What PMMC does

PMMC is a privately held, family-owned healthcare revenue cycle management (RCM) software and services company founded in 1986 by Roger Shaul Jr. and headquartered in Charlotte, North Carolina. The company serves more than 550 hospitals and health systems across 45 U.S. states, providing SaaS-based tools and professional services that address contract management, denial and underpayment recovery, chargemaster optimization, patient estimation, and price transparency compliance. Its core platform, Intelli+, sits on a proprietary calculation engine (Xact Engine™) and integrates RecoveryAI® for denial/underpayment pattern detection and predictive appeal scoring, and DocumentsAI™ for automated contract document ingestion and workflow. Supporting modules include Contract Management, Contract Models, Analytics+, Estimator+, Strategic Pricing+, Charge Capture+, Denial Management Software, MRF Files, and full-service Recovery+ and Compliance Services engagements. Reported technology performance metrics include 99.8% contract entry accuracy, 9.5% additional net revenue from payer contract modeling, a 16.7% lift in appeal success rates using RecoveryAI®, and an 8.6% reduction in 'lesser-of-charges' impact on net revenue. The platform processes over 20 structured and text data types and integrates with existing hospital systems for claim-level analysis.

Name

PMMC

Legal name

PMMC

Website

https://pmmconline.com

Company type

Private

Founded year

1986

Operating status

Operating

Headcount range

51–100 employees

Short description

PMMC is a family-owned healthcare revenue cycle management software and services company serving 550+ hospitals and health systems across 45 U.S. states. Its proprietary Xact Engine and AI modules automate payer contract modeling, denial appeals, and patient estimation for enterprise healthcare providers.

Ownership category

akta.pro rank

Product category

Healthcare Revenue Cycle Management Software

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Price Transparency, Estimates & Patient Financial Clearance (HLACACAK)

akta.pro secondary industries

RCM Outsourcing & Managed Billing Services (HLACACAN), Patient Billing, Statements & Payment Processing (HLACACAG)

Keywords

• Healthcare revenue cycle management
• Contract management software
• Denial management software
• Chargemaster management software
• Payer reimbursement analytics

Headquarters

HQ city

Charlotte

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

Personnel, Technology or R&D, Operations, Marketing or Sales, Infrastructure

Revenue model

1. Revenue Cycle Management Software and Services: PMMC generates revenue through a combination of SaaS software subscriptions and professional services for healthcare revenue cycle management. Their platform includes contract management, denial management, underpayment recovery, contract modeling, chargemaster solutions, and patient estimation tools. Services range from full outsourcing to targeted audits and consulting engagements.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels6 records

Core offering

PMMC sells a SaaS-based healthcare revenue cycle management platform that helps hospitals and physician groups manage payer contracts, identify and recover underpayments and denied claims, optimize chargemaster and pricing, and generate patient cost estimates. Its proprietary Xact Engine™ and AI modules (RecoveryAI®, DocumentsAI™) power contract modeling, denial analytics, and revenue optimization, complemented by professional services for denial recovery, underpayment collections, and compliance.

Product overview

PMMC offers a unified healthcare revenue cycle management platform built around its proprietary Xact Engine℠ and AI technologies. The core platform (Intelli+) integrates analytics, automation, and expert services across the revenue cycle. Key modules include Contract Management and Contract Models for payer negotiation support, Denial Management Software and Recovery+ services for claim resolution, CDM Solutions (with Strategic Pricing+ and Charge Capture+) for chargemaster optimization, and patient-facing Estimator+ tools for price transparency. The AI layer is powered by RecoveryAI® for denial/underpayment detection and pattern analysis. Analytics+ serves as the reporting backbone, while Compliance Services and MRF Files address regulatory requirements. The system captures and processes over 20 data types to deliver a claimed 99.8% accuracy rate.

