MEDCOM
MedCom Solutions provides proprietary SaaS-based Chargemaster management and revenue cycle analytics software, augmented by consulting services, for U.S. hospitals, health systems, ambulatory surgery centers, and physician practices.
- Company typePrivate
- Founded1986
- HeadquartersPittsburgh, United States
- Headcount11–50
- GTM typeB2B
- OfferingSoftware
What MEDCOM does
MedCom Solutions is a privately held healthcare technology and consulting firm founded in 1986 and headquartered in Pittsburgh, Pennsylvania. The company sells a proprietary software-plus-services stack targeting U.S. hospitals, multi-hospital health systems, ambulatory surgery centers (ASCs), and physician practices. Its flagship is CMNavigator® SaaS — a Chargemaster (CDM) management and charge-capture platform protected by U.S. Patent Numbers 7,565,300 and 7,761,410 — which was rebuilt as a cloud-native SaaS application in 2022. The platform is extended by MPNavigator® SaaS (market pricing analytics using Medicare-reported data), RANavigator® SaaS (835 payment and denial analytics rendered through Tableau dashboards), the patent-pending C3Navigator® clinical-charge connectivity module, CMNavigator-CDM (AI-powered charge descriptor monitoring), and the newly launched CMNavigator-OR surgical theater charge acuity system.
The technology is hosted on Amazon Web Services with Expedient Data Center providing managed cloud services, cybersecurity, and disaster recovery, and integrates with Epic, Cerner, Allscripts, Meditech, and CPSI EHR systems. Embedded AI capabilities include coding intelligence for CPT/HCPCS validation, anomaly detection on charge descriptors, and predictive analytics for revenue forecasting. MedCom monetizes through annual or multi-year SaaS subscriptions sold via consultative direct enterprise sales to CFOs, Revenue Cycle Directors, and hospital leadership, plus project-based consulting engagements including Comprehensive Chargemaster Review, Strategic Pricing Review, Order Entry Review, Surgical Charge Analysis, Supply Charge Review, Payor Contract Analytics & Negotiations, and Price Transparency Support. The company reports a 93% client retention rate, a stated minimum ROI of 300% on Chargemaster Review engagements, and named outcomes such as a $2.3M net revenue impact for Kaleida Health and cash-on-hand improvement from 4 to 48 days at Chan Soon-Shiong Medical Center at Windber. No funding rounds, institutional ownership, or M&A activity are disclosed in the available data.
MEDCOM firmographics
Firmographics- Name
- MEDCOM
- Legal name
- MedCom Solutions, Inc.
- Website
- https://medcomsolutions.com
- Company type
- Private
- Founded year
- 1986
- Operating status
- Operating
- Headcount range
- 11–50 employees
- Short description
- MedCom Solutions provides proprietary SaaS-based Chargemaster management and revenue cycle analytics software, augmented by consulting services, for U.S. hospitals, health systems, ambulatory surgery centers, and physician practices.
- Ownership category
- akta.pro rank
Where MEDCOM is headquartered
LocationHeadquarters
- HQ city
- Pittsburgh
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
MEDCOM business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Personnel, Technology or R&D, Operations, Marketing or Sales, Infrastructure
Revenue model
- SaaS Software Subscriptions: MedCom generates revenue through proprietary Software-as-a-Service (SaaS) solutions including CMNavigator® SaaS, MPNavigator® SaaS, and RANavigator® SaaS. These subscription-based platforms provide Chargemaster management, pricing analytics, and payment analytics. Pricing is consultative and quote-based, typically sold on an annual or multi-year contract basis.
- Professional Consulting Services: Revenue from consulting engagements including Comprehensive Chargemaster Reviews, Surgical Charge Analysis, Strategic Pricing Reviews, Order Entry Reviews, Payor Contract Analytics, and Price Transparency Support. Services are sold as project-based or ongoing retainer engagements, typically targeting healthcare organizations seeking revenue cycle optimization.
