Top 5 Encoda Alternatives and Competitors 2025

Description

MD Clarity began building RCM software over 10 years ago with the goal of revealing payer reimbursement behavior to providers in detail. It’s found that many payers do not adhere to the contract rates and terms they agreed to initially. Providers don’t have to tolerate these breaches. 

MD Clarity’s contract management solution, RevFind, has been built from the ground up to document, parse, and analyze contract details. It compares every payment coming in to those listed in contracts. When discrepancies occur, it lists them in a report and even assigns them to different staff workflows. 

To improve revenue collection on the front end, it has engineered ClarityFlow, a patient payment estimate (or GFE) solution. This platform not only helps providers meet No Surprises Act standards, but also collects more revenue from patients up front. Now that patients with HDHPs are responsible for 30% of practice revenue, collecting as much patient revenue as possible as early as possible is imperative. 

Today, MD Clarity counts some of the largest American healthcare systems among its clients. Its integrations include a range of practice management systems, clearinghouses, and data warehouses.   

Contract management

MD Clarity's contract, underpayment, and denials solution, RevFind, handles the most complex healthcare environments, often serving physician groups and MSOs with locations in multiple states. It streamlines contract centralization, analysis, task management, and reporting processes. Accustomed to multi-specialty organizations operating across multiple locations, this platform supports CFOs and revenue cycle staff alike. To mitigate any lack of contract expertise among RCM staff, MD Clarity has built sophisticated modeling capabilities to support detailed contract analysis across many different reimbursement methodologies.

Another key RevFind differentiator is its hands-on approach to contract uploading. By handling this task themselves, MD Clarity significantly reduces the administrative burden on clients.

RevFind's reporting capabilities include:

• payer contract performance measurement
• payer ranking against competitors and Medicare benchmarks
• comprehensive underpayment identification
• denial identification
• revenue forecast
• payer mix analysis
• operating and total margin reports
• contract modeling to reveal the impact of proposed payer changes on revenue 

Like Encoda, RevFind’s underpayment detection feature compares actual payer reimbursements against contracted rates in real time. It generates detailed revenue cycle reports that equip staff to address discrepancies with payers efficiently.

RevFind's ability to break down underpayments by various factors like payer, CPT code, provider, location, and combinations of these factors ensures that CFOs and revenue cycle leaders can pinpoint just where they need changes and concessions from payers. One orthopedics MSO with over 200 physicians across several states used RevFind to identify $10.3 million in underpayments and automate the generation of 12,500 annual patient estimates. Many of MD Clarity’s clients have achieved similar results. 

Patient payment or good faith estimates

MD Clarity's patient payment estimation platform, Clarity Flow, gained significant attention following the implementation of the No Surprises Act of 2022. This law mandates that healthcare providers provide good faith estimates for self-pay and uninsured patients. Because of the increase in patient payment responsibility, some organizations have chosen to provide upfront estimates to all patients. 

Clarity Flow automates several key patient payment estimate functions previously handled by RCM staff. These functions include

• eligibility verification  estimation of benefits
• customized estimate letter generation
• automated estimate delivery triggered at appointment scheduling
• tracking of  deposit collections
• transfer of collected funds to the provider accounts

This automation alleviates staff workload, enabling them to concentrate on more complex cases and patient attention. By automating eligibility verification and estimate generation, Clarity Flow helps healthcare organizations enhance operational efficiency and streamline their processes.

Complex estimates requiring staff review are sent to the provider for manual processing. The high degree of automation in eligibility verification and estimate generation reduces the operational workload for healthcare organizations, eliminating the need for additional staffing.

Encoda and MD Clarity contract management solution similarities  

MD Clarity and Encoda both aim to optimize healthcare practices' financial performance by gaining control over and insights into payer contracts. Both companies encourage providers to maximize revenue from existing payer agreements. However, their similarities end there, as MD Clarity delivers several more important contract management functionalities than Encoda. 

Encoda and MD Clarity contract management solution differences  

MD Clarity offers a comprehensive contract management solution, including contract creation, negotiation, execution, and renewal. Encoda’s functions end at underpayment identification, workflow automation, and claim scrubbing. By offering software operated by the provider’s RCM team or administration, MD Clarity helps providers keep revenue cycle costs lower than a solution like Encoda that combines their software with their own RCM staff. 