Differentiator

Problem solved

Functional benefit

Products and services

• Xact Engine™ Proprietary AI-driven calculation engine for healthcare finance that analyzes performance through multiple data lenses and processes over 20 data types for industry-leading accuracy in revenue cycle calculations. Available to hospitals and health systems as the calculation layer of PMMC's RCM platform.
• RecoveryAI® AI-powered denial and underpayment management tool that identifies patterns in denied claims, predicts appeal success probability, automatically categorizes denials, and surfaces high-value recovery opportunities for hospital revenue cycle teams.
• Intelli+ RCM Platform AI-powered revenue cycle management platform that analyzes every claim against payer rules, automates routine tasks, integrates with existing systems, and provides configurable workflow optimization for hospital revenue cycle operations.
• Contract Management Software Comprehensive contract management solution with term-by-term data entry achieving 99.8% accuracy, enabling healthcare organizations to manage payer contracts, track compliance, and identify revenue leakage.
• Contract Models Financial modeling tool that simulates payer contract performance scenarios, forecasts reimbursement outcomes, and supports payer negotiations with data-driven insights and benchmarking capabilities for hospitals and health systems.
• Denial Management Software Denial tracking and resolution tool with advanced analytics and AI-driven features that identify denial trends, reduce claim rejections, and improve financial outcomes for hospital revenue cycle teams.
• Recovery+ Service Full-service denial and underpayment collections offering that identifies, analyzes, and recovers owed revenue through expert team intervention and appeals process management for hospitals and health systems.
• CDM Solutions Charge Description Master management suite including CDM modeling, automated charge capture, compliance updates, benchmarking reports, and strategic pricing tools for hospitals and physician practices.
• Charge Capture+ Automated charge capture solution that improves the accuracy of charge entries, reduces billing errors, and maximizes reimbursement opportunities for hospitals and physicians.
• Strategic Pricing+ Data-driven pricing audit solution that identifies revenue improvement opportunities, ensures pricing aligns with market benchmarks, and maintains competitive compliance for hospitals and physician practices.
• Estimator+ (Staff and Consumer) Automated patient estimation tools providing accurate upfront cost estimates based on payer contracts and historical billing data, improving point-of-service collections and patient satisfaction for hospitals.
• Analytics+ Real-time revenue cycle analytics platform providing customizable dashboards, detailed reporting, and insights into denial trends, payer performance, reimbursement rates, and operational metrics for hospital leadership.
• DocumentsAI™ Document management solution that automates document workflows, converts existing contract agreements into structured databases, and optimizes contract terms through AI-powered processing for healthcare organizations.
• Negotiated Rate Analytics Market intelligence tool providing actionable insights into payer reimbursement rates, benchmarking internal performance against competitors, and identifying critical discrepancies in contract terms for hospitals and health systems.
• Online Market Analytics Market intelligence tool providing actionable insights into pricing trends, reimbursement rates, and competitor strategies to support informed pricing decisions for hospital chargemaster management.
• MRF Files Machine-Readable Files solution ensuring compliance with price transparency requirements, providing accurate pricing data validation and CMS guideline alignment for hospitals.
• Compliance Services Regulatory compliance support for price transparency, No Surprises Act requirements, standard charge files, and CDM regulations, reducing audit risk and penalty exposure for hospitals and health systems.
• AI Revenue Cycle Management AI-driven revenue cycle solution leveraging analytics and automation to streamline workflows, reduce errors, and deliver real-time insights for improved efficiency and financial performance for hospitals.

Quantifiable outcome

• 9.5% additional net revenue from payer contract negotiations using PMMC Contract Models
• +4 more outcomes

Named customers7 records

Segments1 record

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability6 records

Feature8 records

Partnerships

Five partnerships are on record, tiered core and minor.

• PremiercoreChannel Partner/ Reseller/ DistributorPartnership with Premier healthcare GPO to provide revenue cycle management solutions to Premier member organizations, offering vetted partnership, clear accountability, and exclusive promotions.
• HFMA (Healthcare Financial Management Association)coreStrategic or Co-development PartnerHFMA Peer Review designation validates PMMC's commitment to industry standards, best practices, and ethical conduct in healthcare finance.
• University of North Carolina at CharlotteminorOthersPMMC supports undergraduate and graduate programs, with senior executives serving on advisory boards, demonstrating commitment to education and community engagement.
• University of FloridaminorOthersPMMC supports graduate and undergraduate programs, demonstrating commitment to education and social responsibility.
• Queens University in CharlotteminorOthersPMMC supports programs with senior executives serving on advisory boards, demonstrating commitment to education and community engagement.

Scale indicators8 records

Recent moves7 records

Expansion highlights5 records

Direct peers

• FinThrive: End-to-end RCM software platform specializing in revenue integrity, contract management, and denial/underpayment recovery — directly comparable to PMMC's denial management, contract modeling, and RecoveryAI offerings for hospital systems.
• Waystar: Large healthcare revenue cycle and claims management platform covering patient access, denial management, and analytics. Competes head-to-head with PMMC in hospital RCM software, including AI-driven workflow automation.
• Experian Health: Provides RCM, patient access, eligibility, and claims-management solutions to hospitals and physician groups. Overlaps with PMMC on patient estimates, identity management, and denial/pre-bill workflows.
• Availity: Healthcare clearinghouse and RCM platform serving payers and providers. Competes with PMMC in payer-provider data exchange, eligibility, and claims-management workflows used by hospitals.

Emerging players

• AKASA: AI-native RCM automation platform targeting hospital revenue cycle operations. Competes on machine-learning-driven denial automation and workflow efficiency, a similar strategic angle to PMMC's RecoveryAI.
• Cedar: Patient financial engagement platform focused on billing, estimates, and payment experience. Overlaps with PMMC's Estimator+ and patient-facing billing modules in consumer-style price transparency.
• Infinx: Healthcare revenue cycle technology and services company with strong AI/automation focus on prior authorization, denials, and underpayment recovery — a more focused overlap with PMMC's RecoveryAI workflow.

Broad incumbents

• R1 RCM: Large, scaled RCM technology and outsourcing platform serving hospitals and health systems. Competes with PMMC across both technology and managed-services layers of revenue cycle.
• Optum (Change Healthcare): Diversified healthcare technology and services business including claims management, RCM, and analytics. Represents the broadest incumbent competitor to PMMC's hospital-focused RCM software.
• Omega Healthcare: Large RCM outsourcing and managed-services provider for hospitals and physician groups. Adjacent to PMMC's Recovery+ and denial/underpayment services business on the services side.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

• Xx.com/pmmc_online
• Facebookfacebook.com/168705766499257
• LinkedInlinkedin.com/company/pmmc

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles3 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments1 record

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about PMMC