Top 10 Revenue Cycle Management (RCM) Companies In The USA

Healthcare providers face challenges due to the increasing complexity of billing processes, dynamic regulatory changes, and a notable shift toward value-based care. Tackling these challenges in-house has slowed down their processes, which is why there has been a growing demand for Revenue Cycle Management (RCM) companies.

In the USA, over 354 RCM companies are operating to deliver various RCM solutions to healthcare practices.  However, choosing the right partner amidst this surge is no easy task. The selection process requires meticulous consideration of factors such as industry expertise, technological capabilities, service offerings, locations, etc.

Recognizing the complexities involved, Invensis has compiled a comprehensive list of the top 10 RCM companies in USA. This curated compilation serves as a valuable resource for healthcare decision-makers, offering insights into the strengths and specialties of each provider. Before delving into the top RCM companies, let’s discuss what Invensis is capable of as a trusted healthcare RCM partner.

Invensis

Specifics	Details
Key Services	Medical Coding, Coding Audits, Risk Adjustment HCC Coding, Medical Billing, Medical Accounts Receivable, Medical Billing Charge Entry, Demographic Detail Entry, Medical Records Indexing, Explanation of Benefits (EOBs), Insurance Claims, Payment Posting, Indexing of EOBs to Patient Accounts, Medical Claim Data Entry, Medical Claims Processing, Medical Claim Data Validation, Denial Management, Denial Tracking and Analysis, Data Analytics and Reporting.
Countries Served	USA and Canada
Notable Clients	Medium-sized healthcare clinics, dental clinics, diagnostic imaging centers, individual practitioners, large hospitals, specialty hospitals, ambulatory surgery centers, physical therapy centers, behavioral health facilities, rehabilitation centers, chiropractic offices, radiology centers, home healthcare agencies, and more.
Contact Details	Invensis Inc. 2785 Rockbrook Dr STE 204 Lewisville, TX 75067 Telephone: +1 (302)-261-9036

Invensis is a leading healthcare revenue cycle management company with over 22 years of experience. Backed by over 5000 professionals, Invensis specializes in delivering end-to-end RCM solutions. We leverage cutting-edge technology, industry compliance knowledge, and a customer-centric approach to optimize billing processes, enhance cash flow, and mitigate financial risks for healthcare providers.

Over the years, Invensis has assisted hospitals, clinics, and physician practices in optimizing their services for enhanced revenue control. Our comprehensive RCM solutions cover various services, including medical coding, billing, records indexing, claims processing, payment posting, denial management, and accounts receivables. Our extensive experience and service delivery expertise have made us a reliable choice for healthcare providers based in the US.

10 Best RCM Companies in the USA

The following is a list of the top 10 revenue cycle management companies in the USA.‍

1. PwC Revenue Cycle Managed Services

Specifics	Details
Key Services	Accounts receivable collection services, Billing and follow-up, Revenue cycle outsourcing and special projects, Cash posting, Denial management, Clinical/physician advisory services, Customer service, Revenue cycle automation, Analytics support, and Patient access support.
Countries Served	The USA and many global locations.
Notable Clients	Individual practitioners, small medical practices, medium-sized healthcare clinics, outpatient facilities, and more.
Contact Details	300 Madison Avenue, New York; New York 10017. Telephone: +1 (646) 471 4000.

Established in 2002, PWC Revenue Cycle Managed Services excels in offering operational support functions, including revenue cycle, call center, and testing, to healthcare entities like hospitals, medical groups, and payers. Operating in surge, partial, or full-function outsource capacities, the services leverage thousands of onshore and optional offshore resources. The company specializes in flexible revenue cycle management solutions, employing automation through machine learning and artificial intelligence to streamline repetitive tasks.

