Top 5 ReveloHealth Alternatives & Competitors 2024

The complexity of healthcare contracts – particularly for physician groups and management services organizations – is soaring. 

Large physician groups and MSOs handle many different types of contracts (fee-for-service, value-based, capitation, pay-for-performance, ACO, Medicare/Medicaid, commercial) from a variety of insurers, often across several states. With all types of contracts getting “updated” by both payers and federal entities throughout the year, keeping them current becomes a struggle. Commercial payers can even execute their amendments without provider approval.   

The level of attention today’s payer contracts require exceeds staff expertise and time. Given that a 2023 CWH Advisors study found that 63% of providers are dealing with staffing shortages in their revenue cycle departments, more physician groups and MSOs are turning to contract management software. This technology automates contract review and approval, underpayment identification, review status, version control, renewal reminders, compliance monitoring, reporting, and more. 

About Revelo Health

Revelo Health takes a unique spot in the spectrum of healthcare organization revenue cycle management. Primarily a software and technology company, it is a point solution that focuses solely on claims repricing. Where typically the clients of repricing services are payers, Revelo Health offers these services to providers to support their revenue cycle. Historically, it’s been payers who’ve conducted repricing internally or via third party administrators as part of their claims adjudication process. 

What is claims repricing and why is it important to the provider revenue cycle?

Because of claims filing mistakes, missed payer updates, unmatched definitions of terms, and more, payers' and providers’ prices for the same service may differ. After receiving claims, payers “reprice” each service and remit accordingly. While providers have not traditionally conducted repricing, when payers remit less than expected or deny the claim altogether, providers take the hit.  

By targeting providers, ReveloHealth helps them anticipate:

•  how payers will price their claims before submission
•  ensure they are being reimbursed according to contracts
•  gain insight into payer pricing methodologies and change their strategy accordingly 

By giving providers access to technology and insights typically reserved for payers, ReveloHealth aims to create transparency and efficiency in provider claims that support revenue optimization. Historically, payer pricing choices have been opaque to providers. Revelo contends that its repricing technology bridges the gap between payer and provider perspectives on claims pricing, thereby limiting confusion and contention. Further, Revelo aims to eliminate provider estimation in pricing for treatments. By repricing claims in real time, providers can see potential reimbursements before submitting claims. With these insights, ReveloHealth helps providers identify and avoid potential issues early in the process. 

Just before the pandemic, ReveloHealth began offering its repricing products after recognizing that the healthcare delivery system is plagued by high cost of collection for both providers and payers. At that time, it partnered with Cognizant to create its flagship product, Repricity. Cognizant is a global professional services company that provides information technology, consulting, and business process outsourcing services. Cognizant entered the healthcare RCM technology space by acquiring TriZetto.  

Trizetto is an end-to-end revenue cycle management provider that offers solutions covering the entire RCM process, from patient access and eligibility verification to claims processing, payment posting, and collections. TriZetto® QicLink™, TriZetto® ClaimsExchange^TM and TriZetto® NetworX Pricer®, all operate on Repricity repricing technology. 

Revelo Health Solutions

• Repricity™ - Revelo Health’s flagship product Repricity reprices claims according to current payer rate sheets and stipulations in real-time, a capability that sets them apart from many other contract management systems. 
• iCalibrate™ contract management - Inventory, assess, index, value, and manage the integrity of your managed care contracts in real-time. 
• eRCM™ -  while Revelo states it offers end-to-end revenue cycle operations, it really only handles the claims aspects of healthcare, from eligibility and EOB through payment posting. Through its partnerships with Trizetto, it offers key RCM tasks like eligibility checks, scheduling, charge capture and more that the large, end-to-end RCM companies like Experian, WayStar, and R1 RCM promote. 
• iStack delivers the claims and operations reporting in the areas of underpayment discovery, variances, and trends of financial and operational metrics. These reports focus closely on repricing actions. 
• OneCareCost™ generates the explanation of benefits and generates patient cost estimations. 

Overall, Revelo Health provides data and insights concerning any revenue task that involves repricing and adjudication.  

Ratings

ReveloHealth has yet to earn reviews on G2, Capterra, or Software Advice.  

