Revenue cycle management software automates and optimizes physician group workflows. It detects underpayments, verifies patients' eligibility for health benefits, and creates and sends patient payment estimates. By automating these processes, healthcare organizations across the United States have successfully improved net revenue, streamlined workflows, and reduced administrative staff workload.
A recent competitor among revenue cycle solution providers, HealthMe helps physician groups accept self-pay patients by providing a convenient payment platform and automating the good faith estimates (GFEs) the No Surprises Act now mandates for this population. Because – unlike most RCM companies – HealthMe doesn’t offer a suite of solutions, your research into RCM software partners should include these alternatives. You want to ensure your RCM partner can scale with you as your physician group grows.
What Is HealthMe and how does it optimize provider revenue cycle?
Founded in 2016, HealthMe is one of the first online platforms serving only self-pay patients and the specialty physician groups that accept their cash payments. Billing itself as an online marketplace for transparent and reasonably-priced healthcare, HealthMe ensures speciality physician groups can accept patients looking for high-value care outside of (or in addition to) their insurance plans.
Using this platform, patients can compare prices of the self-pay healthcare packages offered by specialty providers in their area. Once patients fill in a few fields, HealthMe emails them all specialty physician groups that are part of their system, along with those providers’ prices for their services.
With direct access to specialty care, patients bypass the need for referrals or involvement by insurance. This level of accessibility allows patients more control over their healthcare decisions.
As all HealthMe patients are self-pay, they receive good faith estimates. While staff can generate a GFE with HealthMe’s encrypted, HIPAA-compliant system, patients can also generate their own GFE online if they choose.
HealthMe facilitates self-pay patient payments
HealthMe maintains that it supports physician group revenue and patient volume by funneling in patients who either are not insured or prefer to get care outside of their insurance plan.
Streamlining direct-pay processes helps to simplify administrative tasks, reduce inefficiencies, and increase practice revenue. It offers physician groups fairly priced, bundled healthcare packages that its research indicates patients will pay for outside of insurance. To ensure legislative compliance and adequate demand, their client service team builds these packages around current state requirements as well as market conditions.
With payments running through the HealthMe system rather than insurance, payments become available in the practice bank account via ACH within 72 hours with no paperwork needed. Physician groups collect all payments pre-service.
HealthMe has some limitations that physician groups should be aware of. First, providers must utilize the custom health packages HealthMe has created. Healthcare organizations and physicians cannot create their own. Then, providers are obligated to provide all the services delineated within the pre-set HealthMe service packages. These packages include the common diagnoses patients receive and treatment plans that each specialty typically provides. They list all prices involved so patients face no surprises. While they cannot pick unique diagnostics or treatments, providers are free to price their packages as they see fit.
Keep in mind, too, that HealthMe does not accept Medicare patients.
Packages typically involve the doctor’s visit and diagnosis, along with basic diagnostic testing like labs, EKG, x-rays. Ancillary services like MRIs, physical therapy and outpatient surgical procedures are also available.
List of 8 Top HealthMe Alternatives
- MD Clarity
- Health Here
- Change Healthcare
- R1 RCM
An RCM solution with deep experience in good faith estimates and net revenue recovery
One of the first revenue cycle management companies, MD Clarity’s mission is to use advanced technology to provide healthcare price 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.
MD Clarity features in common with HealthMe
MD Clarity and HealthMe both offer the secure, HIPAA-compliant good faith estimates the No Surprises Act mandates for self-pay patients.
Synergizing the data from patient files and digitized payer contracts, MD Clarity’s Clarity Flow verifies eligibility, generates patient estimates, and auto-sends these estimates to the patient. Patients have the option to use a SmartPay platform or the embedded link in the estimate to send in a deposit or prepay the entire estimated bill. With cash on the line, patients are reluctant to miss appointments.
At this time, HealthMe does not have the capability to auto-send estimates to patients.
During implementation, the physician group staff works together with the MD Clarity customer success team to create estimate letter template text based on individual provider preferences.
Often, it takes several letter templates with varying text, each based on patient needs, diagnoses, and treatments, to cover the entire patient base. Estimates are sent automatically according to user-defined parameters set up during implementation. These patient cost estimates can also include information about financing options like CareCredit or financial counseling, demonstrating the group’s willingness to work with patients of all budgets. All estimates comply with the No Surprises Act.
MD Clarity features in addition to HealthMe
Contract Analytics: Both HealthMe and MD Clarity house uploaded and digitized payer contracts that they use to verify eligibility and create GFEs.
