Top 30 Best Healthcare Denial Management Software Systems
As insurers examine medical claims more closely, healthcare denial management software is becoming essential. These solutions support healthcare providers in enforcing appeal protocols, automating tracking, analyzing denial trends, and minimizing revenue loss. Organizations may improve revenue integrity, raise clean claim rates, and restore control over payment schedules with more intelligent denial automation. The landscape now offers a combination of enterprise-grade suites and agile provider-focused technologies, regardless of whether you’re a hospital, billing service, or specialized practice. This guide presents the Top 30 healthcare denial management software systems, offering detailed feature breakdowns, pricing info, pros/cons, expert commentary, and demo video links to help you make an informed decision.
Top 30 Best Healthcare Denial Management Software Systems
1. Waystar
Waystar automates denial identification, workflow triage, and analytics across the revenue cycle. Ideal for hospitals, health systems, and physician groups.
Key Features – Real‑time denials alerts, automated workflow assignments, analytics dashboards, payer benchmarking
Pros and Cons – Pros: End‑to‑end denial capture, strong reporting. Cons: Can be complex to set up in smaller practices.
Detailed Pricing – Subscription-based pricing via quote; demo available.
Expert Commentary – “Waystar reduces denial cycle time and gives teams clear visibility—they reclaim revenue they never knew they were losing.” – Sarah Liu, Revenue Cycle Director
Demo Video – Watch Waystar Denials Management demo
2. Availity Denials Manager
Availity’s solution centralizes denial monitoring and appeals across payers through a unified portal. Best for community hospitals and ambulatory networks.
Key Features – Claim scrubbing, payer-specific remittances, denial tracking, appeal automation
Pros and Cons – Pros: Integrated with Availity platform, payer coverage. Cons: Most effective only if already using Availity.
Detailed Pricing – Included with Availity membership; demo available.
Expert Commentary – “By embedding denial workflows into Availity’s claims flow, organizations get faster triage and more successful appeals.” – Mike Evans, Billing Operations Manager
Demo Video – Watch Availity Denials Manager demo
3. Olive AI
Olive uses AI to detect denials, automate appeal letters, and surface denial root causes. Ideal for health systems and revenue cycle teams looking to scale.
Key Features – AI-powered denial detection, auto-appeal generation, insight dashboards, payer performance tracking
Pros and Cons – Pros: Reduces manual workload significantly. Cons: May require data integration and initial tuning.
Detailed Pricing – Enterprise pricing; demo available.
Expert Commentary – “Olive takes years of denial expertise and embeds it into attentive AI—denials are caught proactively rather than reactively.” – Dr. Keisha Brown, RCM Analytics Lead
Demo Video – Watch Olive AI Denial Management demo
4. Change Healthcare Denial Management
Part of Change Healthcare’s broader RCM suite, this tool offers proactive denial insights and automated follow-up workflows. Best for medium to large providers.
Key Features – Denial carousel, root-cause analytics, workflow automation, payer benchmarking
Pros and Cons – Pros: Deep payer dataset, integrated with revenue tools. Cons: Requires Change Healthcare RCM environment.
Detailed Pricing – Quote-based; demo available.
Expert Commentary – “By merging payer data with internal workflows, Change cuts denial turnaround and boosts financial performance.” – Laura Chen, Revenue Integrity Manager
Demo Video – Watch Change Healthcare Denial Management demo
5. Trizetto Facets Denial Management
Built into TriZetto Facets Payer platform, this outbound denial module helps payers and payers-adjacent teams manage appeals at scale. Best for payers.
Key Features – Denial reason code analysis, automated appeal workflows, member education tracking
Pros and Cons – Pros: Aligned to payer-side operations. Cons: Not suited for provider-based use.
Detailed Pricing – Pricing via Cognizant sales; demo available.
Expert Commentary – “Facets’ denial toolkit helps payers ensure regulatory and contractual appeals are automated and tracked.” – Alex Grant, Health Plan Operations Lead
Demo Video – Watch TriZetto Facets Denial Management demo
6. Epic Resolute Denials
Epic’s integrated denial management module works within the Resolute billing system. Ideal for large hospital networks using Epic EHR.
