Claims Processing Software
Claims Processing software automates insurance claims management, electronic submission and collections. These applications offer a full feature suite of efficient claims processing management tools along with integrated accounting and customer relationship management (CRM) solutions. Claims Processing software offers real-time processing and reporting on the administrative and revenue generation activities for insurance industry firms, employee health plans and benefit managers. They cater to a variety of product sectors including life, health, automotive, COBRA, workers compensation, employer liability and others. Claims Processing software is related to Insurance Policy software and Medical Billing software.
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Waystar, the combination of Zirmed and Navicure, provides next-generation, cloud-based technology that simplifies and unifies the healthcare revenue cycle. Our innovative platform allows clients to collect more with less cost and less stress, so they can focus on their goals, patients and communities. Waystar has scored Best in KLAS claims clearinghouse every year since 2010 and earned multiple #1 rankings in both medical claims processing and patient payment solutions from Black Book surveys Learn more about Waystar Waystar provides next-generation, cloud-based technology that simplifies and unifies the healthcare revenue cycle. Learn more about Waystar
Patch is an online insurance assistant that helps healthcare providers and patients understand out-of-network benefits in minutes and submit claims online. No more dealing with insurance companies by phone or submitting claims by paper. Using Patch, healthcare providers can let patients know the exact reimbursement amount to expect and automatically submit an optimized claim on their behalf. Learn more about Patch Healthcare professionals can now leverage insurance benefits while avoiding the constraints of being in-network Learn more about Patch
One solution for all benefits administration. Any benefits plan can be built and managed: medical, dental, vision, life and disability, Medicaid, Medicare, Medicare Supplement, care management and long-term care health benefits, flexible spending accounts (FSAs), health savings accounts (HSAs), health reimbursement accounts (HRAs) and COBRA. All transactions are real time, including integrated online payments, cost containment, fraud and abuse edits, provider matching and pricing. Learn more about Virtual Benefits Administrator Manage all Health Care benefits including Medical, Dental, Life, Disability, Vision, FLEX, COBRA, Medicaid/Medicare/MedSupp on 1 system Learn more about Virtual Benefits Administrator
PLEXIS Healthcare Systems is a leading payer technology company that delivers trusted enterprise core administration and claims management solutions to healthcare payers and delivery systems around the globe. PLEXIS ignites growth, innovation, and efficiencies across diverse business lines for payer organizations such as health plans, dental plans, vision plans, TPAs, cost containment companies, specialty groups, government healthcare, and international insurers. Learn more about PLEXIS Payer Platforms PLEXIS delivers trusted enterprise core administration and claims management software to leading payer organizations across the globe. Learn more about PLEXIS Payer Platforms
FileHandler Enterprise is an intuitive claims administration system designed to help streamline and automate workflows for the claims and risk management market. Complete with new dashboards, reporting functionality, business intelligence tools, and improved security, FileHandler Enterprise is the new benchmark for Claims Management Software. Learn more about FileHandler FileHandler Enterprise will transform your companys data into rich visuals built and defined by you. Learn more about FileHandler
Claims management software with custom reports, workflow, notices, letters, notifications, reminders, document management, & web portal. Claim types include medical, insurance, injury, auto, asset, 3rd party, class action, litigation, taxi, occupational workers compensation, OSHA, and more. Track subrogation, litigation, approval history, expenses, costs, payments, and reserves. Fully hosted or self hosted with professional support & training. Powerful, highly customizable, & user friendly. Learn more about A1 Tracker New generation claims software designed to meet unique business needs, bring value to your business, & streamline claims management. Learn more about A1 Tracker
DataCare provides software solutions for the workers' compensation industry to better manage medical treatment and billing. Our Medical Process Manager and UR platforms help integrate a medical aspect to the claims workflow and expedite the communication process between the URO and requesting physician. While our Care++ mobile application was created for patients to communicate with their nurses, adjusters and claims staff can also send/receive messages to/from the application. Learn more about Ahshay Web-based SaaS medical case management, utilization review, and claims enhancement software. Learn more about Ahshay
