Resolv Healthcare

Name

Resolv Healthcare

Legal name

Resolv Healthcare

Website

https://resolvhealthcare.com

Company type

Private

Founded year

2022

Operating status

Operating

Headcount range

251–500 employees

Ownership category

akta.pro rank

Product category

Healthcare Revenue Cycle Management

NAICS

Computer Systems Design and Related Services (54151), Management Consulting Services (54161)

SIC

Services-Prepackaged Software (7372), Hospital & Medical Service Plans (6324)

akta.pro primary industry

Claims Management, Scrubbing & Clearinghouse (HLACACAB)

akta.pro secondary industries

Patient Billing, Statements & Payment Processing (HLACACAG), Provider Credentialing & Enrollment (Payer Contracting Ops) (HLACACAM)

Keywords

• Revenue cycle management
• Medical billing services
• Healthcare RCM
• Medical credentialing
• Claims management software

Headquarters

HQ city

West Warwick

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. RCM Services Revenue: Comprehensive revenue cycle management services including billing, coding, claims management, denial management, credentialing, and payer enrollment for healthcare organizations. Services are customized to practice type and delivered through high-touch service model.
2. Software Product Licenses/Subscriptions: Proprietary RCM software products including CareTracker, PrognoCis, SalientView, Conexem, CompData, and Practice View offered to healthcare providers. Products provide analytics, claims management, and practice management functionality.
3. Professional Services: Consulting services, workflow optimization, credentialing support, and implementation services for healthcare revenue cycle operations.

Pricing tiers

Go-to-market motion2 records

Distribution channels2 records

Marketing channels5 records

Core offering

Resolv Healthcare provides end-to-end revenue cycle management services — including billing, coding, claims management, denial management, credentialing, and payer enrollment — for ambulatory practices, hospitals, laboratories, dental practices/DSOs, and workers' compensation providers. The company complements these services with a portfolio of proprietary RCM software products (CareTracker, PrognoCis, SalientView, Conexem, CompData, and Practice View) and offers professional consulting, workflow optimization, and implementation services under multi-year, quote-based contracts.

Product overview

Resolv Healthcare is a Harris Revenue Cycle Business offering a unified suite of revenue cycle management (RCM) solutions across multiple healthcare segments. The product portfolio includes CareTracker, PrognoCis, and SalientView as core RCM brands, complemented by specialized products: CompData and Conexem for workers' compensation and personal injury claims management, and Practice View (integrated with Open Dental) for dental practice revenue cycle management. The company serves ambulatory practices, hospitals and hospital-based providers, laboratory services, dental practices and DSOs, and workers' comp and personal injury providers.

Differentiator

Problem solved

Functional benefit

Brands

• CareTracker: Healthcare revenue cycle management product
• PrognoCis
• SalientView
• Conexem
• CompData
• Practice View + Open Dental

Products and services

• CareTracker CareTracker is a Resolv Healthcare revenue cycle management product for healthcare providers, offering RCM functionality tailored to provider workflows.
• PrognoCis PrognoCis is a Resolv Healthcare revenue cycle management product for healthcare providers, providing RCM functionality as part of the company's vertical software portfolio.
• SalientView SalientView is a Resolv Healthcare revenue cycle management product for healthcare providers, providing RCM functionality across the company's product portfolio.
• Conexem Conexem is workers' compensation and personal injury billing and claims management software that helps medical practices manage injury-based cases with specialized reporting requirements and legal case integration. It is used by more than 200 medical providers in California for hospital, outpatient surgery center, and provider RCM including legal representation.
• CompData CompData is workers' comp case resolution software with the industry's only fully integrated EAMS and EDEX search, enabling 75% faster claims search and verification. Since 1987, CompData has helped hospitals with lien recovery and has electronically filed more than 2 million liens and other documents.
• Practice View + Open Dental Practice View is a web-based dental practice management and revenue cycle dashboard that integrates seamlessly with Open Dental, a HIPAA-compliant open-source dental practice management software. It provides practice analytics, patient accounts management, FPC funding details, claims list with timely filing deadline tracking, comprehensive reporting, patient eTools, and secure off-site data backups for dental practices and DSOs.
• Revenue Cycle Management Services Comprehensive managed RCM services including billing, coding, claims management, denial management, credentialing, and payer enrollment for ambulatory practices, hospitals, laboratories, dental practices/DSOs, and workers' compensation and personal injury providers. Services are customized to practice type and delivered through a high-touch service model.
• Medical Credentialing and Payer Enrollment Services Credentialing support, payer enrollment, workflow optimization, consulting, and implementation services for healthcare revenue cycle operations, with documented 1-5% revenue lift from credentialing improvements.

Quantifiable outcome

• 1-5% revenue lift from credentialing improvements
• +4 more outcomes

Named customers2 records

Segments5 records

Ideal customer profiles5 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration1 record

Feature6 records

Scale indicators5 records

Recent moves7 records

Expansion highlights5 records

Direct peers

• Availity: Healthcare information network providing eligibility, claims and prior authorization solutions. Competes with Resolv in payer-provider data exchange and revenue cycle workflow software.
• Waystar: Cloud-based healthcare RCM software platform spanning claims management, patient billing and payments. Competes with Resolv's CareTracker/PrognoCis/SalientView products across the same hospital and ambulatory verticals.
• Coronis Health: Mid-market healthcare RCM services and technology provider serving ambulatory, hospital and specialty practices. Closely comparable scale and vertical mix to Resolv, often competing for similar mid-market RCM contracts.
• Revecore: Specialist in complex claims RCM, including workers' compensation and motor vehicle accident cases. The closest direct comparable to Resolv's Conexem and CompData products within California workers' comp and PI niches.
• EnableComp: Specialized workers' compensation and complex claims RCM provider for hospitals and health systems. Directly comparable to CompData/Conexem in the workers' comp and complex claims subsegment Resolv targets.
• R1 RCM: Largest publicly-traded pure-play healthcare RCM services and software provider. Directly comparable to Resolv in serving hospitals and ambulatory providers with end-to-end revenue cycle solutions, but at materially larger scale.

Broad incumbents

• Optum (UnitedHealth Group): Diversified healthcare services and technology giant with a significant RCM and payment integrity franchise. Competes with Resolv across enterprise hospital RCM, but as one capability within a much broader payer-provider-services portfolio.
• athenahealth: Cloud-based EHR and practice management vendor with a bundled RCM services offering. Targets many of the same ambulatory and group provider customers Resolv serves, often competing on integrated workflow.
• Experian Health: Healthcare-focused division of Experian offering eligibility, claims management, patient billing and identity products. Overlaps with Resolv's RCM software stack, especially in patient access and billing workflows.
• NextGen Healthcare: EHR/PM and RCM vendor serving ambulatory practices and specialty groups. Competes directly with Resolv's ambulatory and group provider solutions through bundled software-plus-services offerings.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/ResolvHC
• Facebookfacebook.com/ResolvHealthcare
• LinkedInlinkedin.com/company/resolv-healthcare

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles10 records

Subsidiaries5 records

Funding overview

Funding rounds

Investors

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

M&A

Investments

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

Frequently asked questions about Resolv Healthcare