Key Features – Claim-level denial tracking, automated tasks, denial reporting, payer-specific configuration
Pros and Cons – Pros: Works natively with Epic workflow. Cons: Only available to Epic users.
Detailed Pricing – Included in Epic license; implementation via Epic.
Expert Commentary – “Embedding denial prevention directly into Epic workflows ensures clinicians and coders catch issues before they hit.” – Heather Mills, Epic Revenue Workflow Specialist
Demo Video – Watch Epic Resolute Denials demo
7. R1 RCM™ Denials
R1 provides both software and managed services to reduce and appeal healthcare denials. Best for health systems seeking blended solutions.
Key Features – Denial analytics, appeal submission oversight, staff augmentation, root-cause dashboards
Pros and Cons – Pros: Service/software combo increases denial resolution. Cons: Less software autonomy; service fees apply.
Detailed Pricing – Custom service/software pricing; demo available.
Expert Commentary – “R1 brings the human and digital together—ideal for teams needing implementation support.” – Kevin Ortiz, VP Revenue Strategy
Demo Video – Watch R1 Denials Management demo
8. PatientKeeper Denial Manager
A standalone denial tracking system that complements existing billing workflows. Ideal for mid-size institutions lacking integrated denial tools.
Key Features – Denial tracking dashboard, appeal letter generation, denial follow-up assignments, reporting tools
Pros and Cons – Pros: Easy to adopt, fast deployment. Cons: Needs integration with EHR/billing systems.
Detailed Pricing – License-based pricing; demo available.
Expert Commentary – “PatientKeeper’s denial manager is a straightforward, no-frills tool that delivers fast ROI.” – Alison Park, Clinical Billing Supervisor
Demo Video – Watch PatientKeeper Denial Manager demo
9. eMDs Denial Guard
Denial Guard is part of the eMDs suite, helping physician practices proactively monitor denials in real time. Best for ambulatory providers.
Key Features – Live denial alerts, payer rules engine, appeal templates, denial analytics
Pros and Cons – Pros: Real-time monitoring, built-in appeal templates. Cons: Limited to practices on eMDs.
Detailed Pricing – Tiered pricing based on practice size; demo available.
Expert Commentary – “eMDs Denial Guard empowers practices with preemptive controls—reducing loss before it happens.” – Sarah Jenkins, Practice Management Consultant
Demo Video – Watch eMDs Denial Guard demo
10. McKesson Denials Defense
McKesson’s Denials Defense automates denial categorization, appeals, and reporting within its pharmacy and supply chain RCM modules. Best for health systems.
Key Features – Denial classification engine, appeal tracking, reporting dashboards, payer comparative analytics
Pros and Cons – Pros: Integrates with McKesson systems, pharmacy-focused. Cons: Best-suited for McKesson customers.
Detailed Pricing – Subscription pricing; demo upon request.
Expert Commentary – “Pharmacy and supply chain teams benefit from Denials Defense by seeing trends and avoiding future write-offs.” – Laura Thompson, Pharmacy Revenue Manager
Demo Video – Watch McKesson Denials Defense demo
11. Kareo Billing Denial Management
Kareo provides denial tracking tools built into its billing platform, perfect for independent practices and billing services.
Key Features – Real-time denial alerts, smart billing rules, appeal management, claim re-submission tracking
Pros and Cons – Pros: User-friendly, made for small practices. Cons: Limited scalability for enterprise needs.
Detailed Pricing – Subscription pricing starts at $125/month per provider; demo available.
Expert Commentary – “Kareo makes denial tracking manageable for small practices who need fast visibility and clean claims.” – Jamie Hall, Medical Billing Trainer
Demo Video – Watch Kareo Denial Management demo
12. eClinicalWorks Denial Management
Integrated into eCW’s RCM and billing solution, this module automates claim denial analysis and appeals within ambulatory EHR systems.