Unlike HealthMe, however, MD Clarity’s solutions also analyze payer contract performance to help you determine your best and worst payers so you can renegotiate for better terms. It also models how payer-proposed contract changes can impact cash flow should a payer ask for a change in terms. Rather than simply accepting the change, you can simulate the impact it will have on your net revenue. Because running this analysis takes just minutes, it’s more likely you will take this step and reject or modify a payer’s proposed (and often unfavorable) changes. HealthMe does not offer contract analytics at this time.
RevFind: Focused on improving physician group net revenue, MD Clarity has created RevFind, a tool that compares all payments to payer contract terms and alerts staff to discrepancies. Underpayments are a common and often undiscovered source of additional net revenue for physician groups and healthcare organizations. Automating underpayment discovery can start the process of sweeping in millions in net revenue without over-taxing your staff. RevFind also helps ensure your team has your chargemaster set optimally. Through its work queues feature, it assigns appeals and investigations to staff automatically so users can review task statuses in one place. HealthMe has not created an underpayments solution at this time.
MD Clarity has earned an average of 4.7 / 5 stars on G2. HealthMe has not yet accrued enough reviews to publish ratings.
A HealthMe competitor that serves high-value provider networks
HealthHere specializes in providing high-value or “value-based” healthcare organizations’ automated patient access and revenue cycle services. Their solutions include building and automating episodic payment models (bundled payments), enabling convenient patient payments, providing flexible payment options, reducing patient wait times, enhancing patient engagement, and relieving staff burden.
Their software suite includes:
- Flow - patient intake: mobile check-in and in-clinic kiosks & tablets that automate intake, relieve front-desk bottlenecks, and provide patients convenience and cost transparency.
- Q Code - patient cost estimates: pre-service and good faith estimate generation.
- Qub - an episodic payments system: build and automate episodic payment models, allowing to price, publish, and automate your payment procedures.
- Pay - patient payments: Healthhere.com enables convenient patient payment options, integrating these from pre-check to post-procedure.
- Pro - patient-reported outcomes: this solution collects patient-reported outcomes, providing additional data beyond mere financial measures and supporting with high-value provider network values goals.
These services ease operations at busy, value-based care physician groups.
Solutions HealthMe shares with HealthHere
Both HealthMe and HealthHere offer all pre-service estimates including the good faith estimates mandated by the No Surprises Act for self-pay patients. The differences are significant, however.
HealthMe focuses on building payment bridges between patients who prefer to self-pay and providers who need the structure to accept these payments. It doesn’t offer the suite of services HealthHere offers to speed patient intake, create estimates or offer payment options.
Neither HealthMe nor HealthHere have accrued enough reviews to publish ratings.
A HealthMe competitor offering full RCM services
An end-to-end revenue cycle management solution, TriZetto serves hospitals, health systems, and payers. Its software for provider side automates prior authorizations, eligibility verifications, contract management, billing, coding and more.
Features TriZetto shares with HealthMe
Like HealthMe, TriZetto assures providers that they can complete their good faith and other pre-service estimates with their tools. A software company, TriZetto does not act as a marketplace for providers and self-pay patients the way HealthMe does.
Trizetto does offer patient cost estimates which it calls Patient Responsibility Estimations. They claim their estimates communicate payment expectations and increase patient payment which in turn decreases bad debt.
TriZetto has an average rating of 4.3/5 stars on G2. HealthMe has not yet accrued enough reviews to publish ratings.
An API-forward HealthMe competitor
Change Healthcare / Optum
Change Healthcare had been a prominent player in the healthcare industry for more than a decade when United Healthcare acquired it in 2022, merging it with its subsidiary, Optum. Change Healthcare offers a comprehensive suite of revenue cycle management (RCM) solutions. It targets a wide range of markets including hospitals, physician groups, and healthcare systems. Its solutions include:
- data-driven RCM analytics help providers identify trends, pinpoint areas of improvement, and make informed decisions to enhance revenue generation and streamline operations.
- self-service clearinghouses which facilitate efficient claims processing
- payment accuracy solutions which help healthcare providers ensure accurate reimbursement for services
Change Healthcare / Optum Features Shared with HealthMe
Change and HealthMe both offer good faith estimates for self-pay or uninsured patients.
Change Healthcare and Optum both have scores of 3.7/5 stars on G2.
A HealthMe alternative known for outsourced revenue cycle management
Initially established as Accretive Health, this revenue cycle solution company re-branded as R1 RCM in 2017. A leading RCM company based in Salt Lake City, Utah, R1 RCM is serves hospitals and healthcare systems.
