Quick Overview
- 1#1: Waystar - Provides end-to-end revenue cycle management with AI-driven claims processing, denial management, and patient payments for healthcare providers.
- 2#2: athenahealth - Delivers cloud-based revenue cycle management integrated with EHR for streamlined billing, collections, and analytics in ambulatory practices.
- 3#3: Epic Systems - Offers Resolute revenue cycle platform with comprehensive billing, claims scrubbing, and financial reporting for large health systems.
- 4#4: Oracle Health - Integrates revenue cycle management tools for claims processing, eligibility verification, and payment posting within enterprise EHR environments.
- 5#5: Optum - Powers revenue cycle with advanced analytics, automation, and payer connectivity through its Change Healthcare platform.
- 6#6: Kareo - Simplifies RCM for independent practices with billing, patient payments, and denial prevention features.
- 7#7: AdvancedMD - Manages revenue cycles for specialty practices via cloud-based scheduling, billing, and ERA posting.
- 8#8: NextGen Healthcare - Supports ambulatory RCM with claims management, remittance processing, and performance analytics.
- 9#9: Veradigm - Facilitates revenue cycle through integrated practice management, clearinghouse services, and reporting.
- 10#10: eClinicalWorks - Handles RCM tasks including electronic billing, patient statements, and AR management in its EHR suite.
Tools were selected based on performance, feature depth, user-friendliness, and value, ensuring they align with the needs of diverse practices, from small clinics to large health systems.
Comparison Table
Healthcare revenue cycle management (rcm) software is vital for optimizing financial operations, and this table breaks down key tools like Waystar, athenahealth, Epic Systems, Oracle Health, and Optum, examining their core features, integrations, and use cases. Readers will discover which software aligns with their practice size, specialty, or workflow needs, helping them make informed decisions to enhance efficiency, reduce denials, and accelerate revenue.
| # | Tool | Category | Overall | Features | Ease of Use | Value |
|---|---|---|---|---|---|---|
| 1 | Waystar Provides end-to-end revenue cycle management with AI-driven claims processing, denial management, and patient payments for healthcare providers. | enterprise | 9.7/10 | 9.8/10 | 9.2/10 | 9.1/10 |
| 2 | athenahealth Delivers cloud-based revenue cycle management integrated with EHR for streamlined billing, collections, and analytics in ambulatory practices. | enterprise | 9.2/10 | 9.5/10 | 8.7/10 | 8.4/10 |
| 3 | Epic Systems Offers Resolute revenue cycle platform with comprehensive billing, claims scrubbing, and financial reporting for large health systems. | enterprise | 8.7/10 | 9.4/10 | 6.7/10 | 7.8/10 |
| 4 | Oracle Health Integrates revenue cycle management tools for claims processing, eligibility verification, and payment posting within enterprise EHR environments. | enterprise | 8.4/10 | 9.2/10 | 7.1/10 | 7.9/10 |
| 5 | Optum Powers revenue cycle with advanced analytics, automation, and payer connectivity through its Change Healthcare platform. | enterprise | 8.2/10 | 8.7/10 | 7.4/10 | 7.8/10 |
| 6 | Kareo Simplifies RCM for independent practices with billing, patient payments, and denial prevention features. | specialized | 8.1/10 | 8.4/10 | 8.6/10 | 7.7/10 |
| 7 | AdvancedMD Manages revenue cycles for specialty practices via cloud-based scheduling, billing, and ERA posting. | enterprise | 8.1/10 | 8.4/10 | 7.6/10 | 7.7/10 |
| 8 | NextGen Healthcare Supports ambulatory RCM with claims management, remittance processing, and performance analytics. | enterprise | 8.1/10 | 8.5/10 | 7.7/10 | 7.9/10 |
| 9 | Veradigm Facilitates revenue cycle through integrated practice management, clearinghouse services, and reporting. | enterprise | 8.1/10 | 8.7/10 | 7.6/10 | 7.9/10 |
| 10 | eClinicalWorks Handles RCM tasks including electronic billing, patient statements, and AR management in its EHR suite. | enterprise | 7.2/10 | 7.8/10 | 6.5/10 | 7.0/10 |
Provides end-to-end revenue cycle management with AI-driven claims processing, denial management, and patient payments for healthcare providers.
Delivers cloud-based revenue cycle management integrated with EHR for streamlined billing, collections, and analytics in ambulatory practices.