IMS is an industry-leading claims/risk management system, covering all commercial lines including P&C, workers' compensation, auto, and general liability. IMS accurately and easily manages the entire claims lifecycle, from first report of incident through issuing payments and collections. IMS's rich features allow for document management, reserves, payments, notes, diary, subrogation, EDI, and bill review. Learn more about Incident Management System Claims & risk management system for P&C, workers comp, auto and general liability. In- house enterprise systems and cloud services. Learn more about Incident Management System
Trusted by over 60,000 mental health professionals, TherapyNotes helps behavioral health therapists manage their practices more efficiently through an easy-to-use, secure platform for notes, billing, scheduling, and more. TherapyNotes simplifies administrative work, giving practitioners more time and energy to focus on providing effective care for their clients. Learn more about TherapyNotes.com Trusted by over 60,000 mental health professionals, TherapyNotes EHR software helps therapists manage their practices more efficiently. Learn more about TherapyNotes.com
PDSpectrum is a robust modern policy processing system for P&C Insurance Companies, MGAs, and Program Administrators. PDSpectrum includes: administration, accounting, billing, claims, rating, underwriting, document management, and agent inquiry & quoting. It provides full data connections and integrations to major risk assessment partners. PDSpectrum is hosted, supported and maintained by Priority Data and accessed by company staff, agents and their partners via a secure web-browser connection. Learn more about PDSpectrum PDSpectrum is a cloud-based policy administration system that easily manages your business such sales, accounting, billing, and more. Learn more about PDSpectrum
This is a secure, standards based, cloud-based electronic claims processing and low volume adjudication Software. This Software is suitable for TPAs, ASOs, IPAs & BPOs. Features include claims validation, claims adjudication, aggregated data access and handling of denials & rejections. The software provides both Provider access and TPA administrator access to process claims. The Software is available for monthly subscription. Learn more about expEDIum Claims Portal This is a secure, standards based, cloud-based electronic claims processing and low volume adjudication Software. Learn more about expEDIum Claims Portal
Web based P&C Claims Administration System supporting a wide range of claim processing requirements. TPA, SIR Entities, Risk Managers. Client-centric workflow, Email integration, Messaging and Alerts, Shared Calendar, Litigation Support, Document Management - store any format including MP3 and DVD, Form Letters, Stat Reporting, Robust Transaction Processing - Reserving, Payment/Check Issuance and Recoveries. Learn more about CaseworksPro Web based Claims Administration System supporting a wide range of claim processing requirements. Learn more about CaseworksPro
DuxWare was "cloud based" before the term was even invented. Our users have grown with us for over 26 years and in the process taught us how to support and make DuxWare perfect for their practices. Perfect because DuxWare allows them to move efficiently through their daily routine in clinics large and small. Perfect because, at the end of the day, the PROVIDERS GET PAID. Why? DuxWare gets it right and our support team has been in their shoes. Call us to become part of the DuxWare family today! Learn more about DuxWare Web Based Practice Management Software incorporating an effective Clinical Claim Scrubber. Learn more about DuxWare
The # 1 ranked Claim management system for independent adjusters, TPA's, MGA's, & Mutual Ins. Co.'s. System does not apply to Public Adjusters. Entire system is based on the input from our 1000's of Users. Integrates with Outlook, Quick Books, Xactimate, Xactanalysis, Symbility, NFIP/NFS, LEDES and Google Maps. FileTrac also offers an Adjuster Database module that allows you to track licenses, certificates and so many other criterias. Best suited for companies with 85+ claims per month. Learn more about FileTrac The # 1 ranked Claim management system for independent adjusters. Integrates with QuickBooks, Outlook and all estimating software. Learn more about FileTrac
Billing Dynamix has invested the past decade improving and automating the "Straight Through Process" to reduce billing delays, remove the potential causes of denials, and monitor for underpayments. This leads to reduced collection times, greater compliance and higher reimbursements. It provides you complete transparency and control over your billing processes. Reduce the risk of errors and delays by integrating with your EHR. In-house or Full Service programs available. Learn more about bestPT The most powerful and customizable billing and RCM system available. Integrates with your EHR. Inhouse of Full Service options. Learn more about bestPT
HEALTHsuite is a comprehensive benefit administration system and claims processing software solution designed for health plans administering Medicaid and / or Medicare Advantage benefits. HEALTHsuite is a rules-based auto adjudication software solution designed to automate all aspects of enrollment / eligibility, benefit administration, provider contracting / reimbursement, premium billing, medical management, care management, claims adjudication, customer service, reporting and more. Learn more about HEALTHsuite Comprehensive benefit administration system and claims processing software solution designed for Medicaid and Medicare health plans. Learn more about HEALTHsuite
