Quick Overview
- 1#1: Epic Systems - Provides comprehensive revenue cycle management and billing integrated with EHR for large hospitals, handling claims, denials, and payments efficiently.
- 2#2: Oracle Cerner - Delivers advanced hospital billing and revenue cycle solutions with AI-driven claims processing and interoperability for enterprise healthcare systems.
- 3#3: MEDITECH - Offers integrated EHR and billing software optimized for mid-sized hospitals, focusing on accurate coding, charge capture, and regulatory compliance.
- 4#4: athenahealth - Cloud-based platform for hospital revenue cycle management, automating billing, insurance verification, and patient collections.
- 5#5: NextGen Healthcare - Enterprise RCM software with robust hospital billing features including predictive analytics for denials and streamlined reimbursements.
- 6#6: Veradigm - Provides scalable billing and practice management solutions for hospitals, emphasizing claims scrubbing and EDI integrations.
- 7#7: McKesson - Hospital billing software with strong focus on charge capture, financial reporting, and integration across clinical and financial workflows.
- 8#8: Waystar - Specialized revenue cycle platform for hospitals excelling in claims management, patient payments, and denial prevention.
- 9#9: eClinicalWorks - Integrated EHR and billing system for hospitals with tools for eligibility checks, superbills, and AR management.
- 10#10: TruBridge - RCM and billing solutions tailored for community hospitals, offering cost-effective claims processing and financial analytics.
Tools were selected and ranked based on feature robustness (e.g., claims processing, denial management), usability, reliability, and value, ensuring alignment with the unique requirements of hospitals, from large enterprises to community facilities.
Comparison Table
Hospital billing software is vital for efficient financial management, and selecting the right tool depends on specific operational needs. This comparison table examines leading solutions like Epic Systems, Oracle Cerner, MEDITECH, athenahealth, and NextGen Healthcare, outlining key features, strengths, and suitability for different healthcare settings. Readers will gain insights to identify the software that best matches their facility’s requirements and goals.
| # | Tool | Category | Overall | Features | Ease of Use | Value |
|---|---|---|---|---|---|---|
| 1 | Epic Systems Provides comprehensive revenue cycle management and billing integrated with EHR for large hospitals, handling claims, denials, and payments efficiently. | enterprise | 9.4/10 | 9.8/10 | 7.2/10 | 8.9/10 |
| 2 | Oracle Cerner Delivers advanced hospital billing and revenue cycle solutions with AI-driven claims processing and interoperability for enterprise healthcare systems. | enterprise | 8.7/10 | 9.2/10 | 7.4/10 | 8.1/10 |
| 3 | MEDITECH Offers integrated EHR and billing software optimized for mid-sized hospitals, focusing on accurate coding, charge capture, and regulatory compliance. | enterprise | 8.2/10 | 8.5/10 | 7.4/10 | 8.0/10 |
| 4 | athenahealth Cloud-based platform for hospital revenue cycle management, automating billing, insurance verification, and patient collections. | enterprise | 8.6/10 | 9.1/10 | 7.9/10 | 8.2/10 |
| 5 | NextGen Healthcare Enterprise RCM software with robust hospital billing features including predictive analytics for denials and streamlined reimbursements. | enterprise | 8.2/10 | 9.0/10 | 7.4/10 | 8.0/10 |
| 6 | Veradigm Provides scalable billing and practice management solutions for hospitals, emphasizing claims scrubbing and EDI integrations. | enterprise | 7.6/10 | 8.4/10 | 6.7/10 | 7.2/10 |
| 7 | McKesson Hospital billing software with strong focus on charge capture, financial reporting, and integration across clinical and financial workflows. | enterprise | 8.1/10 | 8.7/10 | 7.2/10 | 7.6/10 |
| 8 | Waystar Specialized revenue cycle platform for hospitals excelling in claims management, patient payments, and denial prevention. | enterprise | 8.2/10 | 9.0/10 | 7.4/10 | 7.9/10 |
| 9 | eClinicalWorks Integrated EHR and billing system for hospitals with tools for eligibility checks, superbills, and AR management. | enterprise | 7.6/10 | 8.0/10 | 6.7/10 | 7.2/10 |
| 10 | TruBridge RCM and billing solutions tailored for community hospitals, offering cost-effective claims processing and financial analytics. | enterprise | 7.8/10 | 8.2/10 | 7.5/10 | 7.6/10 |
Provides comprehensive revenue cycle management and billing integrated with EHR for large hospitals, handling claims, denials, and payments efficiently.
