ARxChange

What ARxChange does

ARxChange (legal entity TriCap Technology Group, LLC) is a US-based healthcare financial technology company founded in 2005 by Joseph LaManna and Dr. James Zadoorian. The company has built ARxPRO, a cloud-based patient revenue optimization platform that uses its proprietary 'Patientnomics' methodology to deliver identity verification, insurance discovery, charity care and adaptive financial assistance, patient segmentation, probability-to-pay scoring, workflow optimization, and business intelligence to hospitals, health systems, and revenue cycle management firms. Core intellectual property is protected by three granted US patents (USPTO Nos. 7,949,597; 8,234,209; 8,442,903) covering processes for sorting, ranking, scoring, and valuing consumer receivables, including medical debt; the company also operates what is described as the nation's largest receivables marketplace with roughly $25 billion in listings and connects into more than 2,000 payor/clearinghouse databases for insurance discovery.

The business operates a hybrid B2B enterprise model. ARxPRO is delivered via multi-year subscription-style contracts with healthcare providers, complemented by performance-based fees tied to measurable outcomes such as incremental cash collections, insurance cash recovery, and revenue uplift. Distribution combines direct enterprise sales with embedded channel partnerships: ARxPRO is integrated into Deloitte's Patient Collections Intellect, Eisner Amper's EA-Collect, Navigant's patient analytics platform, and Payor Logic's verification stack, and is offered as a Preferred Partner through state hospital associations in South Carolina, Georgia, and Tennessee. In February 2022, ARxChange announced a partnership with Mastercard to jointly develop and commercialize the Healthcare Commerce Network, extending its footprint from back-office revenue cycle analytics into consumer-facing pricing, billing, and payments. Named customers include Deloitte, Eisner Amper, Navigant, New York Presbyterian, Mount Sinai Health System, HBCS, Payor Logic, and HSI Financial, with reported outcomes such as $3.9M in incremental collections, $7.9M in identified insurance payments, and roughly tripled liquidation rates at a major academic medical center.

The company is privately held with 1-10 employees, founder-controlled, and has not disclosed institutional funding. Revenue is not publicly reported.

Name

ARxChange

Legal name

TriCap Technology Group, LLC

Website

https://arxchange.com

Company type

Private

Founded year

2005

Operating status

Operating

Headcount range

1–10 employees

Short description

ARxChange is a US healthcare fintech that sells ARxPRO, a cloud-based patient revenue optimization platform using proprietary Patientnomics analytics, insurance discovery, and adaptive financial assistance to hospitals, health systems, and revenue cycle management firms, distributed through enterprise sales and consulting and hospital association channels.

Ownership category

akta.pro rank

Product category

Healthcare Revenue Cycle Management Software

NAICS

Software Publishers (5132), Computer Systems Design Services (541512)

SIC

Services-Computer Programming, Data Processing, Etc. (7370), Services-Computer Integrated Systems Design (7373)

akta.pro primary industry

Medication Pricing, Copay Assistance & Patient Financial Support Tools (HLACAKAN)

akta.pro secondary industries

Patient Engagement, Education & Messaging Platforms (portal/CRM integrated) (HLALABAJ), Identity, Fraud & Insurance-Specific RegTech Platforms (FSAGAGAJ), Document, Workflow & Policy Servicing Automation (RPA/No-Code) (FSAGAGAK), Healthcare Provider ERP (Hospital Operations, Supply Chain, Finance) (HDAEAEAH)

Keywords

• Healthcare revenue cycle
• Patient financial care
• Insurance discovery services
• Medical debt analytics
• Patient receivables management

Headquarters

HQ city

New York

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

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

Revenue model

1. ARxPRO Platform Subscription: Cloud-based analytics and business intelligence platform subscription for healthcare providers and revenue cycle firms. Delivers patient revenue optimization, identity verification, insurance discovery, charity care, patient financial care, business intelligence, and optimized workflow capabilities.
2. Performance-Based Revenue Services: Services tied to measurable outcomes such as incremental cash collection, insurance cash recovery, and revenue improvement metrics. Client testimonials reference millions in incremental collections.

