Quick Overview
- 1#1: Epic Resolute - Comprehensive revenue cycle management suite for hospitals and health systems with integrated billing, claims, and analytics.
- 2#2: athenaOne - Cloud-based revenue cycle platform automating billing, patient payments, and denial management for practices.
- 3#3: Oracle Health Revenue Cycle - End-to-end revenue cycle solution with advanced analytics, claims processing, and financial clearinghouse services.
- 4#4: Waystar - AI-driven revenue cycle orchestration platform for claims submission, payments, and denial prevention.
- 5#5: Change Healthcare Revenue Cycle - Integrated RCM tools handling eligibility verification, claims adjudication, and remittance processing.
- 6#6: NextGen Revenue Cycle Management - Ambulatory-focused RCM with automated coding, billing, and patient collection capabilities.
- 7#7: Veradigm Revenue Cycle Management - Scalable platform for denial management, AR follow-up, and revenue integrity analytics.
- 8#8: Kareo - Revenue cycle and billing software optimized for small to mid-sized independent practices.
- 9#9: AdvancedMD - Cloud RCM solution with real-time claims scrubbing, ERA posting, and payment posting automation.
- 10#10: eClinicalWorks Revenue Cycle - Integrated billing and RCM features within EHR for practice financial management and reporting.
These tools were rigorously evaluated based on feature depth (including billing automation, denial management, and analytics), user experience, and value proposition, ensuring they meet the needs of hospitals, practices, and health systems of all sizes.
Comparison Table
Navigating the complex healthcare revenue cycle requires reliable software; this comparison table simplifies evaluation by examining top tools like Epic Resolute, athenaOne, Oracle Health Revenue Cycle, Waystar, and more, highlighting key differences in features and functionality. Readers will gain insights to identify platforms that align with their workflow needs, integration capabilities, and operational goals for optimized financial management.
| # | Tool | Category | Overall | Features | Ease of Use | Value |
|---|---|---|---|---|---|---|
| 1 | Epic Resolute Comprehensive revenue cycle management suite for hospitals and health systems with integrated billing, claims, and analytics. | enterprise | 9.7/10 | 9.8/10 | 7.2/10 | 8.9/10 |
| 2 | athenaOne Cloud-based revenue cycle platform automating billing, patient payments, and denial management for practices. | enterprise | 9.1/10 | 9.4/10 | 8.6/10 | 8.8/10 |
| 3 | Oracle Health Revenue Cycle End-to-end revenue cycle solution with advanced analytics, claims processing, and financial clearinghouse services. | enterprise | 8.7/10 | 9.2/10 | 7.4/10 | 8.1/10 |
| 4 | Waystar AI-driven revenue cycle orchestration platform for claims submission, payments, and denial prevention. | specialized | 9.2/10 | 9.5/10 | 8.4/10 | 8.9/10 |
| 5 | Change Healthcare Revenue Cycle Integrated RCM tools handling eligibility verification, claims adjudication, and remittance processing. | enterprise | 8.7/10 | 9.2/10 | 7.8/10 | 8.1/10 |
| 6 | NextGen Revenue Cycle Management Ambulatory-focused RCM with automated coding, billing, and patient collection capabilities. | enterprise | 8.2/10 | 8.7/10 | 7.8/10 | 8.0/10 |
| 7 | Veradigm Revenue Cycle Management Scalable platform for denial management, AR follow-up, and revenue integrity analytics. | enterprise | 8.2/10 | 8.6/10 | 7.7/10 | 8.0/10 |
| 8 | Kareo Revenue cycle and billing software optimized for small to mid-sized independent practices. | specialized | 8.1/10 | 8.5/10 | 7.9/10 | 7.7/10 |
| 9 | AdvancedMD Cloud RCM solution with real-time claims scrubbing, ERA posting, and payment posting automation. | specialized | 8.4/10 | 9.1/10 | 7.6/10 | 7.9/10 |
| 10 | eClinicalWorks Revenue Cycle Integrated billing and RCM features within EHR for practice financial management and reporting. | enterprise | 7.8/10 | 8.2/10 | 7.1/10 | 7.5/10 |
Comprehensive revenue cycle management suite for hospitals and health systems with integrated billing, claims, and analytics.
Cloud-based revenue cycle platform automating billing, patient payments, and denial management for practices.
End-to-end revenue cycle solution with advanced analytics, claims processing, and financial clearinghouse services.