Delivers advanced hospital billing and revenue cycle solutions with AI-driven claims processing and interoperability for enterprise healthcare systems.
Offers integrated EHR and billing software optimized for mid-sized hospitals, focusing on accurate coding, charge capture, and regulatory compliance.
Cloud-based platform for hospital revenue cycle management, automating billing, insurance verification, and patient collections.
Enterprise RCM software with robust hospital billing features including predictive analytics for denials and streamlined reimbursements.
Provides scalable billing and practice management solutions for hospitals, emphasizing claims scrubbing and EDI integrations.
Hospital billing software with strong focus on charge capture, financial reporting, and integration across clinical and financial workflows.
Specialized revenue cycle platform for hospitals excelling in claims management, patient payments, and denial prevention.
Integrated EHR and billing system for hospitals with tools for eligibility checks, superbills, and AR management.
RCM and billing solutions tailored for community hospitals, offering cost-effective claims processing and financial analytics.
Epic Systems
enterpriseProvides comprehensive revenue cycle management and billing integrated with EHR for large hospitals, handling claims, denials, and payments efficiently.
Single-database architecture enabling real-time integration of clinical data with automated billing workflows for unmatched accuracy and efficiency
Epic Systems offers a comprehensive electronic health record (EHR) platform with an integrated Revenue Cycle Management (RCM) module specifically designed for hospital billing. It automates the entire billing lifecycle, from charge capture and claims submission to denial management, patient collections, and financial analytics. Tailored for large-scale healthcare organizations, Epic ensures seamless interoperability between clinical documentation and financial workflows, reducing errors and accelerating reimbursements.
Pros
- Fully integrated RCM with EHR for accurate charge capture and reduced denials
- Advanced analytics and AI-driven tools for revenue optimization
- Proven scalability and reliability in top U.S. hospitals handling high volumes
Cons
- Extremely high implementation costs and lengthy deployment (often 2-3 years)
- Steep learning curve requiring extensive staff training
- Less suitable for small or mid-sized facilities due to complexity and expense
Best For
Large hospitals and multi-facility health systems needing enterprise-grade, fully integrated billing and clinical solutions.
Pricing
Custom enterprise pricing with multimillion-dollar implementation fees plus annual subscriptions based on beds/users (typically $500K-$10M+ upfront).
Oracle Cerner
enterpriseDelivers advanced hospital billing and revenue cycle solutions with AI-driven claims processing and interoperability for enterprise healthcare systems.
AI-powered revenue intelligence for predictive denial management and optimized reimbursements
Oracle Cerner, part of Oracle Health, offers a comprehensive Revenue Cycle Management (RCM) solution integrated within its Millennium EHR platform, designed specifically for hospital billing. It streamlines processes from patient registration and charge capture to coding, claims submission, denial management, and collections, ensuring regulatory compliance and revenue optimization. The system leverages clinical data for accurate billing, reducing errors and accelerating reimbursements in complex hospital environments.
Pros
- Deep integration with EHR for seamless clinical-to-billing workflow
- Advanced automation for claims processing and denial prevention
- Scalable for large hospitals with robust analytics and reporting
Cons
- Steep learning curve and complex interface for new users
- High upfront implementation and customization costs
- Lengthy deployment timelines often exceeding 12-18 months
Best For
Large hospitals and multi-facility health systems needing an enterprise-grade, integrated EHR and billing solution.
Pricing
Custom enterprise pricing; typically $1M+ for implementation plus ongoing subscription fees scaling with bed size and modules (e.g., $500K-$5M annually).
MEDITECH
enterpriseOffers integrated EHR and billing software optimized for mid-sized hospitals, focusing on accurate coding, charge capture, and regulatory compliance.
Real-time integration of clinical documentation with billing for automated, accurate charge capture
MEDITECH's Expanse platform offers comprehensive hospital billing software as part of its integrated EHR and revenue cycle management (RCM) suite. It streamlines billing workflows including charge capture, claims management, denial resolution, patient statements, and financial reporting. Designed for acute care hospitals, it leverages real-time clinical data to ensure accurate billing and compliance with healthcare regulations like HIPAA and ICD-10.
Pros
- Deep integration with EHR for automated charge capture and reduced errors
- Robust tools for claims scrubbing, denial management, and regulatory compliance
- Scalable for mid-to-large hospitals with strong analytics and reporting
Cons
- Steep learning curve and less intuitive interface compared to competitors
- Lengthy and costly implementation process
- Limited flexibility for custom workflows without vendor support
Best For
Mid-to-large hospitals needing a fully integrated EHR and billing solution with strong clinical-financial alignment.