- System Conversion Services: CDM (ChargeMaster) conversion services for hospitals undergoing IT/EHR system transitions (Epic, Cerner, Allscripts, Meditech, CPSI). Includes parallel conversion, direct cutover, and phased approach methodologies with implementation support.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Annual | SaaS Software Solutions (CMNavigator®, MPNavigator®, RANavigator®) |
| Other | Multi-year contract | Comprehensive Chargemaster Review |
| Other | Multi-year contract | Payor Contract Analytics & Negotiations |
| Other | Multi-year contract | Strategic Pricing Review |
Go-to-market motion1 record
Distribution channels1 record
Marketing channels9 records
MEDCOM product offering
Product offeringCore offering
MedCom Solutions sells proprietary Software-as-a-Service platforms and professional consulting services that help U.S. hospitals, health systems, ambulatory surgery centers, and physician practices capture accurate charges, manage their Chargemaster (CDM), optimize surgical and supply pricing, and analyze 835 payment and denial data to recover revenue. Its flagship CMNavigator® SaaS, complemented by MPNavigator®, RANavigator®, and the patent-pending C3Navigator®, is sold alongside project-based consulting engagements including Comprehensive Chargemaster Review, Strategic Pricing Review, Surgical Charge Analysis, and System Conversion Services.
Product overview
MedCom Solutions offers a unified platform-plus-modules product portfolio centered on healthcare revenue cycle management and Chargemaster (CDM) optimization. The core platform is CMNavigator® SaaS, a proprietary Software-as-a-Service solution for Chargemaster management and charge capture, protected by U.S. Patent Numbers 7,565,300 and 7,761,410. This platform is augmented by complementary SaaS products including MPNavigator® SaaS for market pricing analytics and RANavigator® SaaS for 835 Payment & Denial Analytics. Key modules include the C3Navigator® patent-pending clinical charge capture technology, the CMNavigator-OR surgical theater charge acuity system, and CMNavigator-CDM AI-powered charge descriptor monitoring. Supporting the software portfolio is a suite of consulting services including Comprehensive Chargemaster Review, Strategic Pricing Review, Order Entry Review, Surgical Charge Analysis, Supply Charge Review, Payor Contract Analytics & Negotiations, Price Transparency Support Services, and Physician Practice Performance Analytics. The complete offering enables healthcare organizations to manage the full revenue cycle from charge capture through final billing and reimbursement optimization.
Differentiator
Problem solved
Functional benefit
Brands
- CMNavigator SaaS: Chargemaster management SaaS solution for hospitals and physician practices
- MPNavigator SaaS
- RANavigator SaaS
- C3Navigator
Products and services
- CMNavigator® SaaS Flagship Chargemaster management SaaS providing centralized CDM maintenance, accurate coding and compliance oversight, automated pricing with market visibility, and clinical-to-financial connectivity; protected by U.S. Patent Numbers 7,565,300 and 7,761,410. Sold to hospitals, health systems, and physician practices.
- MPNavigator® SaaS
Quantifiable outcome
- 93% client retention rate demonstrating long-term partnership value
- +5 more outcomes
Companies that use MEDCOM
Customer profileNamed customers7 records
Segments4 records
Ideal customer profiles3 records
MEDCOM technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration5 records
AI capability5 records
Feature6 records
MEDCOM partnerships and signals
Strategic signalPartnerships
Three partnerships are on record, tiered core.
- Amazon Web Services (AWS)coreAmazon Web Services provides cloud infrastructure hosting for MedCom's CMNavigator® SaaS solution. AWS partnership ensures high performance, availability, scalability, compatibility, and offsite disaster recovery protection for the SaaS platform without burdening client IT staff.
- Expedient Data CentercoreExpedient Data Center partners with MedCom to manage CMNavigator® SaaS solution infrastructure. Provides managed cloud services ensuring cybersecurity, performance monitoring, and disaster recovery replication.
- EHR Integration Partners (Epic, Cerner, Allscripts, Meditech, CPSI)coreMedCom's CMNavigator® SaaS integrates seamlessly with major Electronic Health Record systems including Epic, Cerner, Allscripts, Meditech, and CPSI. Integration ensures connectivity between clinical order entry systems and Chargemaster for accurate charge capture during IT system conversions and ongoing operations.
