MD Clarity RCM

by MD Clarity
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OVERVIEW

Revenue optimization software for healthcare providers that automates payer underpayment detection, patient cost estimates, and contract optimization.

MD Clarity is a cloud-based revenue optimization platform designed to help healthcare provider groups accelerate cash flow and identify missed revenue opportunities. The platform's core mission is to make the healthcare payments experience easier and more transparent for everyone involved, addressing the information asymmetries that often favor insurance companies over patients and providers.

The software is composed of key modules:

  • RevFind: Automates the detection of variances between contracted rates and actual payer payments, helping to recover missed revenue and providing executive-friendly dashboards for net revenue opportunities.
  • Clarity Flow: Provides HIPAA-secure patient cost estimates, verifies eligibility in real-time, and enables upfront collections through a patient payment portal. It also adheres to transparency rules via No Surprises Act-compliant Good Faith Estimates (GFEs).
  • Contract Optimization: Allows providers to benchmark payer performance, model the revenue impact of proposed contract changes, and negotiate more effectively.
  • Denials Management: Helps identify, appeal, and analyze denial trends by payer, CPT code, and denial reason to streamline appeals processes and improve operational efficiency.

MD Clarity primarily serves provider groups, physician groups, and Managed Service Organizations (MSOs) across various specialties. It is used by finance and revenue cycle teams to reduce revenue leakage, minimize bad debt, and ensure fair payment from payers and patients.

RATING & STATS

User Rating
4.2/5.0
31 reviews
Customers
3,000+ facilities
Founded
2010

KEY FEATURES

  • Automated Payer Underpayment Detection (RevFind)
  • Patient Cost Estimates (Clarity Flow)
  • No Surprises Act (GFA) Compliance
  • Contract Benchmarking and Scenario Modeling
  • Real-time Eligibility Verification
  • Denials Management and Appeals Streamlining
  • Upfront Patient Collections and Payment Portal

PRICING

Model: subscription
Customized subscription based on organizational workflows and needs. Solutions are available à la carte. A single license covers unlimited users. Contact sales for a customized offer.

TECHNICAL DETAILS

Deployment: cloud, saas
Platforms: web, mobile
📱 Mobile Apps🔌 API Available

USE CASES

Revenue Cycle Acceleration and OptimizationCompliance with Healthcare Price Transparency RulesReducing Patient Bad DebtManaged Care Contract Negotiation and Optimization

INTEGRATIONS

EpicathenahealthModMedeClinicalWorksNextGenPM and EHR systems (via API/HL7/FHIR)

COMPLIANCE & SECURITY

Compliance:
HIPAANo Surprises Act (Good Faith Estimates)
Security Features:
  • 🔒HIPAA-Secure Estimates
  • 🔒Data Encryption

SUPPORT & IMPLEMENTATION

Support: email, phone, dedicated account manager, weekly liaison meetings
Target Company Size: small, medium, enterprise
TRAINING AVAILABLE

PROS & CONS

✓ Pros:
  • +Superior customer support and responsiveness.
  • +High accuracy in patient cost estimates and GFE compliance.
  • +Effective automation of payer underpayment detection (RevFind).
  • +Unlimited users on a single license.
  • +Automates manual work for estimates and appeals.
✗ Cons:
  • -Can be non-intuitive or difficult to learn initially.
  • -May not have all insurance plans/copays loaded in the system.
  • -Limited editing capabilities for some users.

ABOUT MD CLARITY

Other software by MD Clarity:
MD Clarity (Denials Management & AppealsDenials tracking and categorization)