Top 8 athenahealth RCM Alternatives and Competitors 2024

Revenue cycle management software automates and optimizes healthcare organizations’ revenue cycles. It verifies patients' eligibility for health benefits, creates and sends patient payment estimates, automates claims billing, and detects payer underpayments. By at least partially automating these processes, providers improve net revenue, streamline workflows, and reduce staff workload. athenahealth offers both software and services from trained specialists who handle the exceptions that software cannot solve. 

athenahealth began as an EHR provider, but over the past 25 years has expanded into revenue cycle, patient engagement, care coordination, and population health management.  

What is athenahealth revenue cycle management and what market does it serve? 

Originally established as Athena Women's Health in San Diego, athenahealth has undergone a steady evolution. In 2000, it focused on healthcare technology and unveiled its first solution, athenaCollector, a cloud-based service for revenue cycle and practice management. In 2006, the company launched athenaClinicals, a service-based EHR system designed to improve usability and ease the burden on healthcare providers and staff. Considering that the HITECH Act which mandated digital healthcare records didn’t go into effect until 2009, athenahealth could be considered a pioneer in this field. 

In 2022, Bain Capital and Hellman & Friedman acquired athenahealth for $17 billion. This infusion helped the company expand its products and reach in the healthcare technology sector.

athenahealth’ products include:

• Revenue cycle management tools
• EHR platforms
• Custom platform creation
• A marketplace platform (which lists recommended healthcare technology solutions)
• Patient portals and payment platforms
• Population health (records)
• Telehealth services
• Advisory services

While athenahealth’s EHR and other solutions serve every size of healthcare organization from independent medical practices to hospitals & health systems, they limit their RCM solution to large hospitals and complex healthcare organizations. They claim to be an end-to-end solution, but some of their reviewers complain that they’ve had to bring on additional outside vendors in addition to athenahealth to hammer out a complete revenue cycle system. 

athenahealth’s RCM solution: IDX

athenahealth IDX is the company’s revenue cycle management solution. It integrates scheduling, eligibility, prior authorizations, billing, and balances into a unified system. Fueled by automation, this software supports hospitals and complex health systems in attaining financial goals, including lowering collection costs and denial rates, as well as enhancing clean claims rates. They assert that their solutions reduce accounts receivable days and the expenses associated with collections. It also aims to minimize redundancies and promote the adoption of best-practice workflows.

Although athenahealth provides an array of healthcare technology solutions, its offerings may not necessarily align with the specific requirements of your organization. Explore athenahealth reviews to get a deeper understanding of athenahealth’s performance and whether this company has what your organization needs. 

List of 8 Top athenahealth Alternatives

• MD Clarity
• TriZetto
• Change Healthcare
• R1 RCM
• TruBridge
• Health Here
• AZZLY
• Dentrix

An RCM solution with expertise in good faith estimates and underpayment detection

MD Clarity

Description

One of the first revenue cycle management companies, MD Clarity has a mission to use advanced technology to provide healthcare pricing transparency to patients and fair net revenue to physician groups, health systems, and managed service organizations. 

Over more than a decade, MD Clarity has partnered with 3,000+ facilities, 150,000+ providers, and facilitated 20,000,000+ patient encounters across the United States. It has recently been recognized as a Built-In Best Place to Work. 

MD Clarity features in common with athenahealth

MD Clarity and athenahealth both address revenue cycle improvement via front- and back-end processes.

Patient pay or good faith estimate generation

Where MD Clarity has offered good faith and patient pay estimates for many years, athenahealth is just now releasing a product that generates them. In depth description of this product is not yet available. 

MD Clarity’s Clarity Flow leverages the data from patient files and digitized payer contracts to:

•  establish patient eligibility
•  generate patient estimates
•  auto-send these estimates to the patient

While many RCM vendors offer automated patient pay or good faith estimate generation, MD Clarity is one of the few that auto-sends them based on a trigger like scheduling. Staff need only touch estimates in cases of unique exceptions. These thorough services relieve staff of repetitive busy work and help organizations avoid new hires. 

With Clarity Flow estimates, patients can use a SmartPay platform or the embedded link that connects to your portal to send in a deposit or prepay their entire estimated bill. With cash invested upfront, patients are reluctant to miss appointments. 

During implementation, provider staff works together with the MD Clarity customer success team to create patient estimate letter templates based on individual provider preferences. MD Clarity will even create several letter templates with text that varies by patient needs, diagnoses, and treatments. This personalized approach covers the entire patient base in a genuine way. 

Estimates deploy automatically based on the parameters defined by users at the time of setup. Moreover, these cost projections for patients may also include details regarding financing alternatives, such as CareCredit or financial advisory services, showcasing the organization's commitment to accommodating patients in all financial situations. Additionally, all estimates comply with the No Surprises Act.