The Origami Risk RMIS and claims management platform was designed by industry veterans committed to helping clients streamline the collection, analysis and reporting of risk information. Our innovative, web based software is designed with the latest technology and is focused on ease-of use, performance and dependability. Each client is managed by a service team member with years of experience who supports the client from implementation to ongoing maintenance. Learn more about Origami Risk RMIS and claims management platform helps clients streamline the collection,analysis and reporting of risk and claims data. Learn more about Origami Risk
QuickCap is an advanced platform designed for IPAs, PHOs, MSOs, TPAs and Risk Based Organizations managing Medicare, Medicaid and Commercial LOBs. It is EDI 5010 compliant in claims, capitation, eligibility, referrals, authorizations, premium billing, case management and related auto routing and workflow processes. QuickCap is a seamless, highly efficient, cost effective, and comprehensive product set today. For more information, please call or contact us through our website. Learn more about QuickCap Advanced software to manage claims, capitation, eligibility, referrals, authorizations, case management and communication. Learn more about QuickCap
Mize Warranty software enables global manufacturers to streamline all warranty processes including inspections, registrations, service plans, claims, returns, supplier recovery, and warranty analysis. Mize warranty help companies to improve customer satisfaction, reduce warranty costs, and improve product quality. Mize warranty software is easy to use, configure, and integrate. Request a demo now to learn how you can optimize warranty management and maximize service contract sales. Learn more about Mize Warranty Software Mize Warranty software enables manufacturers to streamline warranty processes, reduce warranty costs, and improve product quality. Learn more about Mize Warranty Software
Speedy Claims is possibly the easiest to use software available anywhere for billing your patients and insurance companies whether by paper or electronically. An easy to use point and click interface showing the actual CMS 1500 form on the screen makes filling out a claim simple and coupled with our error checking scrubber makes it accurate and powerful. Speedy Ledger makes it easy to track insurance payments and create patient statements. Try us free for 30 days! Very easy to use software for insurance billing, CMS 1500 forms filling, payment tracking and patient billing.
DocuPhase provides software and services for Enterprise Automation. Our platform includes everything an organization needs to execute on their Digital Transformation, Process Improvement, and Growth strategies. We are the automation experts. Partner with the DocuPhase team to transform the way you work. Lets get started. For more information, visit docuphase.com. DocuPhase is a complete browser-based platform that delivers unmatched efficiency and performance to companies around the world.
Streamline your workflow and boost efficiency with our fully-integrated EHR, Practice Management, and Billing solution. Designed by physicians for physicians, our award-winning Intelligent Medical Software caters to over 25 different specialties and practices of any size! Utilize technology that adapts to your practice, not the other way around. Almost every aspect of our software is 100% customizable and tailor-fit to your precise specifications. Schedule a Free Live Demo on our website! The All-in-One EHR, Practice Management, and Billing Solution that Adapts to Your Practice. Custom built for over 25 specialties!
Virtual Claims Adjuster is a web based claims management system designed using the latest software development techniques and interface methodologies to ensure a smooth implementation into your business. As you conduct your day to day business, we work in the background, finding ways to make you more efficient and effective. Our business specialists analyze trends, maintain key industry relationships, & employ advanced techniques to evolve your toolset in a way that exceeds your business needs. As Global Leaders in Claims Management Technology for nearly 2 decades, we provide secure online claims management software worldwide.
NAVRISK VISION is a comprehensive administration tool for General Liability, Medical Practice Liability, and Workers Compensation Claims with additional solutions for Analytics, RMIS, Policy Issuance, Safety and Property Appraisal. We serve clients in the alternative risk market including Self-Insureds, Public Risk Pools, Insurance Brokers, and TPAs. DAVID Corporation is the developer of NAVRISK VISION the alternative risk markets most powerful management automation solution.
Improve the efficiency of your claim lifecycle from start to finish with ClaimRemedi. This solution offers powerful claim processing, cutting-edge scrubbing technology, real-time claim editing, tracking and management. ClaimRemedi offers powerful claim processing, cutting-edge scrubbing technology, real-time claim editing, tracking and management.
