Choosing the right denial management software for your healthcare practice can significantly impact your revenue cycle. With payers tightening their policies and denials becoming more frequent, efficient denial management is not just a luxury—it's a necessity. Here's a look at some of the top software solutions available in 2025, what they offer, and how they perform in real-world settings.
AdvancedMD
AdvancedMD is a well-known player in the healthcare RCM space. Its denial management features are robust and highly automated. The software offers real-time eligibility checks, which can help reduce the occurrence of denials right from the start.
Features
AdvancedMD provides a comprehensive view of denied claims, allowing detailed tracking from submission to resolution. The system automatically flags claims at risk of denial and offers suggested solutions. Its detailed analytics can help practices identify patterns in denials—whether it be a specific payer or a common coding error.
Pricing
Pricing for AdvancedMD isn't openly advertised and generally requires a custom quote. Practices report that the cost is competitive for mid-size operations, often based on a percentage of collections.
Real-World Results
Practices using AdvancedMD have reported a reduction in their denial rates by up to 25% within the first year. Its eligibility checking feature alone can prevent up to 20% of common front-end denials.
Athenahealth
Athenahealth offers a cloud-based solution that integrates seamlessly with its broader EHR and practice management offerings. Its denial management capabilities are designed to fit naturally into the daily workflow of billing teams.
Features
Athenahealth's system includes an automated worklist for denials, real-time alerts, and a robust rules engine to preemptively address issues. Its user-friendly interface makes it easy to track appeals and resubmissions.
Pricing
Athenahealth's pricing model is typically subscription-based with additional fees for certain RCM services. Practices often negotiate these rates based on size and need.
Real-World Results
Users have praised Athenahealth for decreasing denial follow-up time by nearly 30%. The system’s automated reminders help ensure no claim slips through the cracks.
NextGen Healthcare
NextGen Healthcare has tailored its denial management software for all practice sizes, offering scalable solutions that grow alongside your organization.
Features
NextGen excels in predictive analytics. It uses machine learning to predict which claims are most likely to be denied and why. This insight allows practices to proactively address potential issues, saving time and resources.
Pricing
While NextGen's pricing isn't publicized, it generally aligns with industry standards for mid-size practice needs. The investment is often justified by the software’s ability to drastically reduce the administrative burden.
Real-World Results
Practices report a 40% improvement in denial resolution speed after adopting NextGen. Its predictive capabilities significantly cut down on denials that require extensive back-and-forth with payers.
Kareo
Kareo is an excellent choice for practices looking for a more straightforward, cost-effective denial management solution. It caters particularly to smaller practices but scales well for mid-size operations.
Features
Kareo's software offers denial resolution tracking, personalized follow-up workflows, and built-in appeal templates. The simplicity of its user interface is both a strength and a limitation—it’s less feature-rich but very easy to use.
Pricing
Kareo's pricing tends to be more transparent than competitors, with a fixed monthly fee that starts at a lower threshold. This makes it attractive for practices with tighter budgets.
Real-World Results
While not as comprehensive as others, Kareo users report a solid 15% reduction in denial rates, mainly thanks to its efficient follow-up workflows and user-friendly design.
Greenway Health
Greenway Health offers denial management tools designed to seamlessly integrate with its suite of practice management solutions, focusing on enhancing productivity.
Features
Key features include automatic denial categorization and advanced reporting tools that provide insights into denial trends over time. It also offers customizable appeal and resubmission workflows.
Pricing
Pricing details are typically available upon request, and they tend to offer tiered options depending on the size and complexity of the practice’s billing operations.
Real-World Results
Users of Greenway Health have observed a notable decrease in denial rates, with some practices reporting a drop by half within the first year. Its data-driven approach helps pinpoint chronic denial sources for strategic improvement.
Final Considerations
When selecting a denial management software, consider the specific needs of your practice. Do you need something deeply integrated with your existing systems, or are you looking for a standalone solution? Evaluate the level of automation you require and whether predictive analytics would make a significant difference in your operations.
Investing in the right software can transform your revenue cycle. It’s not just about reducing denials—it's about freeing up your staff to focus on what they do best: delivering excellent patient care. In 2025, the best denial management software is the one that aligns seamlessly with your practice’s workflow and financial goals, turning what was once a major headache into a smoothly managed process.
Related Articles