Differences between HealthMe and R1 RCM solutions:
- End-to-End Revenue Cycle Software and Services: While HealthMe offers the only a self-pay-patient and provider marketplace and good faith estimate automation, R1 combines its software with a digital workforce that partners with provider staff to carry out nearly revenue cycle tasks. R1 leverages robotic process automation (RPA) and machine learning (ML) to find and correct revenue leakage and staff errors, as well as reduce days in A/R, denials, and underpayments. R1 RCM uses AI-powered analytics solutions to identify and resolve payment-related issues in real-time.
- Patient Experience: While HealthMe’s primary physician group solution is good faith estimates and other patient cost estimates, R1’s EntriPay does not include pay estimates. R1’s patient experience tool bundles registration, intake, clearance, scheduling, and payment into one.
- Claim Management: R1 brings experienced coders as well as software to claims projects. HealthMe Offers no coding services.
R1 RCM has just one score of 0/5 stars on G2.
A HealthMe alternative that provides outsourced RCM consulting
An end-to-end revenue cycle management company founded in 2013, TruBridge serves rural and community hospitals. It provides software solutions that help these organizations manage their revenue cycle, coding and compliance, and patient engagement.
TruBridge's flagship product is its revenue cycle management software which provides real-time data analysis and revenue cycle performance tools. This software provides critical revenue cycle insights, optimizes billing, and relieves staff workloads.
TruBridge also offers:
- Claim Scrubbing and Submission: identifies claim errors and alerts staff to them.
- Denial and Audit Management: hunts and flags denied and audited claims so the organization gets paid faster, increases productivity, and minimizes tedious tasks.
- Contract Management: helps you recover underpayments and stay current with contract changes.
Features similar to those of HealthMe
While TruBridge’s solutions aim to improve overall operations for large hospitals and healthcare systems, HealthMe only provides good faith and patient cost estimates for providers accepting self-pay patients.
TruBridge good faith estimate tool Patient Liability Estimates tool ensures patients avoid surprise bills. Like all estimate software, PLEs help physicians improve cash flow, reduce no-shows, and avoid the write-offs that degrade EBITDA integrity.
TruBridge has a rating of 3.4/5 on G2.
A HealthMe alternative that specializes in behavioral health centers
Founded in 2009, AZZLY is based in Orlando, Florida. The company offers a comprehensive, revenue cycle management cloud-based solution combined with an EHR for behavioral health and addiction treatment providers. It synergizes revenue cycle management, practice management, and electronic health records so that behavioral health centers can focus on providing care.
AZZLY offers a “dual” system that combines EHR with RCM for ease of use.
AZZLY and HealthMe share these features:
Because HealthMe’s primary goal is helping physician groups and healthcare organizations accept self-pay patients, their patient cost and good faith estimate solution is completely built out.
Azzly’s patient pay estimate page, under “patient engagement,” is not built out, stating “more info coming soon!” It may have a solution ready to go should interested prospects ask.
Azzly has 3.9/5 stars on Capterra.
A HealthMe alternative for dental practices
Founded in 1985, Dentrix Dental Systems was acquired by dental and medical supplier Henry Schein in 1997. Dentrix is the first practice management system for Windows (1989) and the first to win approval for Windows 98. Dentrix’s long track record of helping dentists streamline operations and optimize revenues has made it a popular option in the dental industry.
Unlike the other HealthMe competitors, Dentrix’s client base is solely dental practices. Dentists find value in Dentrix’s capability to connect financial and clinical data and insights into one workflow.
Dentrix’s solutions include:
- Billing and collection tools: engineered to speed payment collection, manage debit and credit card payments, collect payments faster, and create and send billing statements. These features also help you track patient eligibility and insurance claims.
- Clinical tools: dentists appreciate that they can access their many 2D and 3D images within the tool. A centralized hub also houses all patient information, giving dentists have the flexibility to store, record, and view data.
Explore MD Clarity’s revenue improvement solutions yourself
If you need a proven patient cost or good faith estimate solution like HealthMe that can share a proven performance history, consider MD Clarity. Providing revenue cycle management software since 2010, we offer far more revenue capture solutions than providers than like HealthMe. Dedicated to healthcare transparency, MD Clarity's products ensure patients get the price transparency they want and you get the improved net revenue you need. Our products automate patient cost estimates, contract optimization, and payer underpayment detection. MD Clarity's Clarity Flow, Contract Analytics, and RevFind provide more opportunities for net revenue improvement than simple patient pay estimate facilitation.
Interested in seeing firsthand how MD Clarity stacks against HealthMe? Book a personalized demo today.