Pricing
Custom enterprise pricing; typically includes upfront implementation fees ($500K+) and annual subscriptions based on hospital size and modules ($1M+ yearly).
athenahealth
enterpriseCloud-based platform for hospital revenue cycle management, automating billing, insurance verification, and patient collections.
AI-powered denial prevention and intelligent claims scrubbing that proactively identifies and resolves issues before submission
athenahealth offers athenaOne Revenue Cycle Management, a cloud-based solution tailored for hospital billing that integrates seamlessly with its EHR platform to streamline claims processing, patient eligibility verification, and payment posting. It automates denial management, provides real-time revenue cycle analytics, and supports compliance with complex hospital reimbursement rules. Designed for scalability, it helps hospitals reduce AR days and maximize reimbursements through AI-driven insights and payer connectivity.
Pros
- Comprehensive revenue cycle automation with high first-pass claim acceptance rates
- Deep integration with EHR for seamless data flow and reduced errors
- Advanced analytics and AI for denial prediction and financial forecasting
Cons
- High implementation costs and lengthy onboarding process
- Steep learning curve for non-technical hospital staff
- Custom pricing lacks transparency and can be premium for smaller hospitals
Best For
Mid-to-large hospitals with complex billing needs that require integrated EHR and revenue cycle management for optimized reimbursements.
Pricing
Custom enterprise pricing, typically starting at $400+ per provider/month plus setup fees, scaled for hospital volumes.
NextGen Healthcare
enterpriseEnterprise RCM software with robust hospital billing features including predictive analytics for denials and streamlined reimbursements.
AI-driven predictive denial management that identifies risks pre-submission to minimize revenue leakage
NextGen Healthcare provides an integrated electronic health records (EHR) and revenue cycle management (RCM) platform, with robust hospital billing features that automate claims submission, eligibility verification, and payment posting. It supports inpatient and outpatient billing workflows, including denial management, AR follow-up, and payer contract analytics to optimize reimbursements. Designed for scalability, it handles high-volume hospital environments while integrating clinical and financial data for better decision-making.
Pros
- Comprehensive claims scrubbing and denial prevention tools reduce errors and accelerate reimbursements
- Seamless EHR integration streamlines workflows from clinical documentation to billing
- Advanced analytics and reporting provide deep insights into revenue cycle performance
Cons
- Steep learning curve requires extensive training for optimal use
- Custom pricing can be expensive for smaller hospitals
- Customer support response times can vary, leading to occasional frustrations
Best For
Mid-to-large hospitals and health systems needing a scalable, integrated EHR and billing solution for complex revenue cycles.
Pricing
Enterprise quote-based pricing, typically $400-$900 per provider/month depending on modules, volume, and customizations.
Veradigm
enterpriseProvides scalable billing and practice management solutions for hospitals, emphasizing claims scrubbing and EDI integrations.
AI-powered predictive denial management that proactively identifies and prevents claim rejections
Veradigm offers a comprehensive revenue cycle management (RCM) platform designed specifically for hospitals, handling everything from patient registration and claims submission to denial management and payment reconciliation. It integrates deeply with Veradigm's EHR systems, enabling seamless data flow to reduce errors and accelerate reimbursements. The solution leverages AI-driven analytics to predict denials, optimize coding, and improve financial outcomes for large-scale healthcare providers.
Pros
- Robust integration with EHR for streamlined workflows
- Advanced AI analytics for denial prediction and revenue optimization
- Scalable for enterprise-level hospital billing needs
Cons
- Complex interface with a steep learning curve
- High implementation costs and lengthy setup times
- Reported occasional system outages and support delays
Best For
Large hospitals and health systems needing integrated RCM with existing EHR infrastructure.
Pricing
Custom enterprise pricing upon request; subscription-based, often $100K+ annually depending on hospital size and modules.
McKesson
enterpriseHospital billing software with strong focus on charge capture, financial reporting, and integration across clinical and financial workflows.
End-to-end revenue cycle analytics powered by AI-driven predictive denial prevention
McKesson offers robust revenue cycle management (RCM) solutions tailored for hospitals, including advanced billing, claims processing, and patient financial services through platforms like McKesson Revenue Cycle Performance Partners. These tools integrate seamlessly with electronic health records (EHRs) and handle complex inpatient and outpatient billing requirements. Designed for large-scale healthcare providers, it emphasizes compliance, denial prevention, and financial optimization to improve cash flow.
