As financial pressures mount on healthcare providers in 2025, AI-powered tools are increasingly critical to drive operational efficiency, streamline workflows and improve financial outcomes, according to Black Book Research.
The market research firm named the top vendors for 19 AI-powered revenue cycle management tools. Black Book ranked vendors based on factors such as accuracy in coding and claims processing, operational efficiency, financial impact through improved collections and reduced denials, user satisfaction, compliance, scalability, ease of integration, innovation and denial reduction effectiveness, according to a June 24 report.
1. RCM AI-enhanced coding
- Optum360
- Solventum
- Startups with the most potential to disrupt established vendors: Nina AI; Charta Health
2. Predictive contract management
- Change Healthcare
- Visiquate
- Startups with the most potential to disrupt established vendors: PayerFusion; Spotdoc
3. Physician documentation
- Microsoft Nuance
- Notable Health
- Startups with the most potential to disrupt established vendors: DeepScribe, ScribeAI
4. Autonomous prior authorization and medical necessity AI
- Waystar
- Cohere Health
- Startups with the most potential to disrupt established vendors: Humata Health; GenHealth.ai
5. Pre-bill documentation integrity and charge capture validations
- Change Healthcare
- Infinx Healthcare
- Startups with the most potential to disrupt established vendors: Claimocity; Vesta Health
6. Real-time benefits and payer rules interpretation
- Oracle Health
- Waystar
- Startups with the most potential to disrupt established vendors: PayerFusion; Spotdoc
7. Generative AI for appeal letters and communication
- iMedX
- RevSpring
- Startups with the most potential to disrupt established vendors: Appeal.ai; ClearClaim
8. Financial risk scoring and patient payment propensity
- ClosedLoop
- Sift Healthcare
- Startups with the most potential to disrupt established vendors: ImagineAI; Cedar
9. AI for coding complex genomic conditions
- Invitae
- Freenome
- Startups with the most potential to disrupt established vendors: Tempus; PathAI
10. AI-powered audit and compliance readiness
- Cotiviti
- Optum360
- Startups with the most potential to disrupt established vendors: AuditAI
11. Contract intelligence and payer rule extraction
- Visiquate
- AArete
- Startups with the most potential to disrupt established vendors: HiLabs; Icertis
12. Continuous learning AI models for denial pattern adaptation
- FinThrive
- Waystar
- Startups with the most potential to disrupt established vendors: Cedar; Claimocity
13. AI for patient financial literacy and education
- RevSpring
- Collectly
- Startups with the most potential to disrupt established vendors: PayZen; ClearGage
14. AI-driven denial adaptation
- Truvada
- Startups with the most potential to disrupt established vendors: Adonis; Agentic AI
15. Payer contract parsing and AI for benefit verification
- Axiom by Strata Decision Technology
- pVerify
- Startups with the most potential to disrupt established vendors: Infinitus; Aarogram
16. AI for predictive revenue forecasting
- Arcadia
- Health Catalyst
- Startups with the most potential to disrupt established vendors: Innovaccer; Luma Health
17. AI for resource and staff optimization
- Qventus
- Lightbeam Health Solutions
- Startups with the most potential to disrupt established vendors: TruBridge; Vianova Health
18. AI for risk adjustment and population health management
- Optum360
- Veradigm
- Startups with the most potential to disrupt established vendors: Innovaccer; Arcadia
19. AI for intelligent document processing
- Hyland Healthcare
- Kofax
- Startups with the most potential to disrupt established vendors: HyperScience; Ephesoft; Nanonets
Read the full report here.