Our software is tailored for all areas of electronic healthcare transactions and developed with the user in mind. Work smarter, not harder to gain efficiency. Claim Master - is an advanced application that manages all aspects of healthcare claims and processes your 837 transactions. Enrollment Master - seamlessly transmits 834 files to plan sponsors, insurance companies, or TPAs. EDI Exchange - securely transports EDI files, manages trading partners, and performs HIPAA compliance checks. HIPAAsuite, a market leader in HIPAA EDI transactions. We have products for every HIPAA transaction including CORE Certified solutions.
Simsol Software provides software solutions to create construction estimates and claims documentation for the property insurance and construction industry. It was one of the original pioneers of computer estimating for property adjusters and was the first software vendor to automate all of the most frequently used functions of the professional property adjuster into a single software application. Simsol Software provides software solutions to create construction estimates and claims documentation for the property insurance and co
Mitchell WorkCenter is a truly universal platform of integrated and innovative solutions specifically designed to help settle claims accurately and efficiently through a powerful interconnected workspace that incorporates performance modules to create a simplified workflow for claims settlement staff and trading partners. Platform of integrated and innovative solutions specifically designed to help settle claims accurately and efficiently.
Improve company's reimbursement plan with analytics system that includes specific network analysis and budget planning capabilities. Improve company's reimbursement plan with analytics system that includes specific network analysis and budget planning capabilities.
We pride ourselves on making simple, affordable claims management software. We've had enough of the insurance industry lagging behind in the technology front, with often expensive, complicated and bloated software. At Claimable, we believe that details matter, and our software has been carefully crafted to provide the tools necessary for timely and efficient claims management. Customer-first claims management software for your business. Streamline your workflow, go paperless and settle more claims!
Claims Manager. A comprehensive insurance software product developed for small to mid tier Claims Departments, Risk Managers and TPAs administering P&C, GL, Commercial Auto, Public Entity, Med Mal, Excess Coverage, WC. Capture relevant claim information, record all file activity. Comprehensive diary and alarm system with full document depository. Claims management system for insurance company claims departments and TPAs with emphasis on complex litigation.
Part of a componentized enterprise suite delivering complete rules-driven, case and customer centric claims management. Part of a componentized enterprise suite delivering complete rules-driven, case and customer centric claims management.
PCMI Corporation offers a modular package of software solutions for the administration of F&I Products, Service Contracts, and Extended Warranties. Our modular platform, Policy Claim and Reporting Solutions (PCRS), supports and automates the full lifecycle of all aftermarket products. PCMI offers a modular package of software solutions for the administration of F&I Products, Service Contracts, and Extended Warranties.
BrightOffice Case Management Software can be used for a variety of cases, including; PPI, Pension Transfers, Mis-sold Mortgages. The software can be customized to suit your business needs, designed to handle claims in high volume. Offering a full end to end solution, Cases CRM will manage your business from client prospecting right through to Invoicing and Payments removing requirements for multiple software packages and streamlining internal processes. Case Management Software, a cloud based software which allows the users to manage their cases from start to finish
Healthaxis is the premiere healthcare payer solutions company that offers customized solutions for commercial and governmental health benefit administrators. Our mission is to enable our customers to pay claims better, faster, & less expensively, reduce administrative costs, & provide better plan value. Our approach is cost-effective and client-focused, making sure that we are listening to their needs of our customers and developing customized solutions for them. Claims processing, benefits administration, and self-service portals for health care benefits administration.
Healthcare claims management solution that designed to track financial transactions, capture and analyze detailed insurance coverage. Healthcare claims management solution that designed to track financial transactions, capture and analyze detailed insurance coverage.
Payapps is a simple yet powerful mobile collaboration tool suitable for all contractors that saves needless time and money wasted on payment submission and approval. Built specificially for the construction industry it is designed to eliminate errors associated with manual processing. Its cloud based, can be accessed anywhere on any device, and is super simple to use. Progressclaim.com reduces risk, saves time & money, improves cash flow and is Security Of Payments Act compliant. A mobile collaboration tool suitable for all contractors designed to streamline the claims processing procedure.
ClickClaims is ideally suited for small to mid-size property and casualty insurance carriers, independent claims adjusting firms, and third party administrators who need the advanced technologies that drive a competitive market. ClickClaims SaaS model allows for rapid deployment, unlimited scalability, performance, security and versatility that legacy systems cannot match, at a fraction of the cost. Built to evolve as technologies emerge, your investment appreciates over time. Carriers, TPAs and IA Firms choose ClickClaims over the competition because it fits every user's expectation and business requirement.