Offers Resolute revenue cycle platform with comprehensive billing, claims scrubbing, and financial reporting for large health systems.
Integrates revenue cycle management tools for claims processing, eligibility verification, and payment posting within enterprise EHR environments.
Powers revenue cycle with advanced analytics, automation, and payer connectivity through its Change Healthcare platform.
Simplifies RCM for independent practices with billing, patient payments, and denial prevention features.
Manages revenue cycles for specialty practices via cloud-based scheduling, billing, and ERA posting.
Supports ambulatory RCM with claims management, remittance processing, and performance analytics.
Facilitates revenue cycle through integrated practice management, clearinghouse services, and reporting.
Handles RCM tasks including electronic billing, patient statements, and AR management in its EHR suite.
Waystar
enterpriseProvides end-to-end revenue cycle management with AI-driven claims processing, denial management, and patient payments for healthcare providers.
RevView AI analytics platform, delivering predictive denial prevention and actionable revenue cycle optimization in real-time.
Waystar is a leading cloud-based revenue cycle management (RCM) platform for healthcare providers, offering end-to-end solutions for claims processing, patient eligibility verification, denial management, and payment posting. It leverages AI and automation to optimize financial workflows, reduce denials, and accelerate reimbursements across hospitals, health systems, and physician practices. With seamless integrations to major EHRs like Epic and Cerner, Waystar provides real-time analytics and patient engagement tools to enhance revenue integrity.
Pros
- Advanced AI-powered automation for claims scrubbing and denial prevention
- Comprehensive analytics dashboard (RevView) for real-time revenue insights
- Broad interoperability with EHRs and practice management systems
Cons
- Enterprise-level pricing may be prohibitive for small practices
- Initial implementation and training can be time-intensive
- Customization requires dedicated support resources
Best For
Large hospitals, health systems, and multi-specialty groups needing scalable, high-volume RCM automation.
Pricing
Custom enterprise pricing; typically $500K+ annually for mid-sized organizations, based on modules, volume, and contract terms.
athenahealth
enterpriseDelivers cloud-based revenue cycle management integrated with EHR for streamlined billing, collections, and analytics in ambulatory practices.
athenaOne Intelligence: AI-powered revenue cycle analytics that proactively identifies leakage and optimizes collections in real-time.
Athenahealth's athenaOne platform is a cloud-based, integrated EHR and revenue cycle management (RCM) solution designed for healthcare providers. It streamlines billing, claims processing, denial management, patient payments, and financial analytics to maximize revenue and ensure compliance. Leveraging AI-driven tools, it offers real-time insights and automation to reduce administrative burdens and improve cash flow for practices of various sizes.
Pros
- Comprehensive RCM automation with high first-pass claim acceptance rates (up to 98%)
- Seamless integration with EHR for end-to-end workflow efficiency
- Advanced AI analytics for revenue forecasting and denial prevention
Cons
- High subscription costs that may strain small practices
- Steep learning curve during initial implementation
- Limited customization options compared to some competitors
Best For
Mid-sized to large medical practices and multi-specialty groups needing a robust, integrated EHR-RCM platform with strong automation.
Pricing
Quote-based pricing, typically $300-$500 per provider per month, including EHR, practice management, and RCM features; scales with practice size.
Epic Systems
enterpriseOffers Resolute revenue cycle platform with comprehensive billing, claims scrubbing, and financial reporting for large health systems.
Unified single-database architecture that synchronizes clinical documentation with financial processes in real-time, minimizing discrepancies and accelerating cash flow.
Epic Systems offers a comprehensive EHR platform with integrated Revenue Cycle Management (RCM) modules, handling everything from patient registration and scheduling to claims submission, denials management, and payment posting. Its RCM tools leverage a unified database to ensure seamless data flow between clinical and financial workflows, reducing errors and improving reimbursement rates. Primarily used by large healthcare organizations, Epic excels in scalability and compliance for complex enterprise environments.
Pros
- Seamless integration with EHR for accurate coding, charge capture, and billing
- Advanced AI-driven analytics for denial prediction and revenue optimization
- Proven scalability and reliability for large health systems
Cons
- Prohibitively high implementation costs and lengthy deployment timelines (often 2-5 years)
- Steep learning curve and complex user interface requiring extensive training
- Limited customization flexibility due to proprietary architecture
Best For
Large hospitals and integrated delivery networks needing enterprise-grade, fully integrated EHR and RCM solutions.
