Quick Overview
- 1#1: Waystar - Provides end-to-end revenue cycle management platform automating claims, denials, and patient payments for healthcare providers.
- 2#2: athenahealth - Delivers cloud-based revenue cycle management integrated with EHR for streamlined billing, collections, and financial reporting.
- 3#3: Epic Systems - Offers comprehensive revenue cycle management within its EHR suite, handling claims processing, eligibility verification, and analytics for large health systems.
- 4#4: Oracle Health - Powers revenue cycle operations through integrated software for patient access, coding, billing, and contract management in hospitals.
- 5#5: Optum Revenue Cycle - Manages full revenue cycle with AI-driven tools for claims optimization, denial prevention, and financial performance improvement.
- 6#6: Veradigm - Supports healthcare revenue cycle with practice management, billing, and analytics solutions for ambulatory practices.
- 7#7: NextGen Healthcare - Provides RCM software with features for scheduling, claims submission, remittance posting, and revenue analytics.
- 8#8: eClinicalWorks - Integrates revenue cycle management with EHR for electronic billing, patient payments, and denial management.
- 9#9: Kareo - Offers intelligent billing and revenue cycle management tailored for independent practices and small groups.
- 10#10: AdvancedMD - Delivers cloud-based RCM with automated billing, ERA posting, and practice financial reporting for specialty practices.
Tools were selected based on functionality, integration capabilities, user experience, and value, prioritizing solutions that deliver robust performance, scalability, and adaptability to complex healthcare revenue cycle challenges.
Comparison Table
Healthcare revenue cycle management (RCM) software is vital for optimizing financial workflows, from claims processing to revenue recovery. This comparison table evaluates tools like Waystar, athenahealth, Epic Systems, Oracle Health, and Optum Revenue Cycle, examining their core features, integration flexibility, and suitability for diverse practice sizes. Readers will discover how each platform addresses common challenges such as denied claims or slow reimbursement, aiding in informed software selection.
| # | Tool | Category | Overall | Features | Ease of Use | Value |
|---|---|---|---|---|---|---|
| 1 | Waystar Provides end-to-end revenue cycle management platform automating claims, denials, and patient payments for healthcare providers. | enterprise | 9.6/10 | 9.8/10 | 9.2/10 | 9.4/10 |
| 2 | athenahealth Delivers cloud-based revenue cycle management integrated with EHR for streamlined billing, collections, and financial reporting. | enterprise | 9.1/10 | 9.4/10 | 8.2/10 | 8.7/10 |
| 3 | Epic Systems Offers comprehensive revenue cycle management within its EHR suite, handling claims processing, eligibility verification, and analytics for large health systems. | enterprise | 8.7/10 | 9.4/10 | 6.8/10 | 7.9/10 |
| 4 | Oracle Health Powers revenue cycle operations through integrated software for patient access, coding, billing, and contract management in hospitals. | enterprise | 8.4/10 | 9.2/10 | 7.6/10 | 8.0/10 |
| 5 | Optum Revenue Cycle Manages full revenue cycle with AI-driven tools for claims optimization, denial prevention, and financial performance improvement. | enterprise | 8.4/10 | 9.2/10 | 7.8/10 | 8.0/10 |
| 6 | Veradigm Supports healthcare revenue cycle with practice management, billing, and analytics solutions for ambulatory practices. | enterprise | 8.2/10 | 8.7/10 | 7.9/10 | 7.8/10 |
| 7 | NextGen Healthcare Provides RCM software with features for scheduling, claims submission, remittance posting, and revenue analytics. | enterprise | 8.2/10 | 8.7/10 | 7.4/10 | 7.9/10 |
| 8 | eClinicalWorks Integrates revenue cycle management with EHR for electronic billing, patient payments, and denial management. | enterprise | 7.6/10 | 8.1/10 | 6.7/10 | 7.4/10 |
| 9 | Kareo Offers intelligent billing and revenue cycle management tailored for independent practices and small groups. | enterprise | 8.1/10 | 8.3/10 | 8.5/10 | 7.7/10 |
| 10 | AdvancedMD Delivers cloud-based RCM with automated billing, ERA posting, and practice financial reporting for specialty practices. | enterprise | 8.1/10 | 8.5/10 | 7.8/10 | 7.6/10 |
Provides end-to-end revenue cycle management platform automating claims, denials, and patient payments for healthcare providers.
Delivers cloud-based revenue cycle management integrated with EHR for streamlined billing, collections, and financial reporting.