List of top 5 ReveloHealth alternatives

• MD Clarity
• Aroris
• Tribunus Health
• Payr Health
• Symplr

A proven underpayment and contract management solution 

MD Clarity

Description

For over a decade, MD Clarity has been a leader in providing comprehensive revenue cycle management solutions, specializing in contract management and modeling, underpayment recovery. The company provides RCM for MSOs, provider groups, and medical practices across various specialties, helping them maximize revenue and reduce collection costs.

MD Clarity's mission centers on ensuring healthcare providers receive fair compensation from payers while offering patients transparent, good-faith estimates of their financial responsibilities. Their advanced contract management and marketing tool RevFind handles the most complex contracts from large systems that use all forms of contracts and payment methods over many locations, states, and specialties. Unlike most competitors, MD Clarity's team handles the entire contract uploading process, significantly reducing the administrative burden on healthcare staff.

Like ReveloHealth, RevFind automatically compares incoming payments against contracted terms to identify underpayments. This proactive approach can lead to substantial revenue recovery, potentially amounting to millions of dollars.

Complementing RevFind, MD Clarity's Clarity Flow automates the generation and distribution of patient payment estimates. This tool enhances patient satisfaction by providing accurate pricing information throughout the care journey. It also improves providers' financial health by increasing upfront collections and reducing accounts receivable and bad debt.

MD Clarity features in common with ReveloHealth

While MD Clarity and ReveloHealth products provide both contract management and monitoring, MD Clarity’s longstanding focus on the entire contract lifecycle has won its clients millions in underpayment restitution. It does not use a partner to carry out this important task. ReveloHealth’s RCM tools come through its partnerships with larger RCM entities, Trizetto and EXL. Both MD Clarity and ReveloHealth software provide contract analysis. 

Also, both MD Clarity and ReveloHealth primarily provide point solutions software  rather than pricey consultants that diminish revenue. Both build much contract management expertise into the software itself. Of course, both provide the customer service teams that onboard providers, facilitate implementation, and simplify continued use. 

Differences between MD Clarity and ReveloHealth

ReveloHealth’s close focus on repricing services means that their contract modeling and performance evaluation services are not as mature. MD Clarity’s RevFind has been purpose-built and tested for over 10 years to locate revenue opportunities in contracts with unfavorable terms or rates. RevFind has also developed advanced machine learning and AI features that ensure you can measure contract performance among payers, ranking them from top to bottom. These results help you take a strong stand during contract negotiations. 

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

At renewal time when proposed payer changes are coming in, RevFind’s contract modeling feature more accurately generates the revenue impact of the complex changes payers propose. 

You can model exactly how proposed payer changes will impact your revenue. Experiment with your own changes via unlimited scenarios. Take a quick tour of MD Clarity’s efficient contract modeling in action here: 

Ratings

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

G2 reviewers have given MD Clarity an average of 4.8 / 5 stars from 11 reviews.

A ReveloHealth competitor focused on denial prevention and management

Aroris

Description

Aroris Health aims to maximize healthcare providers' reimbursement rates through payer contract optimization. Their approach combines advanced data analytics with expert negotiation strategies to boost revenue by converting complex contract documents into user-friendly visual databases and uncovering opportunities for improved rates. Aroris caters to a wide range of healthcare specialties, including ambulatory surgery centers, primary care practices, behavioral health providers, health systems, specialty groups, and rural hospitals.

Aroris's platform offers a suite of features including digitized contracts, comprehensive dashboard reporting, and automated contract renewal notifications. They employ legal and contract experts to review healthcare contracts. 

 Aroris Health's key services are:

• Contract optimization: This service identifies lucrative payment opportunities within existing agreements and develops data-supported arguments for improved contracted rates. It also includes peer benchmarking to help providers set competitive, revenue-enhancing goals.
• Contract negotiation: Aroris employs seasoned healthcare industry negotiators who skillfully balance compromise and assertiveness to achieve optimal outcomes.
• Credentialing services: The company ensures that new providers meet rigorous compliance and quality standards, managing provider credentials through a combination of automated software and expert oversight.

 Features Aroris Health shares with ReveloHealth

Aroris Health and Revelo Health share some common features. Both use data analytics to inform the insights into healthcare revenue cycles and contract performance. Both digitize contracts for easier analysis. Aroris Health and ReveloHealth use their contract management modules to identify payer underpayments.

