Healthrise
Healthrise is a private U.S. healthcare technology and services firm that sells RCM outsourcing, EHR implementation, consulting, and proprietary AI-driven denial and workforce tools to 25+ health systems managing over $40B in revenue.
- Company typePrivate
- Founded2012
- HeadquartersFarmington Hills, United States
- Headcount101–250
- GTM typeB2B
- OfferingServices
What Healthrise does
Healthrise is a private, U.S.-based healthcare technology and services firm founded in 2012 and headquartered in Farmington Hills, Michigan. The company sells end-to-end revenue cycle management (RCM) outsourcing, EHR implementation and support services, strategic consulting, and proprietary AI-driven technology to more than 25 health systems nationwide, reportedly managing over $40B in client revenue and claiming a 5:1 ROI for partners. Its core technology stack is the Qodex platform, which underpins four product modules: Denials Navigator (with the newly launched Navigator AI layer for predictive denial prevention), Quality Audit + Productivity, Revenue Cycle Analytics, and Demand Workforce (a cloud-based nurse shift-matching application). The platform integrates with Epic, Cerner, and Meditech via FHIR APIs and supports AI capabilities including NLP-assisted coding, anomaly detection on denial patterns, and AI-powered claim scrubbing.
Healthrise operates a hybrid business model combining multi-year managed services contracts (AR Management, Extended Business Office, Global Solutions), professional services engagements (interim leadership, project delivery, advisory), and recurring technology subscriptions to its Qodex-powered tools. Go-to-market is exclusively direct enterprise field sales with custom scoping and quote-based pricing, supported by content marketing, HFMA and HIMSS event presence, and an active LinkedIn presence. The firm reports 500 employees (versus a 101-250 firmographic range) and over 400 EHR implementations, with leadership averaging 15-25+ years of healthcare RCM experience.
The company is recognized as a Top 10 performer in the 2025 Best in KLAS Software & Services Awards, holds multiple KLAS customer-rated badges, and reports a 100% partner recommendation rate. It completed a Type 1 HIPAA audit and maintains a HIPAA-compliant posture. No external funding rounds, acquisitions, or parent company ownership are disclosed in the available data, suggesting the firm is founder-led and self-funded.
Healthrise firmographics
Firmographics- Name
- Healthrise
- Legal name
- Healthrise
- Website
- https://healthrise.com
- Company type
- Private
- Founded year
- 2012
- Operating status
- Operating
- Headcount range
- 101–250 employees
- Short description
- Healthrise is a private U.S. healthcare technology and services firm that sells RCM outsourcing, EHR implementation, consulting, and proprietary AI-driven denial and workforce tools to 25+ health systems managing over $40B in revenue.
- Ownership category
- akta.pro rank
Healthrise industry classification
Industry- Product category
- Healthcare Revenue Cycle Management
- NAICS
- Software Publishers (5132)
- SIC
- Services-Health Services (8000)
- akta.pro primary industry
- Claims Management, Scrubbing & Clearinghouse (HLACACAB)
- akta.pro secondary industries
- Patient Access, Registration & Intake (Front-End RCM) (HLACACAE), Consent, Preference & Data Rights Management (incl. HIPAA/GDPR support) (HLACAIAG), Healthcare IT & Health Informatics Staffing (BPACADAK)
Keywords
Where Healthrise is headquartered
LocationHeadquarters
- HQ city
- Farmington Hills
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Healthrise business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure
Revenue model
- RCM Services: End-to-end Revenue Cycle Management outsourcing solutions including AR Management, Extended Business Office, and Global Solutions. Services are tailored to optimize healthcare operations from scheduling through collection, boosting financial performance.
- Consulting Services: Strategic consulting engagements including strategic advisory, interim leadership, project delivery, and data analytics. Provides hands-on support with focus on strategic advisory, interim leadership, project management.
- EHR Services: Credentialed IS resources and conversion expertise for EHR implementations. Services span from initial modeling and planning through implementation, stabilization, and optimization phases.
- Technology Solutions: Proprietary AI-driven technology tools including Denials Navigator, Quality Audit + Productivity, Revenue Cycle Analytics, and Demand Workforce. SaaS/platform-based technology offerings.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Multi-year contract | Custom enterprise solutions - pricing negotiated based on scope and complexity of engagement |
Go-to-market motion1 record
Distribution channels1 record
Marketing channels6 records
Healthrise product offering
Product offeringCore offering
Healthrise delivers end-to-end revenue cycle management outsourcing, EHR implementation and support, and strategic consulting services for U.S. health systems. Its proprietary AI-driven technology suite — Denials Navigator, Quality Audit + Productivity, Revenue Cycle Analytics, and Demand Workforce — is powered by the Qodex platform to prevent claim denials, audit productivity, and optimize clinical staffing.
Product overview
Healthrise offers a unified platform of proprietary AI-driven healthcare technology products complemented by professional services. The core technology suite, powered by Qodex, includes four integrated modules: Denials Navigator (with embedded Navigator AI for predictive denial prevention), Quality Audit + Productivity, Revenue Cycle Analytics, and Demand Workforce. These products work together to address revenue cycle challenges from denials management to workforce optimization. In addition to technology, Healthrise provides three service pillars: RCM Services (outsourcing), EHR Services (implementation and support), and Consulting Services (strategic advisory).