Key Features – Denial automation, customizable rules, reporting dashboards, appeals tracking
Pros and Cons – Pros: Embedded into the eCW ecosystem. Cons: Not suitable for non-eCW users.
Detailed Pricing – Custom pricing per provider; demo available.
Expert Commentary – “For eCW users, this denial management module streamlines appeals and simplifies workflows.” – Dr. Nina Kaur, Practice Systems Analyst
Demo Video – Watch eClinicalWorks Denial Management demo
13. PracticeSuite Denial Manager
A denial resolution platform offering smart alerts and appeal tracking for small to mid-size practices.
Key Features – Automated alerts, denial categorization, appeal letter generation, denial analytics
Pros and Cons – Pros: Affordable, simple interface. Cons: Basic analytics compared to competitors.
Detailed Pricing – Starts at $95/month per user; demo available.
Expert Commentary – “PracticeSuite gives smaller practices a fighting chance to fight back on denied claims with a clear, simple interface.” – Caleb Ortiz, Medical Biller
Demo Video – Watch PracticeSuite Denial Manager demo
14. NextGen Denial Management
Integrated with NextGen’s practice management software, this module monitors and reduces claim denials with smart rules.
Key Features – Denial reporting, payer analysis, claims edits, real-time rejections handling
Pros and Cons – Pros: Seamless with NextGen systems. Cons: Limited third-party integration.
Detailed Pricing – Pricing on request; demo available.
Expert Commentary – “With NextGen, you don’t just see denials—you get context and solutions fast.” – Angela Rivera, RCM Implementation Consultant
Demo Video – Watch NextGen Denial Management demo
15. Athenahealth Denials Workflow
Athenahealth offers a cloud-based denial resolution workflow built into its RCM platform. Best for ambulatory clinics and specialty practices.
Key Features – Denial resolution paths, automation, appeal tasking, denial categorization
Pros and Cons – Pros: Cloud-native, efficient task routing. Cons: Only for Athenahealth users.
Detailed Pricing – Percentage-of-collections model; demo available.
Expert Commentary – “Athenahealth’s approach is workflow-centric—denials get addressed by the right staff at the right time.” – Lindsey Browne, Billing Systems Supervisor
Demo Video – Watch Athenahealth Denial Workflow demo
16. Azalea Health Denial Insights
Azalea’s denial insights module provides claims edit checks, payer rules, and appeals support within its RCM suite.
Key Features – Rejection analysis, smart rules, visual dashboards, appeals queue
Pros and Cons – Pros: Tailored for rural health clinics and small hospitals. Cons: Smaller feature set than larger competitors.
Detailed Pricing – Subscription pricing by provider volume; demo available.
Expert Commentary – “Azalea helps rural health providers avoid common payer traps with clear and visual denial guidance.” – Roger Finley, RCM Advisor
Demo Video – Watch Azalea Denial Management demo
17. CollaborateMD Denial Tracking
A web-based medical billing platform offering denial tracking and resolution built into claims workflows.
Key Features – Denial alerts, claims tracking, claim correction tools, real-time billing insights
Pros and Cons – Pros: Lightweight, browser-based. Cons: Fewer automation features.
Detailed Pricing – Starts at $185/month per user; demo available.
Expert Commentary – “CollaborateMD keeps denials in check with clean, actionable claim history tracking.” – Diane Moore, Insurance Billing Lead
Demo Video – Watch CollaborateMD Denial Tracking demo
18. AdvancedMD Denial Manager
Denial management tools built into AdvancedMD’s billing suite offer automation and batch appeal capabilities.
Key Features – Denial detection engine, bulk appeal generation, payer-specific rules, denial code mapping
Pros and Cons – Pros: Seamless billing integration, strong rules engine. Cons: Learning curve for new users.
Detailed Pricing – Bundled with RCM suite; starts around $300/month; demo available.