Offers comprehensive revenue cycle management within its EHR suite, handling claims processing, eligibility verification, and analytics for large health systems.
Powers revenue cycle operations through integrated software for patient access, coding, billing, and contract management in hospitals.
Manages full revenue cycle with AI-driven tools for claims optimization, denial prevention, and financial performance improvement.
Supports healthcare revenue cycle with practice management, billing, and analytics solutions for ambulatory practices.
Provides RCM software with features for scheduling, claims submission, remittance posting, and revenue analytics.
Integrates revenue cycle management with EHR for electronic billing, patient payments, and denial management.
Offers intelligent billing and revenue cycle management tailored for independent practices and small groups.
Delivers cloud-based RCM with automated billing, ERA posting, and practice financial reporting for specialty practices.
Waystar
enterpriseProvides end-to-end revenue cycle management platform automating claims, denials, and patient payments for healthcare providers.
AI Denial Intelligence, which proactively predicts and prevents denials using machine learning across millions of claims data points
Waystar is a leading cloud-based revenue cycle management (RCM) platform for healthcare providers, automating end-to-end processes from patient access and claims submission to payments and denial management. It leverages AI-driven analytics, extensive payer connectivity, and real-time insights to optimize financial performance and reduce revenue leakage. Trusted by thousands of hospitals and health systems, Waystar delivers scalable solutions that enhance cash flow, compliance, and operational efficiency.
Pros
- Industry-leading connectivity with over 1,400 payers and 14,000 providers for seamless claims processing
- AI-powered tools for predictive denial management and revenue optimization
- Comprehensive analytics dashboard providing real-time visibility into RCM performance
Cons
- Enterprise-level pricing can be prohibitive for small practices
- Initial implementation and integration may require significant time and resources
- Steep learning curve for advanced features despite intuitive core interface
Best For
Large hospitals, health systems, and multi-facility providers needing robust, scalable RCM automation.
Pricing
Custom enterprise subscription pricing based on organization size, volume, and modules; typically starts at $50,000+ annually with quote-based models.
athenahealth
enterpriseDelivers cloud-based revenue cycle management integrated with EHR for streamlined billing, collections, and financial reporting.
AI-driven revenue cycle intelligence with predictive denial prevention and automated workflows
athenahealth is a cloud-based, integrated platform offering electronic health records (EHR), practice management, and robust revenue cycle management (RCM) solutions tailored for healthcare providers. Its RCM tools automate patient eligibility verification, claims scrubbing, submission, denial management, and payment posting to streamline billing workflows and maximize reimbursements. The software provides real-time financial analytics and reporting, helping practices optimize revenue performance across the entire revenue cycle.
Pros
- Comprehensive automation for claims processing and denial management
- Integrated EHR and RCM for seamless workflows
- Advanced analytics and revenue intelligence tools
Cons
- Steep learning curve for new users
- High implementation and subscription costs
- Customer support response times can vary
Best For
Mid-sized to large physician practices and specialty groups needing an all-in-one EHR and RCM solution.
Pricing
Quote-based pricing starting at around $300-$500 per provider per month, with additional fees for custom implementations and advanced modules.
Epic Systems
enterpriseOffers comprehensive revenue cycle management within its EHR suite, handling claims processing, eligibility verification, and analytics for large health systems.
Resolute's AI-enhanced claims scrubbing and denial management with predictive analytics for proactive revenue recovery
Epic Systems offers a comprehensive electronic health record (EHR) platform with integrated revenue cycle management (RCM) solutions through modules like Resolute for hospital and professional billing. It streamlines patient registration, charge capture, claims submission, denial management, and financial analytics, all tightly coupled with clinical workflows. This end-to-end RCM system is designed for high-volume healthcare providers, leveraging AI-driven tools for revenue optimization and compliance.
Pros
- Seamless integration with Epic's EHR for real-time clinical-financial data synchronization
- Advanced analytics and AI-powered denial prevention and revenue forecasting
- Highly scalable for large hospitals and health systems with robust compliance tools
Cons
- Steep learning curve and complex interface requiring extensive training
- Prolonged implementation timelines often exceeding 2-3 years
- Extremely high costs for customization, implementation, and maintenance
Best For
Large hospitals, academic medical centers, and integrated health systems seeking enterprise-grade, fully integrated RCM within an EHR ecosystem.
Pricing
Custom enterprise pricing; implementation costs often $100M+ for large orgs, with annual licensing fees in the millions based on beds/users/modules.
Oracle Health
enterprisePowers revenue cycle operations through integrated software for patient access, coding, billing, and contract management in hospitals.