RevFind centralizes all payer contracts into a unified repository for easy access and management. Additionally, it conducts advanced contract modeling capabilities, allowing practices to simulate the financial impact of proposed payer rate changes and use data-driven insights to strengthen negotiation positions. The platform also automates alerts for critical dates like renewals and expiration while tracking payer performance and revenue impact.

In contrast, Encoda does not provide full-fledged contract management capabilities. Instead, it focuses narrowly on contract reimbursement analytics, helping practices identify underpayments and improper payments based on existing payer contracts. Encoda lacks features such as contract modeling, centralized storage, automated alerts for contract milestones, or negotiation support. Its primary goal is to optimize billing workflows rather than manage the entire healthcare contract lifecycle.

In summary, MD Clarity delivers an end-to-end contract management solution with advanced tools for proactive financial planning and negotiation. Encoda's approach is more limited, focusing solely on analyzing reimbursements to ensure payment accuracy without extending into broader contract lifecycle management functions. 

Take a quick, self-guided tour through MD Clarity’s powerful contract management and underpayments identification tool, RevFind:

Ratings

Recently, Built-In recognized MD Clarity as a Best Place to Work. MD Clarity also made Inc. Magazine’s 2024 list of the 5000 fastest-growing private companies in America. 

G2 reviewers have given MD Clarity an average of 4.2 / 5 stars from 31 reviews.

Description

Like Encoda, competitor Tribunus Health focuses on payer contracting solutions, combining software with RCM staff and consultants to recoup underpayments and manage denials. Tribunus Health goes beyond contract management work, however, by providing enrollment assistance. Its primary targets are substance abuse treatment centers, specialist groups, rural hospitals, and private equity-backed physician groups.

Tribunus utilizes a healthcare price transparency tool powered by PayerPrice, which provides actionable data on negotiated reimbursement rates to aid healthcare providers in contract negotiations and strategic decision-making. Additionally, Tribunus integrates client data into platforms like CommonThread to streamline reporting and improve operational efficiency. These tools are embedded within its broader consulting and contracting solutions rather than being marketed as independent software products.

Tribunus Health’s consultants perform comprehensive contract reviews to prepare providers for negotiations. It identifies any opportunities the provider could have to enter new, more lucrative payer networks. Tribunus Health actively negotiates on behalf of provider clients. 

Features Tribunus shares with Encoda

As with Encoda, Tribunus assigns its own experienced attorneys and other professionals to handle the contract negotiation if requested. Before negotiations begin, however, Tribunus works closely with the healthcare organization to fashion value statements specific to each payer’s style and needs. Their combination of software and expert negotiators is engineered to optimize contracts, ensuring healthcare providers secure favorable reimbursement rates.

Tribunus prides itself on addressing challenges such as stale contracts and the complexities of going in-network for the first time.

Encoda and Tribunus Health share similarities in their focus on improving financial outcomes for healthcare providers, but they approach this goal through distinct methods that complement each other. Here are the key similarities:

• Revenue Optimization - Both Encoda and Tribunus aim to maximize revenue for healthcare providers. Encoda does this by automating claims management, denial resolution, and payment reconciliation, while Tribunus focuses on managed care contracting, negotiating better reimbursement rates, and ensuring competitive payer agreements.
• Data-Driven Solutions - Both companies leverage data to drive decision-making. Encoda uses integrated analytics through its Maestro Analytics™ platform to provide real-time insights into financial performance. Similarly, Tribunus employs proprietary datasets and tools like its Healthcare Price Transparency Tool to analyze reimbursement rates and inform payer negotiations.
• Transparency and Reporting - Transparency is a core value for both organizations. Encoda provides clients with detailed dashboards that track billing performance and payer interactions, while Tribunus offers a contracting process dashboard that allows clients to monitor the progress of payer negotiations.
• Specialty-Specific Expertise - Both companies tailor their solutions to meet the unique needs of healthcare specialties. Encoda customizes its workflows and rules-based automation for various specialties, while Tribunus matches clients with experts who have geographic and specialty-specific knowledge for effective contract negotiations.
• Operational Efficiency - Both organizations aim to reduce administrative burdens for healthcare providers. Encoda achieves this through automation of billing workflows, whereas Tribunus provides end-to-end managed care contracting services, eliminating the need for providers to navigate complex payer negotiations themselves.

Differences between Encoda and Tribunus

• Core focus – Encoda specializes in RCM automation through its software products and RCM staff. Tribunus Health, on the other hand, focuses on managed care contracting and payer negotiations, offering services to optimize reimbursement rates and expand provider networks.