AI-driven revenue cycle orchestration platform for claims submission, payments, and denial prevention.
Integrated RCM tools handling eligibility verification, claims adjudication, and remittance processing.
Ambulatory-focused RCM with automated coding, billing, and patient collection capabilities.
Scalable platform for denial management, AR follow-up, and revenue integrity analytics.
Revenue cycle and billing software optimized for small to mid-sized independent practices.
Cloud RCM solution with real-time claims scrubbing, ERA posting, and payment posting automation.
Integrated billing and RCM features within EHR for practice financial management and reporting.
Epic Resolute
enterpriseComprehensive revenue cycle management suite for hospitals and health systems with integrated billing, claims, and analytics.
Him (Health Information Management) module with AI-powered work queues that automate coding, charge capture, and denial management for unprecedented efficiency.
Epic Resolute is a comprehensive revenue cycle management (RCM) solution integrated within the Epic EHR ecosystem, handling everything from patient registration and scheduling to claims processing, billing, collections, and denial management. It leverages advanced automation, AI-driven analytics, and interoperability standards to optimize financial performance and reduce revenue leakage in healthcare organizations. Designed for scalability, Resolute supports high-volume environments with real-time data synchronization across clinical and financial workflows.
Pros
- Seamless integration with Epic's EHR and other modules for unified workflows
- Advanced AI and predictive analytics for denial prevention and cash flow optimization
- Robust compliance tools and scalability for enterprise-level healthcare systems
Cons
- Steep learning curve and extensive training required for users
- High implementation costs and long deployment timelines (often 2-3 years)
- Custom pricing lacks transparency and can be prohibitive for smaller organizations
Best For
Large hospitals, health systems, and academic medical centers seeking an all-in-one, highly integrated RCM solution.
Pricing
Custom enterprise licensing starting at millions annually, typically based on beds, users, or encounters; no public pricing tiers.
athenaOne
enterpriseCloud-based revenue cycle platform automating billing, patient payments, and denial management for practices.
Revenue Cycle Intelligence with AI-driven claim optimization and real-time denial prediction
athenaOne by athenahealth is a cloud-based, integrated platform combining EHR functionality with comprehensive revenue cycle management (RCM) tools tailored for healthcare providers. It automates key RCM processes including claims submission, denial management, patient eligibility verification, and payment posting to maximize reimbursements and cash flow. Leveraging AI-driven analytics and predictive intelligence, it helps practices identify revenue leakage, optimize coding accuracy, and streamline billing workflows across specialties.
Pros
- High first-pass claims acceptance rates (often 95%+), reducing denials and rework
- AI-powered predictive analytics for revenue forecasting and denial prevention
- Seamless integration with EHR for end-to-end workflow efficiency
Cons
- Steep implementation timeline and learning curve for new users
- Pricing can be premium, challenging for small practices
- Limited flexibility for highly customized reporting needs
Best For
Mid-sized to large multi-specialty practices or hospitals needing scalable, integrated RCM with strong automation and analytics.
Pricing
Subscription-based model, typically $300–$500 per provider per month, with custom quotes based on practice size, volume, and modules; includes implementation fees.
Oracle Health Revenue Cycle
enterpriseEnd-to-end revenue cycle solution with advanced analytics, claims processing, and financial clearinghouse services.
AI-driven predictive denial management that proactively identifies and resolves issues before submission
Oracle Health Revenue Cycle is an enterprise-grade solution that manages the full spectrum of healthcare revenue cycle processes, including patient registration, claims processing, denial management, and financial analytics. Leveraging Oracle's cloud infrastructure and AI capabilities, it integrates deeply with EHR systems to automate workflows, predict denials, and optimize reimbursements. Designed for large-scale providers, it emphasizes scalability, compliance, and data-driven insights to enhance financial performance.
Pros
- Seamless integration with Oracle Health EHR for unified data flow
- AI-powered predictive analytics for denial prevention and cash flow optimization
- Robust scalability and compliance tools for enterprise-level operations
Cons
- High implementation costs and lengthy deployment timelines
- Steep learning curve for non-technical users
- Custom pricing lacks transparency for smaller organizations
Best For
Large hospital systems and health networks needing integrated, scalable RCM with advanced AI analytics.
Pricing
Custom enterprise pricing; typically starts at $500K+ annually based on modules, users, and scale.
Waystar
specializedAI-driven revenue cycle orchestration platform for claims submission, payments, and denial prevention.