AI-powered Intelligent Revenue Cycle with predictive denial management and automated workflows
Oracle Health Revenue Cycle Management is a comprehensive, cloud-based platform that automates and optimizes the entire revenue cycle for healthcare providers, from patient registration and eligibility verification to claims processing, denial management, and financial analytics. It integrates seamlessly with Oracle's EHR systems and leverages AI for predictive insights, charge capture accuracy, and revenue optimization. Designed for large-scale operations, it reduces administrative burdens and improves cash flow through advanced automation and compliance tools.
Pros
- End-to-end automation with AI-driven denial prediction and revenue forecasting
- Deep integration with Oracle Health EHR and other enterprise systems
- Scalable analytics for compliance and performance optimization
Cons
- Lengthy and complex implementation process
- High costs prohibitive for small to mid-sized practices
- Steep learning curve requiring extensive training
Best For
Large hospitals and health systems needing enterprise-grade, integrated RCM with AI capabilities.
Pricing
Custom enterprise licensing; typically annual subscriptions starting at $500K+ for mid-sized organizations, based on modules and scale.
Optum Revenue Cycle
enterpriseManages full revenue cycle with AI-driven tools for claims optimization, denial prevention, and financial performance improvement.
Causal360 AI analytics for real-time revenue cycle performance insights and predictive denial management
Optum Revenue Cycle is a comprehensive enterprise platform from Optum (part of UnitedHealth Group) that manages the full spectrum of healthcare revenue cycle processes, from patient registration and coding to claims submission, denial management, and accounts receivable optimization. It leverages AI, predictive analytics, and automation to reduce denials, accelerate reimbursements, and improve financial performance for providers. The solution integrates deeply with major EHR systems like Epic and Cerner, offering scalable tools for hospitals, health systems, and physician groups.
Pros
- Advanced AI and predictive analytics for denial prevention and AR optimization
- Seamless integration with leading EHRs and robust reporting capabilities
- Proven scalability for large health systems with end-to-end RCM coverage
Cons
- High implementation costs and complexity for smaller practices
- Steep learning curve due to its enterprise-level customization
- Pricing lacks transparency and is heavily service-dependent
Best For
Large hospitals and multi-facility health systems needing sophisticated, analytics-driven RCM at scale.
Pricing
Custom enterprise pricing with implementation fees, per-claim processing, revenue share models, and ongoing service contracts; starts at $500K+ annually for mid-sized implementations.
Veradigm
enterpriseSupports healthcare revenue cycle with practice management, billing, and analytics solutions for ambulatory practices.
AI-powered predictive analytics for denials prevention and revenue forecasting
Veradigm offers a comprehensive Revenue Cycle Management (RCM) platform tailored for healthcare providers, automating billing, claims submission, denials management, and patient collections. Integrated with its EHR systems, it provides real-time analytics and predictive insights to optimize revenue performance and reduce administrative burdens. The solution supports mid-to-large practices with scalable tools for eligibility verification, payment posting, and financial reporting.
Pros
- Seamless EHR integration for unified workflows
- Advanced AI-driven analytics and denials prediction
- Comprehensive claims scrubbing and AR management
Cons
- Steep implementation and customization timeline
- High enterprise-level pricing
- Occasional user interface complexity for smaller teams
Best For
Mid-to-large healthcare practices and hospitals needing integrated RCM with EHR for enterprise-scale revenue optimization.
Pricing
Custom enterprise pricing upon request; modular subscriptions typically range from $200-$500 per provider/month depending on scale and features.
NextGen Healthcare
enterpriseProvides RCM software with features for scheduling, claims submission, remittance posting, and revenue analytics.
AI-powered predictive denial management that proactively identifies and prevents claim rejections before submission
NextGen Healthcare's Revenue Cycle Management (RCM) solution is an integrated component of its flagship EHR and practice management platform, designed to optimize financial workflows for ambulatory and specialty practices. It automates key processes including patient eligibility verification, charge capture, claims scrubbing, submission, denial management, and collections to maximize reimbursements and cash flow. The software leverages analytics and reporting tools to identify revenue leakage and support compliance with evolving payer requirements.
Pros
- Seamless integration with NextGen EHR for unified workflows and accurate charge capture
- Advanced denial management and predictive analytics to reduce revenue leakage
- Robust reporting and dashboards for real-time financial insights and performance tracking
Cons
- Steep learning curve and complex implementation process requiring significant training
- Higher upfront costs and ongoing fees compared to standalone RCM tools
- Occasional glitches in claims processing and slower customer support response times
Best For
Mid-sized ambulatory practices and specialty groups seeking an integrated EHR-RCM platform for comprehensive revenue optimization.