2. Oracle Cerner

Specifics	Details
Key Services	Claims processing, Payment posting, Online bill payment, Self-pay, Accurate payer reimbursement, Denial mitigation, Root-cause analysis, Translation to accurate charge transactions, Analysis of technical and clinical denials, etc.
Countries Served	USA and UK.
Notable Clients	Large hospitals, small medical practices, specialty hospitals, etc
Contact Details	2800 Rockcreek Parkway, North Kansas City, Missouri. Telephone: +1.866.221.8877

Following the acquisition of Cerner on June 8, 2022, Oracle is a global leader connecting people and systems across 250+ facilities worldwide. With a dedicated team of 27,000+ employees, including over 300 experts in the Middle East and Africa, the company specializes in addressing the clinical, financial, and other operational needs of healthcare organizations of all sizes. The diverse workforce, comprising healthcare professionals, engineers, pharmacists, and technicians, is committed to making a meaningful impact on the industry.

3. Change Healthcare

Specifics	Details
Key Services	Patient Eligibility & Enrollment Services, Coverage Insight, Clearance Authorization, Physician and Hospital Coding Services, Insight Coding Services, Coding Quality and Audit Services, Charge Capture Compliance Audit Services, etc.
Countries Served	6 locations in the US.
Notable Clients	Mental health practitioners, psychiatric clinics, counseling centers, addiction treatment facilities, and more.
Contact Details	Nashville, 424 Church St # 1400, United States Telephone: 1 (866) 371-9066

Change Healthcare, formerly Emdeon is a leading player in revenue and payment cycle management for the U.S. healthcare sector. Since its 2015 rebranding following the acquisition of Change Healthcare, the company has been pivotal in connecting payers, providers, and patients. Established in 2007 and now part of a conglomerate, Change Healthcare operates the largest financial and administrative information exchange in the United States. Specializing in mental health and various healthcare sectors, the company offers innovative software solutions for revenue cycle, cost transparency, payment management, health information exchange, and patient engagement.

4. Experian Health

Specifics	Details
Key Services	Patient Access Solutions, Healthcare Collections, Healthcare Claims Management, and Payer Contract Management.
Countries Served	Many locations in the USA
Notable Clients	Chiropractic clinics, physical therapy practices, rehabilitation centers, occupational therapy clinics, wellness facilities, etc.
Contact Details	720 Cool Springs Blvd., Suite 200, Franklin, TN 37067 Telephone: 1 615 661 5657

Experian Health, established in 1994 and headquartered in Franklin, TN, boasts a workforce of 501-1,000 employees. Specializing in revenue cycle management, identity management, care management, patient engagement, and data analytics, the company serves numerous medical practices, labs, pharmacies, and risk-bearing entities. By leveraging their comprehensive solutions, clients enhance business decisions, improve financial performance, and foster robust patient relationships amid the evolving landscape of value-based reimbursement. 

5. Trizetto Provider

Specifics	Details
Key Services	Patient Engagement, Claims Management, Denials & Contract Management, Billing Services, Coding Services, Revenue Recovery Services.
Countries Served	All over the USA.
Notable Clients	Diagnostic imaging centers, medical laboratories, pathology labs, testing facilities, etc.
Contact Details	3300 Rider Trail South, Earth City, MO, 63045 US Telephone: +1 800-969-3666

Established in 1984 as Gateway EDI and acquired by Cognizant in 2014, TriZetto Provider Solutions is a leading healthcare clearinghouse. Trusted by over 340,000 providers, the company offers advanced medical claims processing solutions and a proactive service team for streamlined revenue cycle management. Their electronic medical claims processing, real-time patient eligibility verification, and other tools assist healthcare practices in securing accurate reimbursements, minimizing claims rejections, and enhancing patient payment turnaround time, positioning them for effective management amid industry changes.

6. Eclinicalworks

Specifics	Details
Key Services	Real-time patient insurance eligibility, Visibility dashboards to monitor practice performance, Claim processing, review, scrubbing, and follow-up, Insurance & patient payments, Denials & appeals management, etc.
Countries Served	US and Canada.
Notable Clients	Urgent care centers, retail health clinics, walk-in clinics, occupational health services, general outpatient care, etc.
Contact Details	2 Technology Dr Westborough, MA 01581 USA Telephone: 508-836-2700

eClinicalWorks, with over 20 years in healthcare technology, is dedicated to improving the industry. With a team of 6,000+ employees united in a common goal, they provide cutting-edge solutions as trusted partners. Their relentless pursuit of innovation has established eClinicalWorks as a leader in healthcare IT. Specializing in Revenue Cycle Management, they offer clients the choice of self-service or end-to-end solutions, ensuring industry-leading quality and exceptional customer support.