Pricing
Custom enterprise pricing; typically involves multi-million-dollar implementation fees plus ongoing subscription costs based on users, beds, and modules—not publicly listed.
Oracle Health
enterpriseIntegrates revenue cycle management tools for claims processing, eligibility verification, and payment posting within enterprise EHR environments.
AI-powered Revenue Intelligence for predictive denial management and automated workflow optimization
Oracle Health provides a comprehensive Revenue Cycle Management (RCM) solution integrated within its broader healthcare platform, formerly Cerner, focusing on automating claims processing, billing, denial management, and patient financial engagement. It leverages AI-driven analytics for revenue optimization, eligibility verification, and payment posting across hospitals and health systems. Designed for enterprise-scale operations, it ensures compliance with healthcare regulations like HIPAA while streamlining financial workflows from patient registration to final collections.
Pros
- Robust AI and analytics for denial prediction and revenue recovery
- Seamless integration with Oracle EHR and other enterprise systems
- Scalable for large hospitals and multi-facility networks
Cons
- Steep learning curve and complex implementation process
- High upfront costs and long deployment timelines
- Limited flexibility for smaller practices without heavy customization
Best For
Large hospitals and health systems seeking an integrated, enterprise-grade RCM platform with deep EHR connectivity.
Pricing
Custom enterprise licensing with subscription models starting at $500K+ annually, depending on modules and scale.
Optum
enterprisePowers revenue cycle with advanced analytics, automation, and payer connectivity through its Change Healthcare platform.
AI-powered Revenue Performance Advisor for predictive denial management and cash flow forecasting
Optum offers a comprehensive revenue cycle management (RCM) platform tailored for healthcare providers, including tools for claims processing, coding, billing, denial management, and patient collections. Leveraging AI, analytics, and integration with payer systems via its UnitedHealth Group affiliation, it aims to optimize financial performance and reduce revenue leakage. The solution supports end-to-end RCM workflows, from front-end registration to back-end reporting.
Pros
- Extensive feature set with AI-driven analytics for denial prediction and revenue optimization
- Seamless integration with EHRs and payer systems
- Robust reporting and compliance tools
Cons
- Complex implementation and steep learning curve for smaller practices
- High cost with custom enterprise pricing
- Occasional customer service delays reported
Best For
Large hospitals and multi-specialty health systems needing scalable, analytics-heavy RCM solutions.
Pricing
Custom enterprise pricing, often starting at $100K+ annually based on volume and modules; per-claim or subscription models available.
Kareo
specializedSimplifies RCM for independent practices with billing, patient payments, and denial prevention features.
AI-powered claims scrubbing and denial management that proactively identifies and resolves issues before submission
Kareo is a cloud-based platform tailored for independent healthcare practices, providing integrated electronic health records (EHR), practice management, and revenue cycle management (RCM) tools. It automates billing, claims submission, denial management, AR follow-up, and patient collections to optimize revenue workflows. With analytics and patient engagement features, Kareo helps practices reduce administrative burdens and improve financial performance.
Pros
- Seamless integration of EHR, PM, and RCM for streamlined operations
- User-friendly interface with intuitive dashboards and mobile access
- Robust denial prevention and automated AR management tools
Cons
- Higher pricing tiers can strain smaller practices' budgets
- Limited advanced customization for complex enterprise needs
- Customer support response times can vary during peak periods
Best For
Small to mid-sized independent medical practices looking for an all-in-one, cloud-based RCM solution with strong billing automation.
Pricing
Starts at $140 per provider/month for core software, with RCM services on a revenue share (4-7% of collections) or flat fees; custom quotes for full suites.
AdvancedMD
enterpriseManages revenue cycles for specialty practices via cloud-based scheduling, billing, and ERA posting.
Advanced Claims Manager with AI-powered scrubbing and predictive denial intelligence
AdvancedMD is a cloud-based platform offering integrated electronic health records (EHR), practice management, and revenue cycle management (RCM) solutions designed for ambulatory healthcare practices. It automates key RCM processes such as claims scrubbing, submission, electronic remittance posting, denial management, and patient payment collections to improve cash flow and reduce administrative burdens. The software supports eligibility verification, AR aging analysis, and customizable reporting, making it suitable for specialties like orthopedics, cardiology, and primary care.