Contract management

Contract Analytics: Both athenahealth and MDClarity house upload and digitize payer contracts that they use to create patient payment estimates, verify eligibility, create GFEs, and detect payer underpayments.  

Unlike MD Clarity, however, athenahealth does not offer any functionality to analyze payer contract performance, an important step in revenue optimization. 

In addition to performance analysis, MD Clarity’s RevFind also models how payer-proposed contract changes can impact cash flow should the payer propose a modification. RevFind can simulate the impact the change will have on your net revenue. Because running this analysis takes just minutes, it’s more likely you will take this step and counter a payer’s unfavorable change. Given the level of overwhelm you and your staff labor under, this time savings can make a difference. 

Underpayments: Both athenahealth and MD Clarity use their contract management modules to address payer underpayments. MD Clarity’s tool RevFind, compares all payments to payer contract terms and alerts staff to discrepancies. Due to the labor involved in tracking and addressing them, underpayments are often overlooked. As staff can often recover them easily once they’re discovered, they can be a meaningful source of additional net revenue for physician groups and healthcare organizations. With automated underpayment discovery, providers can find the trends that amount to significant revenue recovery. RevFind also helps ensure you’ve set your chargemaster optimally. Its work queues feature assigns appeals and investigations to a range of team members automatically per your settings so users can review their task statuses in one place. 

Ratings

MD Clarity has earned an average of 4.7 / 5 stars on G2. athenahealth has earned a 3.5 / 5 rating on G2. 

An athenahealth competitor that's also end-to-end RCM

TriZetto

Description

Like athenahealth, Trizetto bills itself as an end-to-end revenue cycle management vendor. It serves hospitals, health systems, some providers, and payers. Its software for the provider focuses on automation of prior authorizations, eligibility verifications, contract management, billing, coding, and more.  

Features TriZetto shares with athenahealth

Like athenahealth, TriZetto assures providers that they will provide an end-to-end solution. A software company, TriZetto does not utilize on- or off-shore labor to augment their clients revenue cycle staff. athenahealth does have coding and claims specialists to handle overflow of these tasks. 

Trizetto’s patient cost estimates, which they call Patient Responsibility Estimations, communicate payment expectations and increase patient payment which in turn decreases bad debt. Their contract management solutions automate underpayment detection and analysis, and provide contract modeling for those who want to predict how changes in prices or terms will impact their revenue. 

Ratings

TriZetto has an average rating of 4.3/5 stars on G2.  

An API-forward athenahealth competitor 

Change Healthcare / Optum

Description

For over a decade, Change Healthcare has been a key player in the healthcare sector until its acquisition by United Healthcare in 2022, which then integrated it into Optum, its subsidiary. Change Healthcare is known for its extensive range of revenue cycle management (RCM) solutions. As with athenahealth, its main clients are hospitals, physician groups, and healthcare systems. Their offerings include:

• data-driven RCM analytics to uncover trends and areas for improvement,
•  self-service clearinghouses for streamlined claims processing 
• payment accuracy tools to ensure correct reimbursement for healthcare services.

Change Healthcare and athenahealth solutions in common

As with Trizetto, both athenahealth and Change Healthcare provide end-to-end revenue cycle management solutions. In addition to their software, both companies also offer services conducted by specialists in billing, prior authorizations, charge capture, and more. A software plus services approach ensures hospitals and health systems cover all patients, including “exceptions” that the software cannot process. Both also offer consulting and advisory services to clients.  

Ratings

Change Healthcare and Optum both have scores of 3.7/5 stars on G2.

An athenahealth competitor known for outsourced revenue cycle management

R1 RCM

Description

Initially established as Accretive Health in 2003, this revenue cycle solution company re-branded as R1 RCM in 2017. Now a leading RCM company based in Salt Lake City, Utah, R1 RCM’s primary market is hospitals and healthcare systems.

Differences between athenahealth and R1 RCM solutions:

• End-to-End Revenue Cycle Software and Services: As with Change and athenahealth, R1 combines its software with a digital workforce. These specialists partner with provider staff to carry out nearly all revenue cycle tasks. R1 RCM’s solutions leverage AI-powered analytics solutions to identify and resolve payment-related issues in real-time. 
• Patient Experience: While athenahealth has begun offering patient pay and good faith estimates, R1’s EntriPay does not compile these pay estimates. R1’s patient experience tool bundles registration, intake, clearance, scheduling, and payment into one. 
• Claim Management: Both athenahealth and R1 can provide experienced HIPAA-compliant coders to claims projects.  

R1 RCM has just one score of 0/5 stars on G2.

An athenahealth alternative that provides outsourced RCM consulting

TruBridge

Description

Launched in 2013, TruBridge is a specialized revenue cycle management company that serves only rural and community hospitals. Its software solutions streamline revenue cycle operations, ensure coding compliance, and enhance patient engagement. The cornerstone of TruBridge's offerings is its comprehensive revenue cycle management software, equipped with real-time analytics and tools to improve revenue cycle performance, facilitate billing processes, and lighten staff workloads.

