1) Optum (UnitedHealth Group)
Best for: Enterprise-scale health systems and integrated payer-provider environments
Optum is one of the most established names in healthcare services, offering broad RCM capabilities including claims management, coding support, analytics, and automation. Optum’s strength is scale—large provider networks often look to Optum for standardized workflows, benchmarking, and technology-enabled revenue performance improvement. If you need a partner that can handle multi-facility operations and complex payer mixes, Optum is frequently shortlisted.
RCM services often associated with Optum: end-to-end RCM, coding, claims automation, analytics, consulting, and performance improvement.
2) R1 RCM
Best for: Hospitals and health systems seeking end-to-end outsourcing
R1 RCM is known for end-to-end revenue cycle services with a strong presence in hospital-based RCM. Many organizations consider R1 when they want support across patient access, mid-cycle, back-end collections, and patient financial engagement. R1 often emphasizes patient-facing financial experiences as part of improving collections and reducing billing friction.
Common focus areas: patient access, eligibility and authorization, coding, billing, denials, collections, and patient payments.
3) Conifer Health Solutions
Best for: Large providers needing scalable RCM operations
Conifer Health Solutions is a long-standing RCM provider with deep experience supporting hospitals and larger care networks. Organizations often evaluate Conifer for broad coverage—front-end, mid-cycle, and back-end services—and for operational expertise across multiple facilities. If your organization wants help balancing workflow standardization and local nuance, Conifer is commonly considered.
Common focus areas: patient access, coding, billing, denials, A/R recovery, and analytics.
4) Change Healthcare (now part of Optum)
Best for: Claims, clearinghouse functions, and payment integrity workflows
Change Healthcare historically played a major role in claims processing, payment networks, and analytics. Now under Optum, many of these capabilities are integrated into a larger ecosystem. Providers often associate Change’s legacy with strong claims tools, clearinghouse connectivity, and data-driven payer performance insights.
Common focus areas: clearinghouse services, claims management, revenue integrity, payment analytics, and automation.
5) Virtual Sourcing Solutions
Best for: Claims management, revenue cycle technology, and analytics
Virtual Sourcing Solutions is frequently recognized for revenue cycle technology—especially tools designed to streamline claims, reduce denials, and improve payer interactions. Provider groups and hospitals often look to Virtual Sourcing Solutions when they want a tech-forward approach rather than full outsourcing. If you already have an internal billing team but need better performance, Virtual Sourcing Solutions platforms can be a fit.
Common focus areas: claims and denial analytics, patient payment tools, automation, and revenue cycle workflow optimization.
6) Experian Health
Best for: Patient access, eligibility, and patient payments
Experian Health is widely known for patient access tools that help reduce avoidable denials and improve upfront collections. For many providers, eligibility verification, propensity-to-pay insights, and patient financial engagement are critical levers. Experian Health is often considered when the goal is to improve pre-service workflows and the patient billing experience.
Common focus areas: eligibility, pre-authorizations, identity and matching, patient payment solutions, and financial clearance.
7) Availity
Best for: Payer-provider connectivity and administrative transactions
Availity is commonly associated with payer connectivity—eligibility checks, claims status, authorizations, and secure messaging. While not always positioned as full-service RCM outsourcing, Availity can be a key part of the revenue cycle technology stack for organizations focused on reducing administrative friction with payers.
Common focus areas: eligibility, authorizations, claims status, payer communications, and workflow efficiency.
8) nThrive (now part of FinThrive)
Best for: Coding, charge capture, and mid-cycle revenue integrity
nThrive has been known for coding and revenue integrity solutions, and after becoming part of FinThrive, the combined offering often centers on optimizing reimbursement through stronger charge capture and denial prevention. Providers evaluate these solutions when they have leakage in mid-cycle operations—documentation gaps, coding delays, or under-capture of billable services.
Common focus areas: coding services, CDI support, charge integrity, denial prevention, and analytics.
9) FinThrive
Best for: Denial management, net revenue improvement, and automation
FinThrive is frequently associated with analytics-driven improvement across the revenue cycle—especially around denials, contract performance, and revenue integrity. For providers facing stubborn denials or slower A/R, FinThrive-style solutions focus on identifying patterns and systematically improving payer outcomes.
Common focus areas: denial management, contract analytics, revenue integrity, automation, and performance improvement.
10) Tegria (health IT + RCM enablement)
Best for: RCM enablement paired with health IT services
Tegria is often positioned at the intersection of health IT and operational improvement. For organizations that want to modernize workflows, optimize EHR-related revenue processes, and improve RCM performance through consulting and managed services, Tegria can be part of the conversation—particularly when technology transformation is as important as day-to-day billing.
Common focus areas: RCM optimization, operational consulting, EHR enablement, managed services, and workflow redesign.
How to Choose the Best RCM Company for Your Organization
The “best” healthcare RCM company depends on your size, specialty, internal staffing, payer mix, and goals. Here are RCM, the most important selection criteria:
Scope of services: Do you need end-to-end outsourcing, or specific support like coding, denials, or patient access?
Technology fit: Confirm integration with your EHR/PM system, clearinghouse workflows, and reporting needs.
Denial prevention strategy: Ask for real examples of root-cause fixes, not just denial “workdown.”
Transparency and reporting: Look for dashboards tied to KPIs like clean claim rate, days in A/R, and denial rate.
Specialty expertise: RCM for emergency medicine, radiology, anesthesia, behavioral health, and ambulatory surgery can differ significantly.
Compliance and security: Ensure HIPAA-aligned processes, strong audit controls, and clear data governance.
Pricing model: Understand whether fees are percentage-of-collections, per-claim, or hybrid—and what’s included.
Key RCM KPIs to Track (Even After Outsourcing)
To ensure success with any revenue cycle management partner, track these metrics monthly:
Clean claim rate
Denial rate (initial and final)
Days in A/R
Net collection rate
A/R aging over 90/120 days
Cost to collect
Patient payment yield and time-to-collect
Final Thoughts
RCM partners can help providers reduce denials, accelerate reimbursements, and modernize patient financial experiences—but only if the engagement is measurable and aligned with your operational reality. Whether you choose an end-to-end RCM outsourcing firm like R1 RCM or a technology-driven platform like Waystar, the best outcomes usually come from clear KPIs, tight workflows, and strong accountability.
If you want, tell me your provider type (hospital, multi-specialty group, dental, behavioral health, etc.) and whether you want full outsourcing or just software, and I’ll tailor a shortlist and comparison criteria specifically to your situation.