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Ambulatory RCM Services 2016
Who Best Meets Needs in This Exploding Market?

author - Aaron Gleave
Aaron Gleave
author - Jonathan Christensen
Jonathan Christensen
October 13, 2016 | Read Time: 3  minutes

Revenue cycle management (RCM) services, which began as an athenahealth innovation years ago, have now exploded in popularity. Of the providers KLAS interviewed, two-thirds using RCM services say they are worth the investment and have helped them become more efficient. Not all providers are finding success, however. Vendor delivery in the key areas of account management, vendor guidance, transparency, and denials has a critical impact on provider success and varies widely among vendors and different practice sizes.

1. CureMD & Pulse Excel among Several Solid Options for Small (≤10 Physician) Practices

For small practices (≤10 physician) CureMD customers enjoy top notch account management and a partnership with their vendor, whose highly responsive staff members treat patient claims as their own. Additionally, CureMD has the highest percentage of customers who say the service is worth the investment. Pulse customers enjoy an all-around positive experience as well, highlighting good transparency into their financial operations. Aprima helps elevate customers' billing efficiency by sharing best practices. From a limited sample, customers report that Allscripts, who has entered the market through acquired capabilities, offers good transparency coupled with strong expertise and support.

who is best meeting the rcm markets needs

2. athenahealth Meets Large Practice Needs Best; NextGen Consistent among All Sizes

Of the few vendors who cater to both small and large practices, athenahealth supports large customers best, with quality tools that offer high transparency to customers. Large customers also value their dedicated account managers. Smaller customers report less success, saying that athenahealth has recently shifted their focus to larger practices. In comparison, NextGen Healthcare is highly consistent among both small and large practices with 80% of their customers reporting RCM services are worth the investment. Customers highlight the fact that NextGen is always trying to improve their customer-centric culture. KLAS interviewed a limited number of eClinicalWorks and Greenway customers; both small and large clients report major challenges with claims processing and overarching vendor communication.

3. CureMD, Aprima, NextGen Set Standards for Account Management Guidance

CureMD's account managers stand out for proactive, personal engagement with clients, who feel CureMD is an integral, trusted part of their practice. Aprima customers say Aprima enhances the customer experience by helping streamline billing processes to drive efficiency. NextGen Healthcare clients report gaining deeper understanding and insight into their specialty clinics' operations. Longstanding Kareo customers feel high account manager turnover has led to inconsistent, sporadic support. In contrast, more recently live clients report more interaction and contact with specifically assigned account managers. Providers say sparse contact from Bizmatics, eClinicalWorks, and Greenway account managers has decreased customer confidence.

elevating account management through guidance

4. athenahealth's Reports Provide Transparency; Allscripts Shows Good Promise

Real-time dashboards and detailed payment and financial reporting give athenahealth customers a comprehensive view into their billing operations. KLAS spoke with a limited number of Allscripts customers, but they enjoy regular report updates from their account managers, as well as ad hoc reporting. The majority of other RCM vendors also offer good transparency to clients. Kareo's, eClinicalWorks', and Greenway's challenges around transparency stem from a breakdown in communication rather than a lack of tools.

how transparent is your vendor

5. Aprima, athenahealth, NextGen Best at Managing Difficult Denials Process

Denials and resubmissions are the most challenging service areas, and Aprima, athenahealth, and NextGen make these processes the smoothest. Aprima customers appreciate that their vendor is proactive in resolving rejected claims rather than leaving the follow-up to clients. athenahealth's rules-based system screens and sorts rejected claims, leading to easier and more efficient customer follow-up. NextGen reduces churn for customers by offering automated tools that flag incorrect codes and avoid processing errors. To varying degrees, most other vendors leave denials management to their clients, without outlining responsibility for follow-up.

how good is your vendors denials management
author - Robert Ellis
Project Manager
Robert Ellis
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.