SmartSimple CMS360 is a platform for designing and deploying solutions that help insurers, health care providers and independent medical examiners gather the right content, make more accurate decisions, and take action to advance business outcomes. Some of the world's largest accident benefit claims and referral management firms look to CMS360 to automate their structured, repeatable processes and centralize case content - giving a complete picture of file history. Accident benefit claims and referral management solution used by insurers, health care providers and independent medical examiners.
CaseBlocks for Claims Management provides a platform for managing your end-to-end claims process. CaseBlocks enables you to rapidly adapt your claims process in order to keep up with new regulations, changes in working practices of 3rd parties and as process efficiencies are identified. CaseBlocks for Claims Management provides a platform for managing the end-to-end claims process.
Our claim management software solution is designed to process both group and individual life and health claims on one digital platform. Supporting a broad range of policy benefits, the software leverages a claimant-centric approach to deliver a superior customer experience with efficiency and accuracy. Hosted on the secure Salesforce Lightning Platform, our software has a modern, user-friendly interface, with deep functionality built by industry experts. Our claim management software solution provides full life cycle claims management, for Life and Health claims.
AquariumClaims is an on-demand web-based, claims management solution. Unlike traditional offerings, it offers lower cost of ownership coupled with high configurability and flexibility: numerous customers have been able to grow their business to new levels of profitability through increased claims processing efficiency, improved customer service levels & higher claim volumes. More business without more people - new levels of performance without higher costs. For further details visit our website. Processes claims and takes cases through from information capture to invoicing.
United Systems and Software, Inc. ("USSI") offers a full line of integrated professional insurance administration systems tailored to meet your specific industries requirements and niche demands. Our software offerings cover a wide variety of industries and lines of business. Since 1979, USSI has been a pioneer in leading edge Insurance Administration Software Systems and Professional Services. Robust software for underwriting, new business processing, policy services, billing, agent commissions, and claims adjudication.
FACTS Services is an integrated technology and services provider focused on providing cost effective healthcare payor solutions across the entire claim continuum. The result is a dramatic reduction in cost and improved turnaround time for all facets of the healthcare delivery cycle. FACTS delivers technology within the ASP and turnkey settings and a full administrative services solution that lowers the overall cost of doing business while increasing the value and quality of customer service. Health Claims Processing Software for on-line adjudication of medical, dental, vision, drug, disability, and COBRA claims.
Provides benefits of a custom-made unified claim processing solution and allows for rapid integration with legacy systems. Provides benefits of a custom-made unified claim processing solution and allows for rapid integration with legacy systems.
WLT Software is a leader in advanced benefit administration and claims processing software for Insurance Companies, Government Plans, TPAs & Self Administered Groups. Whether administering multiple plans covering millions of lives or one plan covering a small group, our scalable solutions can be tailored to fit your needs. Our systems have two deployment options available; either on site installation or as a hosted solution, making them the most flexible systems available for your organization. Benefit administration and claims processing software for Insurance Companies, Government Plans, TPAs and Self Administered Groups.
Quoting, rating, policy administration, billing, claims management and reinsurance software solutions for property and casualty companies of all sizes. This modular system can interface across platforms or operate as a complete end-to-end solution. Advanced Insurance System is a perfect solution for personal, commercial and specialty lines and is available with rates, rules and forms pre-loaded. Integrating AIS into your business is an easy, efficient, and a hassle-free process. Modular policy, quoting, billing and claim administration application.
Risk Manager is an integrated suite of program modules designed for the administration of worker compensation and multi-line liability claims ONLY (not employee benefits). It is suitable for use by any size organization that is self-insured and self-administered, third-party administrators (TPA), governmental agencies, insurance carriers, association of self-insureds, and/or retrospective rating groups. An integrated suite of programs for the administration of worker compensation and property & casualty claims.
Reduce losses via integrated claims tracking system that offers data capture capability for FNOL, NOL, and FROI. Reduce losses via integrated claims tracking system that offers data capture capability for FNOL, NOL, and FROI.
Uses data from practice management system, as well as electronic remittance from Medicare to match claims to EOBs. Uses data from practice management system, as well as electronic remittance from Medicare to match claims to EOBs.