Differences between Aroris Health and ReveloHealth

The two companies’ service models and approaches differ. 

Aroris Health combines software solutions with expert consultants, offering hands-on services including direct negotiation with payers on behalf of healthcare providers. In contrast, ReveloHealth primarily offers software-based solutions, focusing on automated analytics and digital workflows.

ReveloHealth's approach is more technology-driven, emphasizing advanced solutions including real-time analytics and digital workflows. While Aroris Health offers contract negotiation services using their experts, Revelo Health focuses more on providing data and tools to support negotiations rather than conducting them directly. In essence, Aroris Health takes a more consultative approach with significant involvement of human experts, while ReveloHealth sticks with technology.

Ratings

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

A ReveloHealth competitor focused on health systems

Tribunus Health

Description

As with Aroris Health, Tribunus Health offers specialized payer contracting software solutions combined with expert consulting services. Their suite of services encompasses managed care contracting, reimbursement management, enrollment assistance, and advanced analytics. Tribunus Health caters to a diverse range of healthcare providers, including substance abuse treatment centers, specialist groups, rural hospitals, and private equity-backed physician groups.

As part of their service offerings, Tribunus Health conducts thorough contract analyses through comprehensive reviews. Additionally, they actively identify potential opportunities for providers to join new, potentially more profitable payer networks, thereby expanding their revenue streams and market presence.

Features Tribunus shares with ReveloHealth

Unlike ReveloHealth, Tribunus assigns its own experienced attorneys and other professionals to handle the contract negotiation if requested. Before negotiations begin, Tribunus experts work 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. As mentioned earlier, ReveloHealth is primarily a technology platform. 

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

Differences between Tribunus Health and ReveloHealth

ReveloHealth and Tribunus Health – while both focused closely on contract management – exhibit distinct differences. 

ReveloHealth specializes in claims repricing technology, primarily serving payers and third-party administrators (TPAs) with software-based solutions. These solutions emphasize automated analytics and digital workflows. 

ReveloHealth’s Repricity is narrowly focused on real-time analytics for claims repricing. In contrast, Tribunus Health offers a broader range of services, including managed care contracting, reimbursement management, enrollment assistance, and analytics. Tribunus targets healthcare providers such as substance abuse treatment centers, specialist groups, rural hospitals, and private equity-backed physician groups across all 50 states. 

Like Aroris, Tribunus Health's approach combines proprietary software with expert consulting services, offering a more hands-on methodology that includes active contract negotiation support. While ReveloHealth provides data and tools to support negotiations, Tribunus Health directly engages in contract negotiations using their expert consultants. 

Ratings

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

A ReveloHealth competitor focused closely on contracts

PayrHealth

Description

PayrHealth offers a comprehensive approach to payer contracting, blending software with expert consulting services, similar to competitors Tribunus and Aroris. Their suite of solutions encompasses thorough contract reviews, in-depth analysis of contract language and fee schedules, as well as strategic market assessments. This comprehensive strategy empowers healthcare providers to secure advantageous contract terms, maximize reimbursement rates, and maintain a competitive edge in the market.

The company's services cater to a diverse range of healthcare entities, including primary care and specialist physicians, behavioral health providers, hospitals, ambulatory surgery centers, and integrated delivery systems. PayrHealth's approach is scalable, allowing for newer or smaller healthcare providers to access resources and expertise typically reserved for large health systems.

PayrHealth offers:

• Thorough contract evaluation: Ensuring providers have optimal agreements with appropriate payers and products.
• In-depth contract language review: Negotiating contract terms to enhance claims processing and streamline authorization procedures.
• Detailed fee schedule examination: Conducting customized assessments based on the frequency and types of codes billed.
• Proactive reimbursement rate negotiations: Pursuing rate increases to keep pace with inflation and support future investments.
• Comprehensive market intelligence: Guiding providers through evolving market dynamics to capitalize on emerging opportunities.
• Strategic new payer plan negotiations: Establishing favorable baseline terms when entering into relationships with new payers.

Differences between PayrHealth and ReveloHealth

PayrHealth and ReveloHealth have distinct differences in their focus and approach. 

