The nation’s healthcare leaders constantly repeat that revenue cycle management (RCM) is essential for medical providers today, particularly those struggling to improve cash flow and control soaring operating expenses. RCM oversees and orchestrates a portion of the end-to-end administrative operations associated with eligibility verification, patient estimates, claims submission, coding, collections, and reimbursement. By automating menial, repetitive tasks, an RCM system relieves staff workload.
In addition to assisting staff in getting administrative tasks completed, the analysis revenue cycle management performs pinpoints workflow and coding errors that lead to denials and delayed care.
What Is R1 RCM?
R1 RCM is one of the largest RCM software options in the United States, serving hospitals, physician groups, and healthcare systems (but not payers).
R1 offers end-to-end revenue cycle solutions with the aim of easing patient financial services from the point of eligibility and scheduling to billing and collections. For the exceptions that arise, R1’s software is backed by a digital workforce that works together with provider staff. 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. It also leverages AI-powered analytics solutions to identify and resolve payment-related issues.
Specifically, their revenue integrity programs include:
- Chargemaster Optimization - pinpoints where compliance can be improved.
- Charge Capture - finds missing charges and incorrect coding
- Contract Management - detects underpayments, notifies staff of contract updates
- Contract modeling - models how changes to contracts and charges impact revenue
- HIM Coding Review - scans for proper CPT and HCPCS codes and DRGs
- Transfer DRG Review - evaluates transfer-eligible accounts for missing reimbursements.
- Payment Variance Analysis - Finds underpayments and denied accounts. Conducts appeals processes to recoup that revenue.
- Strategic Pricing - scrutinizes chargemaster, payer contracts, and competitor pricing to establish provider prices.
Their end-to-end revenue cycle programs include:
- Patient Access - scheduling, registration, clearance, intake, and payment functionality
- Patient Friendly Billing - online bill pay, automated payment plans, and omnichannel customer service.
- Denial Management and Prevention - pinpointing and rectifying root causes of chronic errors that lead to denials.
- Intelligent Automation - automation to speed and support administrative workflows like prior authorizations, patient estimates, eligibility verification, scheduling, charge capture, accounts receivable recovery, and more.
- Workflow optimization - using software and a digital workforce to support front, middle and back-end operations.
- Performance Improvement - using metrics and analytics to examine revenue cycle health.
Their Entri™ patient access product integrates with provider EHRs and ushers patients into the patient access process by streamlining scheduling, patient estimates, registration, clearance, intake, and payment.
The company claims to have reduced operating costs by 20%, improved revenues up to 5%, and fueled a 40% increase in patient satisfaction.
While R1 has a roster of large clients, it may or may not serve your needs ideally.
Best R1 RCM Ratings
Customer reviews provide potential buyers with insights into product quality, customer service, and additional details that help readers understand how appropriate the product or service is for them. Anyone can access these R1 RCM reviews:
KLAS collects and aggregates reviews from clients of over 150 healthcare software and services companies. Rather than relying on a handful of interviews with clients, KLAS compiles a complete client list for every product and calls thousands of these healthcare executives to explore their experiences with the product. It compiles its findings in its vendor ratings which are free to all online. It also reaches out to user groups and conducts thorough internet searches before publishing its ratings.
KLAS also publishes The Best in KLAS report, which recognizes the top healthcare software and services companies in dozens of categories. These rankings derive from the feedback of thousands of providers during the year. Healthcare software and services companies proudly showcase their Best in KLAS awards on their websites.
On KLAS, R1 scored 80.1 / 100 overall in services and 82.4 / 100 overall for its software. To compare, competitor Change Healthcare earned a 78.9 overall performance score for services and a 92.4 overall performance score for its software. Similarly, competitor Athenahealth earned an 81.3 overall performance score for services and an 84.2 overall performance score for its software.
This year, R1 has also won three KLAS awards:
Specifics behind the ratings are only available with a KLAS subscription.
Worst R1 RCM Client Reviews
The only R1 RCM review on G2 is negative. G2 states, “There are not enough reviews of R1 RCM for G2 to provide buying insight.” This review objects to a lack of control over the system and information and the difficulty of manually moving accounts from one workflow to another.
There are no R1 RCM reviews on Capterra, GetApp, TrustRadius, or SoftwareAdvice review sites.
Employee Reviews of R1 RCM
Review sites can be tricky for two reasons. First, negative experiences with products can prompt more people to take the time to leave reviews. Positive experiences often go unreviewed. Also, consider that reviews can sometimes be cultivated by marketing departments. Still, they offer valuable insights into products.
Employee reviews offer another dimension of a company. They can reveal company treatment of employees and even customers. A negative review of company leadership can be a warning sign. See what employees posted about R1 on several platforms.
Employees left 2,064 reviews on Glassdoor, giving the company an average rating of 3.7 out of 5. While 73% of reviewers approve of the CEO, just 57% would recommend working at R1 to a friend.
On the positive side, reviewers often mention substantial pay and benefits, as well as opportunities for travel and advancement. They appreciate the flexibility of working from home some days and the attention to work / life balance. Most mention a supportive environment where co-workers are helpful.
At the same time, many comments indicate a disorganized company with a goal to outsource as much work as possible to other countries. There were many comments about management failing to communicate and lead effectively. Some reviewers did not feel supported by their HR departments and mentioned that breaks were insufficient.
Indeed.com reviewers left 839 reviews, rating the company an average of 2.8 out of 5. Overall, R1 scored 63 on overall “work wellbeing,” a number Indeed considers “low.”
As with Glassdoor reviewers, Indeed reviewers split over whether the work environment was supportive or isolative. Many appreciated the opportunity to work from home and the unlimited PTO, but others felt overworked without recognition. Where some claim it’s an “awesome place to work,” others feel disconnected from their teammates. Comments about management not communicating effectively with employees and flushing all the work out to cheaper labor in other countries also appear.
Positive R1 RCM Employee Reviews
The best employee R1 RCM reviews mention the exciting growth the company is undergoing. This growth has clearly provided career opportunities for some, most of whom appreciate working remotely. They also mention working with driven, interesting colleagues on supportive teams, although negative comments about management disorganization abound.
R1 also provides unlimited PTO to employees who’ve been there past a certain period. This flexibility allows for a better work / life balance.
Negative R1 RCM Reviews From Employees
Again, R1 employees find management makes their job stressful and difficult. The worst review cites a lack of training followed by criticism for not understanding the job. There’s also repeated instances stating management had little respect for employees.
Outsourcing jobs to India is another sore spot for employees. Apparently, some get hired on only to be told their job was outsourced. A sense that an employee could be replaced at any time – often by a foreign worker – dominates the atmosphere.
Looking for an R1 Alternative?
MD Clarity is a cloud-based revenue cycle management software that offers similar features to R1 RCM. It enhances the patient experience by providing accurate good faith estimates and insurance eligibility verification – the transparency today’s patients demand – and the No Surprises Act mandates in some cases. With automated patient estimate workflows, you can accurately project out-of-pocket expenses, send estimates automatically, and collect patient payments. The estimates provide patients with the option to choose from various payment plans and submit payments directly. MD Clarity simplifies coverage and payments for patients, resulting in a better patient experience that aligns with the No Surprises Act.
MD Clarity also utilizes deep analytics to monitor contract performance, identify payer underpayment trends, and compare performance across contracts. These valuable insights empower you to negotiate better terms and improve revenue. Choose MD Clarity for a more profitable bottom line, faster payments, and practice compliance. Request a demo today.