• Service model – Encoda primarily provides software-driven solutions complemented by RCM services to enhance billing efficiency and transparency. In contrast, Tribunus combines proprietary tools with hands-on consulting services, including direct contract negotiation with payers and strategic market assessments.

• Target areas – Encoda addresses operational inefficiencies in billing workflows by integrating with practice management systems and automating claims processes. Tribunus targets contract management challenges, such as stale agreements or entering new payer networks, while also providing enrollment assistance and reimbursement management.

• Markets Served – Encoda primarily serves physician practices and medical billing companies across various specialties by improving RCM efficiency. Tribunus caters to a broader range of healthcare entities, including rural hospitals, substance abuse centers, private equity-backed groups, and specialty providers.

Tribunus does not have any reviews on G2, Capterra, Software Advice, or Software Finder at this time. 

Description

As with Tribunus and Encoda, PayrHealth combines proprietary tools and expert consulting services. 

PayrHealth serves a wide range of healthcare entities, including primary care physicians, specialist physicians, behavioral health providers, hospitals, ambulatory surgery centers (ASCs), integrated delivery systems, and other healthcare organizations. They cater to both small and large practices, providing the comprehensive resources typically reserved for larger health systems.

PayrHealth's primary services are:

• Complete payer management – A comprehensive solution that handles every aspect of the payor-provider relationship, including contract negotiation, ongoing management, and revenue cycle optimization. This service ensures providers secure competitive reimbursement rates while minimizing administrative burdens.
• Contract negotiation and management – Expert-driven services that review, negotiate, and manage payer contracts to maximize reimbursement rates and ensure compliance. This includes fee schedule analysis, contract language review, and strategic market assessments.
• Credentialing services – Credentialing of healthcare providers with insurance payers. This service reduces delays, maintains compliance with regulatory requirements, and allows providers to focus on patient care. 
• Revenue cycle management – Streamlines billing and collections processes to reduce denials, accelerate payment cycles, and ensure financial stability for healthcare organizations.
• SlicedHealth contract modeling platform – PayR Health integrated with SlicedHealth to use advanced AI to simulate contract scenarios, identify underpayments, and optimize financial outcomes. This data-driven tool helps providers negotiate more effectively by evaluating proposals against historical and projected financial performance.

Differences between Encoda and PayrHealth

• Core focus - Where Encoda specializes in revenue cycle management automation, PayrHealth focuses on comprehensive payer management, including contract negotiation, credentialing, and revenue cycle services. Encoda’s claims scrubbing, real-time analytics, and automated workflows reflect this focus. PayrHealth offers end-to-end services such as payor contracting strategy, credentialing, and revenue cycle optimization, along with tools like the contract modeling platform for advanced payor negotiations.
• Technology vs. services - Encoda is primarily SaaS-based, but it offers RCM services as well. PayrHealth combines its software with hands-on consulting services, offering a more service-heavy approach that includes direct contract negotiations and ongoing payor relationship management. 
• Target markets - Encoda primarily serves physician practices and medical billing companies. PayrHealth caters to a broader range of healthcare entities, including hospitals, health systems, ambulatory surgery centers (ASCs), ancillary providers, and private equity-backed MSOs..
• Payer interactions - Encoda focuses on analyzing payer contracts for underpayments and improving claims processing efficiency, but does not directly negotiate contracts with payers. PayrHealth actively negotiates or renegotiates contracts on behalf of its clients to secure competitive reimbursement rates. 

Overall, Encoda emphasizes automation and technology for RCM optimization, while PayrHealth provides a service-oriented approach focused on managing payer relationships and securing favorable contract terms.

Ratings

PayrHealth has no reviews on G2, Capterra, or others at this time. 

Description

Symplr provides enterprise healthcare operations software and services. It offers consulting services and staffing support in addition to its software solutions.  With over 30 years of experience and a presence in 9 out of 10 U.S. hospitals, its unified platform integrates 28 essential capabilities, simplifying complex workflows across:

• provider data management
• workforce management
• contract and spend management
• compliance 
• quality improvement

Symplr's solutions streamline administrative tasks, reduce costs, and enhance operational efficiency, allowing caregivers to focus more on delivering high-quality patient care. 

Its main services are: 

• Symplr Contract Management – A comprehensive contract lifecycle management solution, Symplr securely stores all contracts and associated documents in a single, accessible database. The company also erects configurable workflows for approvals, renewals, and compliance. Its compliance monitoring tools ensure adherence to regulations like HIPAA, Stark Law, and the Anti-Kickback Statute, helping organizations avoid penalties.
• ‍Symplr Revenue Cycle Management (RCM) --Symplr’s RCM solutions focus on improving revenue flow and reducing delays in billing processes. 