Scale indicators5 records
Recent moves6 records
Expansion highlights5 records
MEDCOM competitors and assessment
Company assessmentBroad incumbents
- Premier Inc. Premier Inc. is a healthcare performance improvement company whose services include revenue cycle consulting, supply chain, and analytics for hospitals. Comparable to MedCom's consulting + analytics services through Premier's GPO-anchored provider network.
- Cotiviti: Cotiviti provides payment accuracy and revenue cycle analytics services to healthcare payers and providers, including claim editing and recovery. Comparable to MedCom's RANavigator® 835 payment analytics and denial management capability area.
- Optum (Optum360 / RCM): Optum (UnitedHealth Group) offers large-scale healthcare revenue cycle management services and technology through Optum360. Competes with MedCom across the full RCM spectrum, benefiting from parent payor-provider scale rather than specializing in Chargemaster niche.
- Experian Health: Experian Health provides healthcare revenue cycle solutions including patient access, claims management, and identity management. Comparable to MedCom's RCM analytics layer, though positioned as a broader portfolio play within Experian's data and identity business.
Direct peers
- Waystar: Waystar provides cloud-based healthcare revenue cycle management software spanning claims processing, denial management, and patient payments. Competes with MedCom in the analytics and payment intelligence layer (analogous to RANavigator®) at larger enterprise scale.
- Craneware: Craneware (now part of Craneware/FinThrive) is the most direct competitor - a specialist Chargemaster, revenue integrity, and healthcare price transparency SaaS platform serving US hospitals. Operates in essentially the same niche as MedCom's CMNavigator® with broader market share and public listing.
- FinThrive: FinThrive (formerly nThrive) is a comprehensive end-to-end healthcare revenue cycle management SaaS platform covering claims, denials, and analytics. Comparable to MedCom's RANavigator® and broader RCM positioning, though much larger in scale following multiple roll-up acquisitions.
Emerging players
- Kaufman Hall: Kaufman Hall provides performance management and financial planning software, including decision support and cost analytics for hospitals. Adjacent to MedCom's analytics layer (Comparable to Physician Practice Performance Analytics) but focused on enterprise financial planning.
- Huron Consulting: Huron Consulting's healthcare practice provides revenue cycle consulting and performance improvement services for hospitals. Comparable to MedCom's consulting services (Strategic Pricing Review, Chargemaster Review) rather than its software IP, though Huron is significantly larger.
- AGS Health: AGS Health is a revenue cycle management services and analytics firm specializing in medical coding, charge capture, and denials for hospitals. Comparable to MedCom's consulting services and charge capture technology stack, though more services-led than product-led.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat4 records
Key risks6 records
Key highlights6 records
Customer concentration
MEDCOM social profiles
Digital presenceMEDCOM financial estimates
Financial estimateRevenue estimate
Valuation estimate
MEDCOM leadership team
Management profileNumber of profiles
Profiles3 records
MEDCOM funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
MEDCOM 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 MEDCOM
What does MEDCOM do?
MedCom Solutions sells proprietary Software-as-a-Service platforms and professional consulting services that help U.S. hospitals, health systems, ambulatory surgery centers, and physician practices capture accurate charges, manage their Chargemaster (CDM), optimize surgical and supply pricing, and analyze 835 payment and denial data to recover revenue. Its flagship CMNavigator® SaaS, complemented by MPNavigator®, RANavigator®, and the patent-pending C3Navigator®, is sold alongside project-based consulting engagements including Comprehensive Chargemaster Review, Strategic Pricing Review, Surgical Charge Analysis, and System Conversion Services.
Is MEDCOM a public or private company?
MEDCOM is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was MEDCOM founded?
MEDCOM was founded in 1986. It employs 11 to 50 people.
Where is MEDCOM based?
MEDCOM is headquartered in Pittsburgh, United States, in the North America region.
How does MEDCOM make money?
Three revenue lines are on record. SaaS Software Subscriptions are the primary driver. The others are professional Consulting Services and system Conversion Services.
Who are MEDCOM's main competitors?
Broad incumbents on record are Premier Inc., Cotiviti, Optum (Optum360 / RCM) and Experian Health. Direct peers are Waystar, Craneware and FinThrive. Emerging players are Kaufman Hall, Huron Consulting and AGS Health.
Does MEDCOM have an API?
No public API is recorded for MEDCOM.