Pricing tiers

Go-to-market motion1 record

Distribution channels4 records

Marketing channels5 records

Core offering

ARxChange sells ARxPRO, a cloud-based analytics and business intelligence platform for patient revenue optimization at healthcare providers and revenue cycle management firms. The platform delivers identity verification, insurance discovery (searching 2,000+ payor/clearinghouse databases), charity care and adaptive financial assistance determination, patient segmentation and personalized financial care, business intelligence dashboards, and optimized workflow management. The company also co-develops the Healthcare Commerce Network with Mastercard to package care and individualize price and payment options based on patient affordability.

Product overview

ARxChange offers ARxPRO, a cloud-based integrated analytics and business intelligence platform for patient revenue optimization. The platform consists of six core modules: Identity Verification & Management, Insurance Discovery & Verification, Charity Care & Adaptive Financial Assistance, Patient Financial Care, Business Intelligence, and Optimized Workflow. These modules work together to provide end-to-end patient financial care — from identity verification and insurance discovery at intake, through charity care determination and adaptive financial assistance, to patient stratification and payment optimization. The platform is powered by the company's 'Patientnomics' methodology and patented analytics (USPTO Nos. 7,949,597; 8,234,209; 8,442,903). Additionally, ARxChange developed the Healthcare Commerce Network in partnership with Mastercard as an online healthcare shopping platform.

Differentiator

Problem solved

Functional benefit

Products and services

• ARxPRO (ARxChange Patient Revenue Optimization) Cloud-based analytics and business intelligence system that discovers, designs, and delivers individually-tailored patient financial care to achieve the highest possible revenue and payment compliance for healthcare providers, revenue cycle firms, and patient finance/billing entities.
• Identity Verification & Management Verifies and enriches patient identities by corroborating and enhancing data with well-established highly-regulated external consumer databases, reducing resources needed to reconcile patient records and improving registration staff productivity through front-end automated processes; on average enhances patient identity and contact data by 55%.
• Insurance Discovery & Verification Insurance discovery and verification service that combines innovative technology with human intelligence to explore coverage options and sources for patients presenting as self-pay. Averages twice the number of queries per payor per account versus other vendors and identifies active coverage on upwards of 5% of pure self-pay balances, netting 1.5%-2% in insurance cash recovery on average.
• Charity Care & Adaptive Financial Assistance Calculates applicable charity classification with custom-tailored options for patients based on financial assistance parameters and affordability characteristics, mathematically aligning patient affordability limits with maximum caregiver revenue expectations. Identifies accounts meeting FAP criteria for automatic routing into specialized workflows.
• Patient Financial Care Intelligently groups patients based on shared payment characteristics and behaviors, applying personalized financial care strategies, workflows, and messages to different segments. Provides multidimensional visibility into patients' unique economic capacities and is backed by ARxChange's three USPTO patents covering the sorting, ranking, scoring, and valuing of consumer receivables.
• Business Intelligence Algorithms generate advanced productivity, operational, and financial data visualizations to monitor performance metrics in real time, blending data from multiple sources into a single view with customizable dashboards, drill-downs, ad-hoc KPI analysis, and metric alerting.
• Optimized Workflow Automatically devises optimal performance pathways that balance resources and mitigate revenue drift and financial risk, determining performance strengths, weaknesses, and opportunities across patient revenue workflow scenarios.
• Healthcare Commerce Network Online healthcare shopping platform developed in partnership with Mastercard that packages care and individualizes price and payment options based on patient affordability, combining ARxChange's analytics and adaptive financial assistance technology with Mastercard's billing and payments capabilities.

Quantifiable outcome

• Incremental cash collection of $3.9M over baseline in 2018 (Major Academic Medical Center)
• +5 more outcomes

Named customers8 records

Segments3 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability5 records

Feature5 records

Partnerships

Six partnerships are on record, tiered core and preferred partner.