7. CareCloud

Specifics	Details
Key Services	Claim Submission, Payment Posting, Payer Followup, Patient Billing, Enter Charges, and Claim Errors.
Countries Served	Several parts of the US.
Notable Clients	Corporate healthcare providers, group medical practices, family medicine clinics, primary care facilities, outpatient services, etc.
Contact Details	7 Clyde Road, Somerset, NJ 08873 Telephone: 866-266-6822

CareCloud, Inc. (formerly MTBC) is a leading American healthcare information technology company, publicly traded, with headquarters in Somerset, New Jersey. Employing 4,000 professionals globally, the company specializes in providing healthcare providers and hospitals with CareCloud Concierge, a comprehensive revenue cycle management solution. With a consultative approach and a dedicated back-office team, CareCloud empowers medical groups to enhance profitability and alleviate administrative challenges, allowing them to prioritize patient care.

8. athenahealth

Specifics	Details
Key Services	Enhanced Claim Resolution, Medical Coding, Authorization Management.
Countries Served	Many locations in the US.
Notable Clients	Occupational health providers, workplace clinics, employee wellness programs, industrial healthcare services, workforce health centers, and more.
Contact Details	Boston Landing, 80 Guest Street, Boston, MA 02135. Telephone: 1 (800) 981-5084

Established in 2019, the rebranded athenahealth combines the seasoned experience of athenahealth, Inc. and Virence Health in healthcare technology. With a nationwide presence, their integrated technology, insights, and broad customer base uniquely position them to comprehend and unlock healthcare data nationwide. Focused on improving the healthcare experience, they expand services in revenue cycle management, clinical records, and patient engagement. The company collaborates with partners, care settings, and providers to eliminate obstacles, fostering a smarter healthcare landscape.

9. NextGen

Specifics	Details
Key Services	A/R recovery, Eligibility services, Analytics with consultative services, Payment posting, Credentialing, Coding services, Call center services, Patient statement services, and more
Countries Served	Many locations in the US.
Notable Clients	Telemedicine services, virtual healthcare providers, remote medical consultations, online health platforms, etc.
Contact Details	3525 Piedmont Rd, NE Building 6, Suite 700 Telephone: 1-800-841-6282

Since 1974, NextGen Healthcare has been a pioneering force in health IT solutions, committed to empowering ambulatory practices globally. With 2,800 employees across the globe, the company focuses on driving growth and achieving results for clients, fostering integrated and collaborative care. Their dedication to promoting healthier populations and addressing current challenges underscores their mission to help practices of all sizes deliver the future of healthcare. The company stands poised for continued success, with a track record reflecting innovation and a commitment to advancing ambulatory care.

10. R1 RCM

Specifics	Details
Key Services	Scheduling, Pre-Reg / Financial Clearance, Financial Counseling, Check-In / Arrival, Charge Compliance, Coding and Acuity Capture, Billing and Follow-Up, Denials Management, Underpayments, Customer Service, Patient Pay / Pre-Collect, etc.
Countries Served	Many Locations in the USA.
Notable Clients	Nonprofit healthcare providers, charitable medical organizations, Telemedicine services, virtual healthcare providers, etc.
Contact Details	433 W. Ascension Way, Suite 200 Murray, Utah 84123 Telephone: 1-312-324-7820

R1 RCM Holdco Inc (R1) is a leading technology-enabled revenue cycle management services provider for hospitals and health systems. Headquartered in Murray, Utah, the company serves over 1,000 clients nationwide and has rapidly grown to become one of the fastest-growing healthcare companies. Their modular solution encompasses practice management, revenue integrity services, business office support, patient experience enhancement, automation solutions, and physician advisory services.

To learn more about Invensis and our expertise in handling revenue cycle management services, reach out to us.