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R1 RCM
Technology-driven revenue cycle management for healthcare providers.
Company Information
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Conpas Rating

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Overview

R1 is a healthcare revenue cycle management company combining agentic AI and human expertise. Serving 95 of the top 100 US health systems, R1 delivers its Phare revenue OS to improve financial performance.

Groups

Number of Employees

10,001+

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Services Provided

Consulting

Capabilities
Industries
Serviced Businesses
Footprint
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Regions

Asia, North America

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Countries

India, United States Of America

Additional Information
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Year of foundation

2003

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Structure

Privately Held

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Industry

Health & Life Sciences

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Offerings

Problems we solve

Solving Healthcare's $200 Billion Revenue Problem

Healthcare providers face mounting administrative complexity, rising denial rates, revenue leakage, manual coding errors, slow claim adjudication, and unsustainable cost-to-collect ratios. We solve these challenges by automating the full revenue cycle — from patient intake and insurance verification through claims coding, denial management, and regulatory reimbursement capture — so providers can focus on care while we recover every dollar they've earned.

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Consulting Solutions By Capability

Enterprise Partnerships

Long-term operating partnerships where R1 manages end-to-end revenue cycle operations using the Phare agentic AI platform to drive yield, reduce cost to collect and accelerate throughput for health systems. Partners with 95 of the top 100 US health systems including Ascension, Sutter, and Providence Health Services, delivering 5–7% yield boost and 50% reduction in cost to collect through integrated technology and operational expertise. This comprehensive partnership model combines financial process transformation with advanced analytics and AI-driven automation to optimize revenue performance across the entire patient-to-payment lifecycle, enabling health systems to capture earned revenue while reducing administrative burden and improving cash flow velocity.

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Physician Revenue Cycle Management

End-to-end revenue cycle management solutions for hospital-owned and independent physician groups, covering patient access, coding, denials, billing, and health information management. Ranked #1 by KLAS in Ambulatory RCM Services (EHR-Agnostic), this offering delivers comprehensive revenue cycle transformation for both hospital-owned and independent physician practices, optimizing each stage from patient registration through final payment collection. The service combines process redesign, technology enablement, and operational management to improve cash flow, reduce administrative burden, and enhance financial performance across diverse physician practice models and EHR environments.

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Revenue Performance

R1 delivers a comprehensive set of revenue performance solutions to optimize, accelerate and navigate revenue recovery — the only revenue cycle partner with the range of technology-enabled solutions and broad expertise to improve accuracy and efficiency and drive fast results across all revenue cycle stages. The suite covers four specialized areas: Revenue Recovery (maximizing payer and patient cash recovery from aging AR, denials, and complex claims), Revenue Optimization (capturing missed or underpaid revenue through comprehensive payment review), Clinical Integrity (improving documentation accuracy and coding specificity with compliance-first solutions), and Regulatory Navigation (capturing all earned government reimbursement under Medicare, Medicaid, and other programs).

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Community Business Office

R1 provides flexible and scalable business office capabilities to rural, community-based and critical access hospitals — combining deep expertise and technology to improve financial performance. Capabilities include payer A/R management, appeals and denials management, underpayment recovery, care coverage patient advocacy, and transition services — providing a comprehensive approach to coding, AR management and payment services to improve the bottom line. Ranked #1 by KLAS in Extended Business Office: Small (1-200 beds), with demonstrated results including 10% gross collections increase for Maniilaq Health Center.

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Digital Solutions By Capability

Phare Access

An AI-powered patient intake product that blends AI agents and intuitive tools to verify insurance, secure authorizations and embed accurate patient data at registration. Automates the critical first step of the revenue cycle by using intelligent agents to validate insurance coverage, obtain necessary authorizations, and capture complete patient demographic and insurance information at the point of service. This product reduces manual data entry, improves insurance verification accuracy, and accelerates the revenue cycle by ensuring complete and correct patient information is available before clinical services are rendered.

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Phare Claim

An enterprise AI product that automatically codes and corrects claims before submission to reduce denials, cut manual rework and optimize reimbursements. Uses machine learning to analyze clinical documentation, apply appropriate coding rules, identify and correct coding errors, and optimize claims for maximum reimbursement before submission to payers. This product reduces claim denials, minimizes manual coding rework, and improves first-pass acceptance rates by ensuring claims are coded accurately and completely at the point of submission.

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Phare Flow

An autonomous AI product that handles remits, denials and outstanding claims to accelerate reimbursements at scale with human expert oversight for exceptions. Autonomously processes incoming remittances, identifies and categorizes denials, manages claim follow-up workflows, and escalates complex exceptions to human experts for resolution. This product accelerates the back-end revenue cycle by automating routine remittance processing and denial management while maintaining quality control through expert human oversight of complex or high-value exceptions.

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