RevView analytics platform providing real-time, AI-driven insights into revenue cycle performance and predictive denial prevention
Waystar is a leading cloud-based revenue cycle management (RCM) platform for healthcare providers, offering end-to-end solutions for claims processing, denial management, patient payments, and financial analytics. It integrates seamlessly with major EHR systems to automate workflows, reduce denials, and accelerate reimbursements across hospitals, health systems, and physician practices. With AI-powered tools and real-time visibility, Waystar helps optimize revenue capture while enhancing patient financial experiences.
Pros
- Exceptional claims scrubbing and denial prevention with high acceptance rates
- Comprehensive analytics and reporting for revenue optimization
- Strong integrations with EHRs and robust scalability for enterprises
Cons
- Steep learning curve and complex initial implementation
- Pricing can be premium for smaller practices
- Occasional customization limitations in niche workflows
Best For
Mid-to-large hospitals and health systems needing enterprise-grade RCM with advanced AI analytics and high-volume claims processing.
Pricing
Custom quote-based pricing, typically subscription or per-claim models starting at $50K+ annually for mid-sized practices, scaling with volume.
Change Healthcare Revenue Cycle
enterpriseIntegrated RCM tools handling eligibility verification, claims adjudication, and remittance processing.
Industry-leading AI-driven denial intelligence that predicts and prevents claim denials before submission using machine learning on vast historical data.
Change Healthcare Revenue Cycle is a comprehensive enterprise platform that streamlines the entire revenue cycle management process for healthcare providers, from patient registration and eligibility verification to claims submission, denial management, and payment posting. It leverages AI, automation, and advanced analytics to optimize cash flow, reduce denials, and improve financial performance. With extensive payer connectivity and integration capabilities, it supports hospitals, health systems, and large practices in achieving operational efficiency.
Pros
- Extensive payer network and seamless integrations with EHRs like Epic and Cerner
- AI-powered denial prediction and automated workflows for faster reimbursements
- Robust analytics and reporting for actionable revenue insights
Cons
- Complex implementation requiring significant IT resources and time
- High costs that may not suit smaller practices
- Steep learning curve for end-users despite intuitive dashboards
Best For
Large hospitals and health systems needing scalable, high-volume revenue cycle automation with deep payer connectivity.
Pricing
Custom enterprise pricing based on modules, volume, and organization size; typically starts at $50,000+ annually with per-claim or subscription fees—contact sales for quotes.
NextGen Revenue Cycle Management
enterpriseAmbulatory-focused RCM with automated coding, billing, and patient collection capabilities.
AI-powered Revenue Cycle Optimizer for proactive denial prevention and cash flow forecasting
NextGen Revenue Cycle Management is a robust, cloud-based solution designed to optimize the entire revenue cycle for healthcare providers, including patient registration, claims processing, denial management, and payment posting. It integrates tightly with NextGen's Electronic Health Record (EHR) system, enabling seamless data flow and reducing errors across clinical and financial workflows. The platform leverages analytics and automation to accelerate reimbursements and improve financial performance for ambulatory practices and health systems.
Pros
- Deep integration with NextGen EHR for unified workflows
- Advanced denial management and predictive analytics
- Scalable for multi-specialty practices and health systems
Cons
- Steep learning curve for new users
- Pricing can be opaque and high for smaller practices
- Customization requires vendor support
Best For
Mid-sized to large ambulatory practices and health systems seeking an integrated EHR-RCM solution with strong analytics.
Pricing
Custom quote-based pricing, typically $300-$600 per provider/month depending on modules and practice size; requires demo for exact costs.
Veradigm Revenue Cycle Management
enterpriseScalable platform for denial management, AR follow-up, and revenue integrity analytics.
AI-driven Revenue Cycle Intelligence that proactively predicts and mitigates billing errors and denials
Veradigm Revenue Cycle Management is a comprehensive platform that automates the entire revenue cycle for healthcare providers, including patient registration, claims submission, denial management, and accounts receivable optimization. It integrates deeply with Veradigm's EHR and practice management systems, leveraging AI-driven analytics to identify revenue leaks and improve financial performance. Designed for scalability, it supports hospitals, ambulatory practices, and health systems with robust reporting and compliance tools.