• MastercardcoreStrategic or Co-development Partner · 3 February 2022Partnership announced February 3, 2022, marrying ARxChange core analytics and adaptive financial assistance technology with Mastercard's billing and payments acumen to offer personalized, flexible pricing and billing options tailored to each patient's financial circumstances. Jointly developing and commercializing ARxChange's Healthcare Commerce Network.
• Eisner AmpercoreStrategic or Co-development Partner · 1 May 2017Eisner Amper's EA-Collect patient payment revenue cycle management solution powered by ARxChange technology. Integration combines consulting services with ARxPRO technology to help hospitals and healthcare centers increase collections while reducing costs on patient responsibility balances.
• DeloittecoreStrategic or Co-development Partner · 22 March 2016Exclusive strategic alliance announced March 22, 2016, to deliver Patient Collections Intellect solution powered by ARxChange. Deloitte integrates ARxChange analytical platform with its operational and customer transformation capabilities to help healthcare providers improve net revenue and self-pay receivable collections. Described as leading the market for helping providers address self-pay challenges.
• Payor LogiccoreTechnology or IntegrationTechnology partnership combining ARxChange's patented analytics and market exchange technologies with Payor Logic's data mining techniques for real-time demographic verification, insurance verification, and insurance discovery. Delivers streamlined patient receivables solution through single point of access.
• South Carolina Hospital Association Solutionspreferred partnerChannel Partner/ Reseller/ DistributorARxChange is Preferred Partner through SCHA Solutions. Integrated solution suite including self-payment analytics driven by big-data science and investment-grade performance helps South Carolina healthcare providers improve net revenue and performance of self-pay receivables.
• Georgia Hospital Health ServicescoreChannel Partner/ Reseller/ DistributorInitiative with GHHS, shared services subsidiary of Georgia Hospital Association, to develop advanced data products that will revolutionize accounts receivable process and strengthen hospital financial performance. GHHS and ARxChange conducting webinar series for Georgia hospitals.

Scale indicators5 records

Recent moves6 records

Expansion highlights5 records

Emerging players

• HealthMark Group: Provider of release-of-information and patient financial care services including self-pay management and insurance discovery; competes for a similar hospital business office workload.
• AKASA: AI-driven revenue cycle automation for hospitals, addressing patient access, claims, and self-pay with machine learning; overlaps with ARxChange's predictive Patientnomics analytics on the same provider RCM buyer.
• Olive AI: Healthcare AI workflow automation company addressing revenue cycle, prior authorization, and patient access tasks; overlaps with ARxChange's optimized workflow and business intelligence modules.

Broad incumbents

• Optum (UnitedHealth Group) Revenue Cycle: Very large incumbent in healthcare RCM, including patient access, eligibility, and self-pay optimization across thousands of providers; competes indirectly as a bundled alternative to ARxPRO.
• Ciox Health: Health information management and clinical data exchange vendor with revenue cycle-adjacent capabilities; broadly comparable large incumbent serving health systems on patient data and billing workflows.

Direct peers

• Waystar: Enterprise revenue cycle management cloud platform serving hospitals with patient access, eligibility, and propensity-to-pay workflows; competes directly with ARxPRO's end-to-end patient financial care positioning.
• Availity: Health information network providing real-time insurance verification, coverage discovery and provider-payor data exchange; overlaps with ARxChange's insurance discovery and verification functionality.
• Experian Health: Direct competitor in patient identity verification, insurance discovery, and coverage search across thousands of payor databases; overlaps with ARxChange's Insurance Discovery and Identity Verification modules on the same hospital buyer profile.
• Cedar: Patient financial engagement and billing platform for hospitals delivering personalized payment plans and digital outreach; competes for the same patient financial experience budget that ARxChange targets with Patient Financial Care.
• Conifer Health Solutions: Tenet-owned hospital revenue cycle services and technology provider covering self-pay, bad debt, and charity care workflows; competes for the same hospital CFO/RCM buyer that ARxChange targets.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks5 records

Key highlights6 records

Customer concentration

• Xx.com/change_rx

Revenue estimate

Valuation estimate

Number of profiles

Profiles2 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 ARxChange