Pros
- Comprehensive integration with EHR and supply chain systems
- Strong denial management and compliance tools
- Scalable for enterprise-level hospitals
Cons
- Steep learning curve and complex implementation
- High upfront costs and customization needs
- Limited flexibility for smaller facilities
Best For
Large hospitals and health systems with high-volume, complex billing needs requiring deep integration.
Pricing
Enterprise-level pricing via custom quotes; typically starts at $500K+ annually depending on modules and scale.
Waystar
enterpriseSpecialized revenue cycle platform for hospitals excelling in claims management, patient payments, and denial prevention.
Clarity AI analytics platform for predictive denial prevention and revenue cycle benchmarking
Waystar is a cloud-based revenue cycle management (RCM) platform tailored for hospitals and health systems, focusing on end-to-end billing processes from patient access to payment collection. It automates claims submission, denial management, patient payments, and provides advanced analytics to optimize revenue. The solution integrates with major EHR systems to streamline workflows and reduce administrative burdens in hospital billing environments.
Pros
- Comprehensive automation for claims and denials reduces errors and A/R days
- Powerful AI-driven analytics like Clarity for revenue forecasting and optimization
- Strong integrations with EHRs such as Epic and Cerner
Cons
- Steep implementation timeline and training requirements for large-scale deployments
- Pricing can be prohibitive for mid-sized or smaller hospitals
- User interface feels dated in some modules despite robust functionality
Best For
Large hospitals and health systems needing scalable, enterprise-grade RCM with advanced analytics.
Pricing
Custom enterprise pricing, typically subscription-based with modules priced per claim volume or as a percentage of collections (contact sales for quotes).
eClinicalWorks
enterpriseIntegrated EHR and billing system for hospitals with tools for eligibility checks, superbills, and AR management.
AI-driven predictive analytics for denial prevention and revenue leak detection
eClinicalWorks is a comprehensive EHR and revenue cycle management platform that includes hospital billing features like automated claims submission, denial management, eligibility verification, and payment posting. It integrates billing directly with clinical workflows to reduce errors and accelerate reimbursements. Designed for scalability across ambulatory practices and smaller hospitals, it supports both cloud and on-premise deployments with robust reporting tools.
Pros
- Integrated EHR-billing workflow for accurate charge capture
- Advanced denial management with automated appeals
- Comprehensive analytics for revenue cycle optimization
Cons
- Steep learning curve and outdated interface
- Inconsistent customer support and implementation delays
- High customization costs for hospital-scale needs
Best For
Mid-sized hospitals and specialty practices needing integrated EHR and billing without enterprise-level complexity.
Pricing
Custom quotes based on users and modules; typically $400-$700 per provider/month plus setup fees.
TruBridge
enterpriseRCM and billing solutions tailored for community hospitals, offering cost-effective claims processing and financial analytics.
AI-powered denial management and predictive analytics that proactively identifies and prevents claim denials
TruBridge provides comprehensive revenue cycle management (RCM) solutions designed specifically for hospitals and health systems, focusing on hospital billing, claims processing, and financial optimization. Their software automates patient registration, coding, charge capture, claims submission, and denial management to reduce revenue leakage and accelerate reimbursements. Integrated with major EHR systems, it offers analytics and reporting tools to enhance operational efficiency and compliance.
Pros
- Comprehensive end-to-end RCM capabilities tailored for hospitals
- Strong integration with EHRs like Epic and Cerner
- Advanced denial prevention and analytics for revenue recovery
Cons
- Pricing can be steep for smaller hospitals
- User interface feels dated compared to newer competitors
- Lengthy implementation and onboarding process
Best For
Mid-sized hospitals and health systems seeking robust, integrated billing and RCM solutions to improve financial performance.
Pricing
Custom quote-based pricing; typically subscription model starting at $50K+ annually depending on hospital size, modules, and services.
Conclusion
The reviewed hospital billing software options highlight diverse strengths, with Epic Systems leading as the top choice for comprehensive, EHR-integrated revenue cycle management. Oracle Cerner follows with advanced AI-driven solutions for enterprise systems, while MEDITECH excels for mid-sized hospitals with focus on accuracy and compliance. These top three, along with the others, demonstrate the industry's focus on streamlining processes, from claims handling to patient collections.
To enhance your hospital's financial health, consider starting with Epic Systems—its integrated tools offer efficiency and scalability that set it apart. Explore the top-ranked option to unlock streamlined billing and improved revenue cycle management.
Tools Reviewed
All tools were independently evaluated for this comparison