Pricing
Quote-based pricing, typically $400-$700 per provider per month including RCM modules, plus one-time implementation fees of $50K+ depending on practice size.
eClinicalWorks
enterpriseIntegrates revenue cycle management with EHR for electronic billing, patient payments, and denial management.
AI-driven predictive analytics in Prism for proactive denial prevention and revenue forecasting
eClinicalWorks is a comprehensive electronic health record (EHR) and practice management platform with integrated Revenue Cycle Management (RCM) capabilities tailored for healthcare providers. It streamlines billing processes through automated claims submission, denial management, eligibility verification, and patient collections. The software provides robust financial analytics and reporting to optimize revenue workflows, making it suitable for practices handling complex billing scenarios.
Pros
- Seamless integration with EHR for end-to-end workflows
- Advanced denial management and claims scrubbing tools
- Scalable analytics for revenue performance insights
Cons
- Clunky user interface with a steep learning curve
- Reported issues with system reliability and downtime
- Customer support can be slow and inconsistent
Best For
Mid-sized to large multi-specialty practices needing integrated EHR and RCM for efficient billing and revenue optimization.
Pricing
Custom quote-based pricing, typically $400-$600 per provider per month plus implementation fees and add-ons.
Kareo
enterpriseOffers intelligent billing and revenue cycle management tailored for independent practices and small groups.
Kareo Intelligence analytics engine that uses AI-driven insights to predict and prevent revenue leakage.
Kareo is a cloud-based healthcare platform focused on revenue cycle management (RCM), electronic health records (EHR), and practice management for independent medical practices. It automates billing, claims processing, patient payments, and denial management to optimize revenue capture and reduce administrative burdens. The software provides real-time analytics and reporting to help practices monitor financial performance and improve cash flow efficiency.
Pros
- Intuitive interface with strong automation for claims scrubbing and submission
- Integrated patient payment portal that boosts collections
- Robust analytics dashboard for revenue insights and denial tracking
Cons
- Pricing can be high for very small practices
- Limited customization options for advanced reporting
- Occasional customer support delays reported by users
Best For
Small to mid-sized independent practices needing an all-in-one RCM solution with minimal setup.
Pricing
Subscription-based starting at around $300 per provider per month, plus potential fees for setup, clearinghouse, and revenue share on billing services (custom quotes required).
AdvancedMD
enterpriseDelivers cloud-based RCM with automated billing, ERA posting, and practice financial reporting for specialty practices.
Revenue Cycle Intelligence with AI-driven insights for predictive denial prevention and AR optimization
AdvancedMD is a cloud-based healthcare software platform specializing in revenue cycle management (RCM) for medical practices, handling everything from patient eligibility verification and claims submission to denial management and collections. It integrates tightly with its EHR and practice management modules to automate billing workflows and provide real-time financial insights. The solution emphasizes compliance with HIPAA and supports multi-location practices with scalable tools for revenue optimization.
Pros
- Robust automation for claims scrubbing and denial management reduces errors and accelerates reimbursements
- Integrated patient payment portal (SmartPay) improves collections efficiency
- Comprehensive analytics dashboard for tracking key RCM metrics like days in AR
Cons
- Pricing can be steep for smaller practices with custom quotes starting high
- Some users report occasional interface glitches and a moderate learning curve for advanced reporting
- Limited flexibility in customization compared to enterprise-level competitors
Best For
Mid-sized specialty practices seeking an integrated EHR-RCM solution with strong automation and compliance features.
Pricing
Custom subscription pricing, typically $400-$729 per provider/month depending on modules and practice size; additional fees for implementation and training.
Conclusion
After evaluating the top contenders, Waystar stands as the leading choice, offering an end-to-end platform that streamlines claims, denials, and patient payments with exceptional efficiency. Athenahealth and Epic Systems follow closely, each with distinct strengths—Athenahealth for its seamless EHR integration and Epic Systems for robust analytics—making them excellent alternatives for varied practice needs. These tools empower providers to optimize operations and enhance financial performance, ensuring healthcare revenue cycles run smoothly.
Start with Waystar to experience its transformative RCM capabilities; whether you choose Waystar, Athenahealth, or Epic, taking action to streamline your revenue cycle is key to success.
Tools Reviewed
All tools were independently evaluated for this comparison