Expert Commentary – “AdvancedMD tackles denials head-on with built-in rules and smart batch appeal workflows.” – Taylor Vance, Practice Tech Consultant
Demo Video – Watch AdvancedMD Denial Manager demo
19. Greenway Health Denial Manager
Integrated denial tracking and resolution features built into the Greenway Intergy platform for ambulatory providers.
Key Features – Claim edit tracking, denial trend analysis, appeal automation, payer guidelines mapping
Pros and Cons – Pros: Well-suited for outpatient practices. Cons: Requires use of Greenway ecosystem.
Detailed Pricing – Custom pricing model; demo available.
Expert Commentary – “Greenway offers an intuitive denial solution that blends seamlessly into practice workflows.” – Dr. Brian Charles, Medical Director
Demo Video – Watch Greenway Health Denial Manager demo
20. DocuTAP (Experity) Denial Solutions
Focused on urgent care centers, DocuTAP by Experity offers denial tracking tools that prevent revenue leakage.
Key Features – Rejection resolution, coding assistance, billing workflow integration, urgent care rule sets
Pros and Cons – Pros: Designed for urgent care. Cons: Less flexibility for other settings.
Detailed Pricing – Subscription pricing; demo on request.
Expert Commentary – “For urgent care centers, DocuTAP ensures billing doesn’t become a blind spot—denials are flagged before claims are even submitted.” – Dr. Melissa Knowles, Urgent Care Business Manager
Demo Video – Watch DocuTAP Denial Management demo
21. Experian Health ClaimSource Denial Manager
Experian’s ClaimSource offers a denial prevention and management engine built for hospitals and health systems.
Key Features – Denial insights, denial forecasting, real-time alerts, payer-specific resolution support
Pros and Cons – Pros: Strong analytics and early warning tools. Cons: Premium pricing; setup may require IT support.
Detailed Pricing – Quote-based; demo available on request.
Expert Commentary – “Experian helps providers act on denials before they even happen. Predictive intelligence is its biggest weapon.” – George Davis, Revenue Optimization Consultant
Demo Video – Watch Experian ClaimSource Denial demo
22. ZirMed Denial Management (now Waystar)
Now part of Waystar, ZirMed’s denial analytics engine supports root-cause correction and automated resubmissions.
Key Features – Root-cause denial engine, payer rules mapping, automatic resubmission, denial heatmaps
Pros and Cons – Pros: Data-rich and fast processing. Cons: Advanced features best for medium to large organizations.
Detailed Pricing – Subscription pricing via Waystar; demo available.
Expert Commentary – “ZirMed, now Waystar, is denial prevention meets denial recovery—both sides handled with power.” – Lisa Tran, Healthcare Revenue Manager
Demo Video – Watch ZirMed Denial demo
23. HFMA MAP App
HFMA’s MAP App helps organizations measure performance and denial management efficiency using industry standards.
Key Features – KPI dashboard, denial performance metrics, benchmarking tools, MAP scorecards
Pros and Cons – Pros: Standardized insights, great for performance reviews. Cons: Focuses on metrics, not direct denial resolution.
Detailed Pricing – Free for HFMA members; licensed for organizations.
Expert Commentary – “The MAP App gives CFOs and revenue leaders a birds-eye view of denial performance in the context of national benchmarks.” – Dr. Olivia Simmons, Healthcare Finance Strategist
Demo Video – Watch HFMA MAP App demo
24. Promantra Denial Management Services
A service-based platform offering end-to-end denial tracking, appeals, and root-cause analysis tailored for medical billing firms.
Key Features – Manual denial follow-up, appeals handling, denial categorization, reporting dashboards
Pros and Cons – Pros: Outsourced denial support with human oversight. Cons: Not a software product; service dependent.
Detailed Pricing – Service-based pricing; consultation required.
Expert Commentary – “Promantra’s human-led model works well for practices lacking internal staff for denial tracking.” – Benjamin Carter, Billing Workflow Consultant
Demo Video – Watch Promantra Denial Services demo
25. QRS Denial Management
QRS offers a denial tracking module within its revenue cycle suite, tailored for specialty practices and smaller hospitals.