Pros
- Comprehensive RCM toolkit with automated claims editing and denial prevention
- Seamless integration with EHR and practice management for end-to-end workflows
- Scalable analytics and reporting for revenue optimization
Cons
- Steep learning curve for advanced features and custom configurations
- Pricing can be high for smaller practices
- Customer support response times vary and may require escalation
Best For
Mid-sized specialty practices needing robust, integrated RCM alongside EHR functionality.
Pricing
Custom quote-based pricing, typically $400-$800 per provider/month for full RCM suite, with additional fees for outsourcing services.
NextGen Healthcare
enterpriseSupports ambulatory RCM with claims management, remittance processing, and performance analytics.
Revenue Cycle Analytics with predictive denial prevention
NextGen Healthcare offers a comprehensive EHR and practice management platform with strong Revenue Cycle Management (RCM) capabilities, including automated claims submission, denial management, patient eligibility verification, and financial reporting. It integrates seamlessly with clinical workflows to reduce errors and accelerate reimbursements for ambulatory practices. The solution supports specialty-specific billing rules and provides analytics for optimizing revenue performance.
Pros
- Deep integration with EHR for streamlined workflows
- Robust denial management and analytics tools
- Customizable billing and reporting for specialties
Cons
- Steep learning curve and complex setup
- Higher pricing for smaller practices
- Limited native mobile access for RCM tasks
Best For
Mid-sized ambulatory and specialty practices needing integrated EHR and RCM functionality.
Pricing
Subscription-based, typically $300-$600 per provider/month plus implementation fees starting at $10K+.
Veradigm
enterpriseFacilitates revenue cycle through integrated practice management, clearinghouse services, and reporting.
AI-powered predictive analytics for denial prevention and revenue cycle optimization
Veradigm offers a robust Revenue Cycle Management (RCM) platform designed for healthcare providers, automating key processes like claims submission, denial management, payment posting, and patient collections. Integrated seamlessly with its EHR systems, it provides end-to-end financial management tools to streamline operations and improve cash flow. Advanced analytics and reporting help organizations identify revenue leakage and optimize payer contracts.
Pros
- Comprehensive RCM tools with strong automation for claims and denials
- Seamless integration with Veradigm EHR and practice management
- Powerful analytics for revenue optimization and compliance
Cons
- Steep learning curve and complex interface
- High costs unsuitable for small practices
- Lengthy implementation and customization process
Best For
Mid-to-large healthcare organizations and health systems needing integrated EHR-RCM solutions for high-volume billing.
Pricing
Custom enterprise pricing, typically subscription-based starting at several thousand dollars per month depending on practice size, users, and modules; requires sales quote.
eClinicalWorks
enterpriseHandles RCM tasks including electronic billing, patient statements, and AR management in its EHR suite.
Prism AI-powered claims intelligence for proactive denial prevention and revenue recovery
eClinicalWorks offers a comprehensive Revenue Cycle Management (RCM) solution deeply integrated with its EHR platform, automating claims processing, eligibility verification, denial management, and payment posting to streamline healthcare billing workflows. It leverages AI-driven tools for claims scrubbing and analytics to reduce denials and accelerate reimbursements. The system supports practices of various sizes with features like patient payment portals and AR management, though it's best suited for users already invested in the eClinicalWorks ecosystem.
Pros
- Seamless integration with EHR for unified clinical and billing workflows
- AI-powered denial prediction and automated claims scrubbing
- Scalable analytics and reporting for revenue optimization
Cons
- Steep learning curve and outdated user interface
- Reported customer support delays and responsiveness issues
- Customization can be complex and time-consuming
Best For
Mid-sized healthcare practices already using eClinicalWorks EHR that need integrated RCM without switching vendors.
Pricing
Custom pricing starting around $400-$600 per provider/month for EHR+RCM bundle, plus optional percentage-based fees (2-6%) for full RCM services.
Conclusion
The top healthcare RCM software options span diverse needs, with Waystar leading as the top choice due to its AI-driven end-to-end management, streamlining claims, denials, and payments. Athenahealth stands out for cloud-integrated EHR workflows in ambulatory practices, and Epic Systems excels with comprehensive tools for large health systems, each offering unique advantages.
Don’t miss out on optimizing your revenue cycle—explore Waystar’s innovative features to transform claims processing, reduce administrative burdens, and enhance practice efficiency today.
Tools Reviewed
All tools were independently evaluated for this comparison