PayrHealth offers a comprehensive suite of services that includes payer contracting, revenue cycle management, and credentialing. They cater to a wide range of healthcare providers, from primary care physicians to integrated delivery systems, and serve both small and large practices. ReveloHealth targets payers and third-party administrators (TPAs) more heavily, while also working with providers.

 While PayrHealth provides complete payer management services, including contract negotiations and market analysis, ReveloHealth sticks to its Repricity claims repricing tool.

ReveloHealth’s partnerships with companies like EXL Health and Cognizant differentiate it from PayrHealth. In essence, PayrHealth offers a more comprehensive suite of services with a balance of technology and consulting, while ReveloHealth specializes in technology-driven solutions mostly for claims repricing and analytics.

Ratings

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

A ReveloHealth alternative that avoids negotiation

Symplr

Description

In addition to contract management, Symplr provides a comprehensive suite of solutions beyond it to encompass workforce and talent management, data management, and spend management. The company has developed pre-configured compliance workflows specifically tailored for healthcare contracting, ensuring alignment between providers' workforce and Symplr's software. 

By offering API-based third-party integrations, Symplr's platform scales from small clinics to large healthcare systems. The software's contract analytics capabilities are designed to identify and address potential issues in contracting and renewal processes, while also revealing opportunities for cost savings. 

To streamline contract creation, Symplr offers configurable templates and standardized terms. The system also includes renewal alert features to help providers stay on top of payer deadlines. User permissions and time tracking further enhance its contract management capabilities.

Features Symplr shares with ReveloHealth

Symplr and ReveloHealth share several key features in their healthcare contract management offerings, including:

• centralized contract storage
• analytics-driven insights
• a focus on regulatory compliance
• automated processes to streamline contract management. 

Both companies prioritize robust contract management and monitoring. 

Differences between Symplr and ReveloHealth

Symplr’s contract management tool, Symplr Contract, is its main offering. Still, Symplr’s healthcare operations solutions extend beyond that tool to include workforce management, data management, and spend management. Symplr’s target market is hospitals and health systems. In contrast, ReveloHealth specializes more narrowly in claims repricing for payers and third-party administrators serving payers.

Rating

Symplr Contract has earned a score of 3.6 / 5 on Capterra. 

How MD Clarity’s contract management & modeling solution optimizes your revenue

Hindered by a dire staffing shortage, healthcare organizations have neglected their contracts, leaving them open to payers’ inaccurate pricing. MGMA found that just 58% of providers review contracts yearly. Sixteen percent review only every two or three years, and 17% never review their contracts. 

Contract negligence leaves you open to declining revenue, as inflation is driving labor and supplies costs ever higher in an environment where provider reimbursements are declining, staying flat or barely inching up. A Boston Consulting Group article shares,

“To offset the double-digit cost jumps and structural economic challenges faced by health systems, the typical health system needs a rate increase of 5% to 8% each year across all payers to break even by 2027.” 

Healthcare organizations must evaluate contracts and insist on higher reimbursements and revenue-enhancing terms.

MD Clarity's RevFind plays a crucial role in ensuring accurate services pricing by automating contract management for practices, physician groups, and MSOs. The software meticulously analyzes each payment against contract terms, providing real-time alerts for any discrepancies. This enables staff to promptly appeal improper reimbursements with payers to maintain revenue integrity. 

RevFind's comprehensive approach includes digitizing and centralizing all agreements in one location, allowing for easy comparison of reimbursements by CPT code and provider location. It also incorporates Medicare benchmarks, offering an additional dimension for evaluating payer contract performance. Detailed analysis helps healthcare providers identify their best and worst payers, providing fuel for negotiations.  A feature that tracks payment trends over time also provides key insights for payer contracting.

The system's automated alerts for contract expiration, renewal, and exit dates ensure that providers never miss critical deadlines. Customizable notifications can be set 90 days in advance to initiate early negotiations. By generating automated reports and identifying systemic root causes of underpayments, RevFind empowers healthcare providers to not only correct current pricing discrepancies but also prevent future underpayments. This proactive approach to contract management and pricing accuracy helps healthcare organizations maximize their revenue and maintain fair, consistent pricing for their services. 

Schedule a demo to see how RevFind delivers accurate pricing in the most complex contracts and catches payer underpayments. Strengthen your contracts with payer contract performance analytics. 

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