Its primary solutions include: 

• Claim Scrubbing and Submission: identifies and flags claim errors 
• Denial and Audit Management: hunts and flags denied and audited claims to speed payer payments. This solution’s automation also increases staff productivity, and minimizes tedious tasks.
• Contract Management: helps you recover underpayments and keep contracts current.

Features similar to those of athenahealth

TruBridge tailors its RCM systems to the needs of large hospitals and complex healthcare systems. athenahealth promotes its RCM solutions to the same population, but provides its EHR and other services to providers and practices of all sizes. 

The TruBridge Patient Liability Estimates tool is designed to help patients avoid unexpected billing surprises by providing accurate cost estimates in advance. This tool not only aids physicians in enhancing cash flow and reducing patient no-shows but also helps in minimizing financial write-offs, thereby preserving the integrity of EBITDA.

Ratings

TruBridge has a rating of 3.4/5 on G2.

An athenahealth alternative that specializes in behavioral health centers

AZZLY

Description

AZZLY offers a comprehensive, revenue cycle management cloud-based solution combined with an EHR for behavioral health and addiction treatment providers. By combining revenue cycle management, practice management, and electronic health records, it frees behavioral health center staff to focus on providing care. 

AZZLY and athenahealth share these features:

Both AZZLY and athenahealth have the “dual” tier of RCM and EHR operations solutions. Where AZZLY limits its industries to behavioral health, athenahealth serves all hospitals, physician groups, and specialties. 

Athenahealth is just now offering a patient pay estimate solution to clients, AZZLY’s proclaims theirs is “coming soon!” 

Azzly has 3.9/5 stars on Capterra.

HealthHere: An Athenahealth competitor that serves high-value provider networks

Description

HealthHere is dedicated to advancing healthcare organizations towards a value-based model by streamlining patient access and enhancing revenue cycle processes. Their offerings focus on automating bundled payment models, facilitating easy patient payments, offering various payment methods, cutting down patient wait times, improving patient interaction, and lightening the workload for healthcare staff.

Features

Their software suite includes:

• Flow - patient intake: mobile check-in and in-clinic kiosks & tablets that automate intake and relieve front-desk bottlenecks.  
• Q Code - patient cost estimates: pre-service and good faith estimates. 
• Qub - a repeated payments system that helps providers build and automate episodic payment models. Facilitates payment procedures, pricing and automation.
• Pay – patient payment facilitation: Via their patient portal, Healthhere.com enables a wide range of patient payment options. It standardizes all communications from pre-check to post-procedure to contain patient confusion.
• Pro - patient-reported outcomes: this solution collects patient-reported outcomes. These surveys deliver measure satisfaction and quality beyond financial measures – key for value-based provider network goals. 

These services ease operations at busy, value-based care physician groups. 

Solutions athenahealth shares with HealthHere

Both athenahealth and HealthHere offer pre-service estimates including the good faith estimates mandated by the No Surprises Act for self-pay patients.  

Ratings

HealthHere has not accrued enough reviews to publish ratings. 

An athenahealth alternative built for dental practices

Dentrix

Description

Founded in 1985, Dentrix Dental Systems was acquired by leading dental and medical supplier Henry Schein in 1997. Dentrix was the first practice management system for Windows (1989) and the first to win approval for Windows 98. Dentrix became a popular option for dentists due to its consistent track record of helping dentists streamline operations and optimize revenues. To fully serve this industry, Dentrix connected financial and clinical data and insights into one workflow. 

Where athenahealth serves all markets and specialties, Dentrix only has dentists as clients.

Features

Dentrix’s solutions include:

• Billing and collection tools:  These tools help dentists track patient eligibility and insurance claims. Dentrix tools create and send billing statements, speed payment collection, and manage debit and credit card payments. 
• Clinical tools: dentists appreciate that they can access their many 2D and 3D images within the tool. A central location houses all patient information so that users can store, record, and view data. 

Ratings

Dentrix has 4.3/5 stars on Software Advice and GetApp.

Explore MD Clarity’s revenue improvement solutions yourself

If you need a good faith estimate solution that has been serving provider groups and MSOs for years, consider MD Clarity’s Clarity Flow. It not only generates accurate estimates based on stored contracts and patient information, but it also sends the estimates without any work from your staff. Dedicated to healthcare transparency, MD Clarity's products ensure patients get the price information they want and you get the improved net revenue you need. Further, MD Clarity’s RevFind delivers the contract optimization and payer underpayment detection that ensure you’re maximizing your reimbursements and contract terms.  

Interested in seeing firsthand how MD Clarity stacks against athenahealth? Book a demo today.

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