwide medical billing and Software Company focusing on delivering revenue-enhancing services to private practices, hospitals, and surgery centers. It also helps bridge the gap between the constant change in healthcare and customers’ changing needs.
3. R1 RCM
R1 RCM is an American RCM company servicing hospitals, health systems, and physician groups across the United States headquartered in the Utah town of Murray with over 15,000 employees, R1 generated $1.5B in revenue in 2022. It offers solutions thataid in resolving and reshaping issues that arise within the revenue cycle efficiency of healthcare revenue cycle management data providers. Billing and collections, new patient information, medical record keeping and coding, coverage and benefit validation, and other similar services are all part of the package. In addition, R1 also provides services in case management, financial stability, business contact, patient satisfaction, and physician advice. By providing what the target audience needs, these services assist healthcare revenue cycle management data providers in meeting payer regulations for invoicing.
AdvantEdge is one of the leading national billing companies that provides medical billing services, practice management, and medical coding services. It focuses on serving hospital-based physicians, hospitals, ambulatory surgery centers, and office-based physicians. The company is headquartered in Warren, New Jersey and it has global locations in India and the USA with over 500 employees.
5. Omega Healthcare
Omega Healthcare is the trusted leader in Technology-Enabled services to streamline the financial, administrative, and clinical communication processes. Headquartered in Ellicott City, Maryland, United States, Omega offers a wide range of medical billing services, including claims processing and accounts receivable management to healthcare providers, payers, and pharma companies. With over 26,000 employees and 500+ RPA bots, Omega delivers $10+ billion in account receivables collected annually, processes 118+ million medical charts annually, and handles 650K+ patient support calls monthly.
6. Convergent USA
Convergent provides a wide range of customer contact management services, and healthcare revenue cycle management services to hundreds of hospitals across the nation to improve financial performance, enhance patient experience and improve physician satisfaction. Established in 1998, with roots dating back to 1950, Convergent has 15 office locations across four time zones, it empowers its clients with an innovative combination of an adaptable workflow engine, technology-enabled operations, next-generation analytics, and professional services.
MedAssist provides hospital and health system revenue cycle management services. MedAssist offers comprehensive services, such as claim scrubbing and denial management, eligibility verification, payment posting, patient billing, and accounts receivable management. Its secure data storage infrastructure allows for patient data to remain confidential and secure. Its 200 million customer interactions, 25000 + Firstsourcers, and 3 Billion + Claims made them a leader in the revenue cycle management market.
NexGen Healthcare is an electronic health record (EHR) and practices management solutions provider specializing in ambulatory care. The company's HER system is fully integrated with all other aspects of the business, including patient self-scheduling, virtual visits, examination, documentation, checkout, billing and collections, and more. In the neighborhood of 5,000 people, NextGen generates around $600 million annually.
9. Experian Health
Experian Health partners with over 63 percent of US hospitals and 7,700+ other risk-bearing entities to provide data-driven insights, connecting and simplifying healthcare for all, including revenue cycle management, identity management, patient engagement, and care management solutions. It is powered by the strong healthcare heritage of our legacy companies, plus the deep data and analytics capabilities of Experian. The healthcare providers—along with thousands of medical practices, labs, pharmacies, and other risk-bearing entities—are making smarter business decisions, boosting their bottom lines, and strengthening patient relationships by partnering with Experian.
Finvi provides revenue recovery solutions for healthcare, government, and education organizations It assists healthcare organizations with charge capture, accounts receivable management, and denial prevention through its proprietary software. By 2023, Finvi expects to generate more than $129.1 million in revenue.
In conclusion, the revenue cycle management USA market is highly competitive and growing at a rapid rate. Many organizations offer revenue cycle management services to businesses of all sizes, from small startup companies to large corporations. Therefore, it is vital to understand each of these organizations and their services to choose the best one for your business.