Differentiator
Problem solved
Functional benefit
Brands
- Qodex: Proprietary technology and analytics platform powering revenue cycle tools including Denials Navigator, Quality Audit + Productivity, Revenue Cycle Analytics, and Demand Workforce.
Products and services
- RCM Services End-to-end revenue cycle management outsourcing including AR Management, Extended Business Office, and Global Solutions that optimize healthcare operations from scheduling through collection for hospital and health system clients.
- EHR Services Credentialed IS resources and conversion expertise covering advisory services, implementation solutions, and post-go-live support for electronic health record systems such as Epic, Cerner, and Meditech.
- Consulting Services
Quantifiable outcome
- 5:1 ROI achieved for health system partners
- +5 more outcomes
Companies that use Healthrise
Customer profileNamed customers3 records
Segments2 records
Ideal customer profiles1 record
Healthrise technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
AI capability6 records
Feature5 records
Healthrise partnerships and signals
Strategic signalScale indicators8 records
Recent moves6 records
Expansion highlights6 records
Healthrise competitors and assessment
Company assessmentDirect peers
- Availity: Availity operates a healthcare information network and revenue cycle platform with strong positioning in claims management, eligibility, and denials, making it a direct peer in the digital health RCM space.
- R1 RCM: R1 RCM is a leading end-to-end revenue cycle management company serving large hospital systems, directly competing with Healthrise's RCM Services and Denials Navigator offerings. Both companies target enterprise health systems with a blend of managed services and proprietary technology.
- Waystar: Waystar provides a cloud-based revenue cycle technology platform covering claims management, denials, and patient access, closely aligned with Healthrise's Qodex platform and Denials Navigator. Waystar represents the pure-play software competitor in the same buyer category.
- FinThrive: FinThrive offers an end-to-end revenue cycle management platform spanning patient access, claims management, and denials, directly overlapping with Healthrise's RCM and Denials Navigator product lines. The company targets similar mid-to-large hospital and health system buyers.
- Cotiviti: Cotiviti delivers payment accuracy, risk adjustment, and revenue integrity solutions to health systems and payers, with overlapping claims management and denials prevention capabilities relevant to Healthrise's Denials Navigator product.
Broad incumbents
- Optum (UnitedHealth Group): Optum operates a massive healthcare services and technology portfolio including revenue cycle, analytics, and AI, and is the dominant scaled incumbent competing with Healthrise across RCM services, denials management, and health system IT staffing.
- Experian Health: Experian Health offers identity, patient access, and revenue cycle management solutions to hospitals and health systems, providing a broader incumbent alternative to Healthrise's integrated RCM and analytics suite.
Emerging players
- AKASA: AKASA applies AI to revenue cycle operations for health systems, focusing on automation of denials, claims, and patient access workflows; it overlaps with Healthrise's Navigator AI and Denials Navigator capabilities as an AI-native emerging competitor.
- Infinx: Infinx provides AI-driven patient access and revenue cycle solutions including prior authorization and denials management, competing with Healthrise in the technology-enabled RCM segment for hospitals and health systems.
- SmarterDx: SmarterDx applies AI to revenue integrity and clinical documentation improvement, intersecting with Healthrise's QA+P and Navigator AI capabilities as an emerging AI-driven competitor in hospital revenue cycle optimization.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
Healthrise social profiles
Digital presenceHealthrise compliance and trust
Trust signalCompliance1 record
Healthrise financial estimates
Financial estimateRevenue estimate
Valuation estimate
Healthrise leadership team
Management profileNumber of profiles
Profiles8 records
Healthrise funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Healthrise M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Healthrise
What does Healthrise do?
Healthrise delivers end-to-end revenue cycle management outsourcing, EHR implementation and support, and strategic consulting services for U.S. health systems. Its proprietary AI-driven technology suite — Denials Navigator, Quality Audit + Productivity, Revenue Cycle Analytics, and Demand Workforce — is powered by the Qodex platform to prevent claim denials, audit productivity, and optimize clinical staffing.
Is Healthrise a public or private company?
Healthrise is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was Healthrise founded?
Healthrise was founded in 2012. It employs 101 to 250 people.
Where is Healthrise based?
Healthrise is headquartered in Farmington Hills, United States, in the North America region.
How does Healthrise make money?
Four revenue lines are on record. RCM Services are the primary driver. The others are consulting Services, EHR Services and technology Solutions.
Who are Healthrise's main competitors?
Direct peers on record are Availity, R1 RCM, Waystar, FinThrive and Cotiviti. Broad incumbents are Optum (UnitedHealth Group) and Experian Health. Emerging players are AKASA, Infinx and SmarterDx.
Does Healthrise have an API?
No public API is recorded for Healthrise.
What industry is Healthrise in?
Healthrise's product category is Healthcare Revenue Cycle Management. Its primary akta.pro industry code is HLACACAB, Claims Management, Scrubbing & Clearinghouse, with a secondary code of HLACACAE, Patient Access, Registration & Intake (Front-End RCM). Its NAICS code is 5132 and its SIC code is 8000.