Key Features – Denial alerts, claim correction, trend dashboards, appeals status tracking
Pros and Cons – Pros: Affordable, practice-focused. Cons: May lack enterprise-level automation.
Detailed Pricing – Pricing varies by provider size; demo available.
Expert Commentary – “QRS simplifies the denial resolution cycle so smaller practices can focus on accuracy and speed.” – Theresa Lane, Small Practice Consultant
Demo Video – Watch QRS Denial Management demo
26. ClaimRemedi Denial Manager
A cloud-based claim editing and denial management platform ideal for medical billing companies and group practices.
Key Features – Rejection detection, denial edits, real-time claims analytics, workflow queues
Pros and Cons – Pros: Affordable, responsive support. Cons: Fewer integrations with larger EHRs.
Detailed Pricing – Starts at $99/month; custom quotes available.
Expert Commentary – “ClaimRemedi is a sharp tool for billing services that want accuracy and real-time visibility into claims.” – Dr. Henry Mendez, Practice Revenue Director
Demo Video – Watch ClaimRemedi demo
27. MedEvolve Denial Manager
MedEvolve offers denial tracking and staff productivity tools designed to identify and resolve revenue leakage.
Key Features – Work effort tracking, denial categorization, AR visibility, claim prioritization
Pros and Cons – Pros: Ties staff actions to denials resolved. Cons: Most useful when integrated with MedEvolve RCM suite.
Detailed Pricing – Custom quotes per user; demo available.
Expert Commentary – “MedEvolve empowers denial teams by showing who resolved what, and how fast—closing performance gaps.” – Naomi Foster, Healthcare Finance Analyst
Demo Video – Watch MedEvolve Denial Manager demo
28. RemitDATA Denial Insights
Offers payer-level denial benchmarking and analytics to uncover systemic revenue cycle issues.
Key Features – Payer performance insights, denial type segmentation, custom dashboards, claim trend reports
Pros and Cons – Pros: In-depth denial forensics. Cons: Not a denial workflow tool—analytics only.
Detailed Pricing – Available through revenue cycle partners; demo available.
Expert Commentary – “RemitDATA exposes denial blind spots and payer inefficiencies others overlook.” – Eric Thomas, Healthcare Analytics Strategist
Demo Video – Watch RemitDATA Denial demo
29. CloudMed Denial Recovery
CloudMed specializes in revenue integrity and denial recovery services using a mix of AI and human auditing.
Key Features – Denial audit, underpayment detection, appeal generation, predictive revenue recovery
Pros and Cons – Pros: High-recovery rates, AI-assisted auditing. Cons: Requires partnership model.
Detailed Pricing – Service-based model; recovery percentage pricing.
Expert Commentary – “CloudMed recovers revenue many systems miss by blending automation with forensic denial audits.” – Dr. Miranda Evers, Hospital Revenue Director
Demo Video – Watch CloudMed Denial Recovery demo
30. Vee Technologies Denial Management
A global RCM services company offering denial management, AR follow-up, and appeals across specialties.
Key Features – AR analytics, root-cause mapping, appeals handling, follow-up workflow tools
Pros and Cons – Pros: Global service scale, multilingual support. Cons: Service-based, not software.
Detailed Pricing – Contract-based pricing depending on provider volume.
Expert Commentary – “Vee Technologies supports providers with scalable denial management staffing, backed by data-driven insight.” – Daniel Rhodes, Medical Billing Outsourcing Lead
Demo Video – Watch Vee Technologies Denial Management demo
Conclusion
Effective denial management is now essential due to tighter payer requirements and increasing claim complexity. These top 30 denial management solutions range from comprehensive RCM suites and AI-powered systems to analytics dashboards and recovery services run by humans. There is a technology to fit your workflow and budget, whether you are a health system trying to automate denials from start to finish or a solo practice trying to streamline appeals. Examine each platform’s demo, learn about its integration capabilities, and choose whether software, services, or a hybrid is best for your company’s objectives.