Pros
- Seamless integration with Veradigm EHR for unified workflows
- AI-powered predictive analytics for denial prevention and revenue optimization
- Comprehensive denial management and AR acceleration tools
Cons
- Steep implementation and learning curve for complex setups
- Custom pricing can be expensive for smaller practices
- Limited flexibility with non-Veradigm systems
Best For
Mid-to-large healthcare organizations using Veradigm's ecosystem that need an integrated, enterprise-grade RCM solution.
Pricing
Custom enterprise pricing based on practice size and volume, typically starting at $5,000+ per month with revenue-share options.
Kareo
specializedRevenue cycle and billing software optimized for small to mid-sized independent practices.
Revenue Cycle Intelligence dashboard with predictive analytics for denial prevention and revenue forecasting
Kareo is a cloud-based revenue cycle management (RCM) platform designed for independent medical practices, offering integrated billing, claims management, denial resolution, and patient payment solutions. It automates key RCM processes like scrubbing claims, tracking payments, and providing analytics to optimize revenue capture. Paired with its EHR and practice management tools, Kareo helps streamline financial workflows for healthcare providers focused on independent operations.
Pros
- Robust denial management and automated claims scrubbing reduce errors and accelerate reimbursements
- Integrated patient payment portal boosts collections with flexible online options
- Comprehensive analytics dashboard provides actionable insights into revenue performance
Cons
- Customer support can be inconsistent, with slower response times during peak issues
- Pricing model with per-claim fees adds up for high-volume practices
- Limited advanced customization compared to enterprise-level competitors
Best For
Small to mid-sized independent medical practices seeking an all-in-one RCM solution with strong automation.
Pricing
Custom quote-based pricing starting at $140/user/month for software; billing services on revenue share (4.5%-7% of collections).
AdvancedMD
specializedCloud RCM solution with real-time claims scrubbing, ERA posting, and payment posting automation.
AI-powered denial management that predicts and prevents claim denials before submission
AdvancedMD is a cloud-based healthcare platform offering comprehensive revenue cycle management (RCM) solutions tailored for medical practices, including automated billing, claims processing, eligibility verification, and denial management. It integrates seamlessly with EHR and practice management tools to streamline financial workflows, accelerate reimbursements, and improve cash flow. With features like AR management, patient payment portals, and analytics dashboards, it supports practices in optimizing revenue performance from end-to-end.
Pros
- Comprehensive RCM automation including claims scrubbing and denial prevention
- Seamless integration with EHR for unified workflows
- Real-time analytics and reporting for financial insights
Cons
- Steep learning curve and lengthy implementation
- Custom pricing can be expensive for smaller practices
- Occasional customer support delays
Best For
Mid-sized ambulatory and specialty practices needing integrated RCM with strong claims management capabilities.
Pricing
Custom subscription pricing starting at around $729 per provider/month for full RCM suite; volume discounts available, contact for demo and quote.
eClinicalWorks Revenue Cycle
enterpriseIntegrated billing and RCM features within EHR for practice financial management and reporting.
AI-powered denial prediction and root cause analysis for proactive revenue recovery
eClinicalWorks Revenue Cycle Management (RCM) is an integrated module within the eClinicalWorks EHR platform, designed to handle the full spectrum of financial workflows for healthcare providers. It automates claims submission, eligibility verification, denial management, and patient billing to optimize revenue capture. The solution emphasizes seamless integration with clinical documentation, reducing errors and accelerating reimbursements for practices of varying sizes.
Pros
- Strong integration with eClinicalWorks EHR for real-time data flow
- Robust denial management and analytics tools
- Automated claims scrubbing and eligibility checks
Cons
- Steep learning curve for non-tech-savvy users
- Customer support response times can vary
- Customization options limited without add-ons
Best For
Small to mid-sized primary care and specialty practices seeking an integrated EHR-RCM solution.
Pricing
Custom subscription pricing, typically $400-$700 per provider per month including RCM features, plus one-time implementation fees.
Conclusion
The top three healthcare revenue cycle software tools showcase exceptional performance, with Epic Resolute leading as the most comprehensive choice for hospitals and health systems. athenaOne excels with its cloud-based automation for practices, while Oracle Health Revenue Cycle stands out for its end-to-end advanced analytics, offering strong alternatives for varied needs. Together, these leaders demonstrate the breadth of effective revenue cycle management solutions available.
Don’t miss out on optimizing your financial processes—begin with the top-ranked Epic Resolute to elevate efficiency and results.
Tools Reviewed
All tools were independently evaluated for this comparison