Key features include:

• Provider credentialing automation: Accelerates the credentialing process by an average of 26 days, minimizing delays in revenue generation.
• Accurate data management: Ensures provider data is accurate across systems to prevent billing errors or delays.
• Integrated workflows: Automates billing processes and compliance tracking to optimize cash flow and reduce administrative burden.

By integrating contract management and RCM capabilities into its broader healthcare operations platform, Symplr enables health systems to optimize financial performance, streamline workflows, and maintain compliance across their operations.

Features Symplr shares with Encoda

• Centralized data management – Both Symplr and Encoda provide centralized platforms for managing critical data. Symplr offers a contract repository for healthcare organizations to store and manage contracts, while Encoda consolidates claims, payer, and practice management system data into a dashboard for financial insights.
• Workflow automation – Symplr automates contract lifecycle processes like approvals, renewals, and compliance tracking, reducing manual effort. Similarly, Encoda automates billing workflows, such as claims submission, denial resolution, and payment posting, to enhance efficiency and reduce administrative burdens.
• Compliance tracking – Symplr ensures adherence to healthcare regulations like HIPAA and Stark Law through compliance monitoring tools. Encoda supports compliance by identifying underpayments and ensuring claims meet payer-specific requirements.
• Advanced reporting and analytics – Both platforms offer robust reporting capabilities. Symplr provides customizable reports to track contract performance and compliance metrics, while Encoda delivers real-time financial dashboards so that practices can address revenue cycle inefficiencies.

Key differences between Symplr and Encoda:

• Core focus –Symplr is an enterprise healthcare operations platform that spans multiple areas, including workforce management, contract lifecycle management, compliance tracking, and procurement optimization. Encoda, on the other hand, focuses on automating billing workflows, denial resolution, and financial analytics for physician practices.
• Breadth of offerings – Symplr provides a wide range of capabilities across 28 product classes, such as provider credentialing, workforce scheduling, vendor management, and quality improvement. Encoda's offerings are narrower and focused exclusively on RCM optimization.
• Target market – Symplr serves a broader range of healthcare entities, including hospitals, health systems, ambulatory surgery centers (ASCs), and payers. Encoda primarily targets physician practices and medical billing companies seeking to streamline their revenue cycle processes.
• Compliance scope – Symplr emphasizes regulatory compliance across multiple domains, including HIPAA adherence, Stark Law compliance, and Anti-Kickback Statute monitoring. Encoda's compliance focus is limited to ensuring accurate claims processing and identifying payer underpayments.

In summary, Symplr offers a comprehensive healthcare operations platform catering to diverse organizational needs, while Encoda specializes in automating and optimizing revenue cycle processes for physician practices.

Rating

Symplr Contract has earned a score of 3.7 / 5 on Capterra. 

Similarities between Syntellis and Encoda

• Focus on revenue optimization - Both Syntellis and Encoda aim to improve financial performance for healthcare organizations. Syntellis achieves this through its Axiom Contract Management solution, which optimizes provider revenue via contract compliance and claims management. Encoda focuses on maximizing collections and reducing inefficiencies in the revenue cycle through its automation tools like Encoda BackOffice™.
• Support for denial management - Both solutions address claim denials. Syntellis helps uncover root causes of denials and focuses follow-up efforts on high-value claims, while Encoda automates denial resolution processes to minimize revenue leakage.
• Advanced analytics - Both platforms offer analytics tools to provide actionable insights. Syntellis includes analytics for contract modeling, payment variance tracking, and financial performance optimization. Similarly, Encoda provides real-time dashboards powered by Maestro Analytics™, enabling practices to monitor revenue cycle metrics and identify underpayments.
• Compliance monitoring – Compliance is a shared focus for both companies. Syntellis ensures adherence to contract terms and payer agreements through automated compliance tracking. Encoda identifies improper payments based on payer contracts, ensuring accurate reimbursement.

While both Syntellis and Encoda share a commitment to enhancing financial outcomes through automation and analytics, Syntellis emphasizes comprehensive contract management across healthcare systems, whereas Encoda specializes in streamlining the revenue cycle for physician practices.

Axiom Contract Management by Syntellis has no reviews on G2 or Capterra at this writing.