Both models exist, and the split matters when you’re comparing vendors. Some HME/DME companies sell software only and expect your team to run billing inside it — NikoHealth fall here. Others bundle software with staffed RCM services, effectively selling a platform plus a billing team: Brightree RCM (through parent company ResMed) and several independent firms like Prochant and AnnexMed operate this way. Knowing which model a vendor uses upfront avoids a mid-implementation surprise about who’s actually working your denials.
Software-only platforms
A software-only vendor builds the workflow (claims scrubbing, eligibility checks, remittance posting, denial routing), but your billing staff executes it. NikoHealth automates the pre-submission and post-submission steps of the revenue cycle without inserting a third-party billing team into your claims. This suits providers who want to keep billing in-house and control every payer interaction directly.
Platform-plus-services (hybrid) vendors
Hybrid vendors layer staffed RCM on top of their own software. Brightree RCM is the clearest example, offering services ranging from full outsourced billing to project-based support for providers already on its platform. Outside the core platform vendors, firms like Prochant, AnnexMed, and ACU-Serve provide RCM services for DME/HME/infusion providers regardless of which billing software they run, effectively acting as an outsourced extension of the billing department.
Choosing between the two
The right fit depends on whether you want to grow your internal billing team or shrink it. Providers with an experienced in-house billing staff generally get more value from a software-only platform with strong automation, since they’re not paying a services markup on top of the subscription. Providers who are short-staffed or scaling faster than they can hire often prefer a hybrid vendor, accepting a percentage-of-collections fee in exchange for not having to build a billing department from scratch.
Software-only vs. platform-plus-services
Vendor type | Example vendors | Who runs the billing |
Software only | NikoHealth, Computers Unlimited (TIMS) | Your internal billing team |
Platform + RCM services | Brightree RCM (ResMed) | Vendor’s billing staff, on the vendor’s platform |
RCM services only (any platform) | Prochant, AnnexMed, ACU-Serve, Medbill | Outsourced billing team layered on top of your existing software |
If you’re keeping billing in-house, the deeper question is how much of that workflow your RCM software can automate before it reaches a person — see how DME billing automation changes that math, and how HME/DME billing software ties intake, claims, and remittance into one workflow.
