The award is achieved from the accumulated client experience scores in the 2021 RCM survey responses from 5,091 practice managers, physicians, business office support staff representing 1,555 medical practices and 690 outpatient facilities. In a marketplace of several hundred core and niche Revenue Cycle Management (RCM) solutions vendors, the current Black Book survey respondents evaluated healthcare provider managed services across the enterprise in all stages of financial operations from patient registration through posting, payments and performance reporting. athenahealth has been top-rated in customer satisfaction in the Black Book annual survey processes since 2016.