Market · 60 vendors
Back Office
Submitting the claim and everything after it: coding, clearinghouses, denials and appeals, revenue cycle operations, patient billing, payment integrity, and the financial layer on top.
Autonomous Medical Coding
AI that reads clinical documentation and assigns billing codes with little or no human review, cutting coding cost and days in A/R.
CodaMetrix
Autonomous coding spun out of Mass General Brigham
Nym
Explainable autonomous coding for ED and outpatient
Fathom
High-volume autonomous coding across specialties
AKASA
Generative AI for coding and revenue cycle operations
Arintra
Autonomous medical coding that runs inside your EHR
Solventum (formerly 3M Health Information Systems)
The incumbent coding and CDI platform, adding autonomous coding
Revenue Integrity & Pre-Bill Review
AI that reviews clinical data to find missed diagnoses, undercoded encounters, and revenue left on the table before the claim goes out.
RCM Automation Platforms
Horizontal platforms that deploy AI agents and workflow automation across intake, authorization, billing, and other administrative flows.
Claims & Clearinghouses
The rails that move claims, remits, and eligibility transactions between providers and payers, from legacy networks to API-first challengers.
Waystar
Public RCM platform spanning claims to patient payments
Availity
Payer-owned network for claims and eligibility
Stedi
API-first clearinghouse for developers
Candid Health
Automated billing infrastructure for digital health
Change Healthcare (Optum)
The largest US medical claims clearinghouse, now part of Optum
Experian Health
Patient access, coverage discovery, and claims tools from Experian
Office Ally
Low-cost all-payer clearinghouse with practice software attached
Denials & Appeals
Platforms that predict, prevent, work, and appeal denied claims, one of the highest-ROI corners of the revenue cycle.
End-to-End RCM
Full-service revenue cycle operators that take over billing operations for health systems and physician groups, increasingly with AI inside.
R1 RCM
The largest end-to-end RCM operator
Ensemble Health Partners
Full-service RCM with operator DNA
Conifer Health Solutions
End-to-end revenue cycle services from a Tenet subsidiary
Omega Healthcare
Global outsourced revenue cycle, coding, and clinical services
Access Healthcare
Global tech-enabled revenue cycle services at scale
TruBridge
RCM services and EHR for rural and community hospitals
Patient Payments & Billing
The patient financial experience: estimates, statements, payment plans, and financing that turn confusing bills into collected revenue.
Cedar
Consumer-grade patient billing for health systems
Collectly
Automated patient billing for medical groups
Inbox Health
Patient billing communication for billing teams
PayZen
Affordability platform with pay-over-time for care
Flywire
Public payments company with a healthcare affordability arm
InstaMed (J.P. Morgan)
Healthcare payments network connecting providers, payers, and patients
Paytient
Health payment accounts to pay medical bills over time
RevSpring
Patient billing communications and payments at enterprise scale
FinPay
Pre-care patient financial engagement and payment plans
Raxia
AI agents that automate patient billing, payments, and support
Payment Integrity & Underpayments
Analytics and AI that catch underpayments, predict payer behavior, and recover revenue payers owe but did not pay.
Anomaly
AI payment intelligence across payers and providers
Rivet
Estimates, underpayment recovery, and denial workflows
Sift Healthcare
Payments AI and analytics for the revenue cycle
MD Clarity
Underpayment detection and patient estimates for provider groups
Machinify
AI payment integrity and accuracy platform for health plans
Zelis
Claims pricing, payment integrity, and payments for payers
Contract & Rate Intelligence
Price transparency data and contract analytics that tell providers what care actually pays, and what to demand in the next negotiation.
Turquoise Health
Price transparency data and contract management
Serif Health
Payer rate intelligence from transparency files
Trilliant Health
Market, demand, and rate analytics for healthcare strategy teams
Financial Planning & Analytics
The CFO stack: budgeting, forecasting, cost accounting, and margin analytics built for health system finance teams.