Venue is a secure web-based claims processing software that can handle multiple lines of insurance claims (except health and dental). Track time and expenses accurately, invoice your clients from within Venue, eliminate duplication using Venue's comprehensive document management, store audio, video and other file formats. Form templates allow you to complete forms with a click of a button. Venue also allows your clients to view the status of their claims and uses 128-bit encryption. Web based claims management system that handles lines including property, casualty, auto, marine, liability.
The V3 System is a complete investment administration solution that helps organizations achieve administrative excellence, harness significant processing efficiencies and realize the potential of true business intelligence. The V3 System is specifically designed to meet the unique needs of investment administration: Opportunity Management Fund Administration Investor Management Portfolio Management Fund Accounting Performance Analytics Enterprise-class software for hedge fund, private equity and alternative asset administration.
Integrated solution for independent claims adjustment agencies. Handles claims, data collection, notes, history, expenses, fraud analysis of claimants and witnesses. Interface to accounting back office to handle third party billing , payroll, (AR/AP/GL/PR). Multi user system, any number of insurance carriers, remote access available. Simplifies management, record keeping and reporting.
Series 3000 is a complete turnkey claims administration solution designed using unlimited system variables which can be programmed to meet your companies specific needs. You won't have to change the way you do business to utilize our software, because we'll partner with your company to ensure that our software is customized to work for you the way you want it to. Claims processing solution with unlimited system variables that can be programmed to meet your specific needs.
KMR Claims Manager is a fully integrated, customizable state-of-the-art medical claims processing software solution for TPAs, self insured and claims administrators. Features include: comprehensive claims processing-ability to scan, receive via EDI or manual entry; coordination of benefits, co-pays & deductibles; full claims history display; adjuster analysis reporting; actuarial reporting; custom & ad-hoc reports, online portals for members/participants & providers, document imaging integration Fully integrated customized claims processing solution for TPAs, self insured, claims administrators.
The Alyce Claims Management System is designed for TPAs, Insurance Carriers and Agencies. It has a very intuitive design, with pages laid out in a logical fashion, which makes it easier for adjusters to get their jobs done faster and more efficiently. Features include multi-tiered infrastructure, duplicate claim alerts, check printing, forms, letters and reports. Intuitive, fast, HTML claims system, designed with detailed business rules and uncompromised security.
Quickly and accurately capturing claim information onsite eliminates the need for followup visits and provides a great chance to engage policyholders in the settlement process. Adjusters can document, estimate, and close a claim in a few easy steps leading to a faster, efficient and more accurate claim settlement. Mobile Claims ensures that onsite estimates become onsite settlements. Available for Android & iOS and works with the greater Symbility Property Claims Ecosystem. Symbility Mobile Claims is a multi-platform enabled field estimating solution used to document, estimate, and close a claim quickly.
Stop wasting money! Our Clients are saving over 50% of their claims processing costs! Let Startech Software show you a better way. Our Eclipse software will save you time and money. Claims like Workers Comp,Tort, GL, P&C, Auto, Long and Short Term Disability can be done with ease. Full featured. Check printing. Fee schedules. Extensive reporting. Top rated customer support. Call or visit website for free demonstration. Total environment designed to manage the needs of workers' compensation claims.
Comprehensive Life, Health, Pensions, Annuity and Investment administration system that can support Individual and Group processing. Comprehensive Life, Health, Pensions, Annuity and Investment administration system that can support Individual and Group processing.
Complete property adjusting software package; quickly complete estimates and create photo sheets, diagrams, captioned reports and more. Complete property adjusting software package; quickly complete estimates and create photo sheets, diagrams, captioned reports and more.
Automates truck insurance form processing by transferring data to any carrier application, broker agreement, permits or any other form. Automates truck insurance form processing by transferring data to any carrier application, broker agreement, permits or any other form.
Workers' compensation software system with policy and claims administration, document management and email alerts. Workers' compensation software system with policy and claims administration, document management and email alerts.
Manages submissions and quotes, policies and premiums, claims, losses payable and premiums receivable. Manages submissions and quotes, policies and premiums, claims, losses payable and premiums receivable.
ppoONE is a leading information services company providing enterprise business solutions for the health care industry. As an ASP or SaaS company, ppoONE is a leader for automated claims repricing, provider and fee schedule management, credentialing, customer service, EDI and reporting for PPOs, TPAs and insurance carriers. Using the power of the Internet, we deliver a flexible, highly accurate and productive easy-to-use system that streamlines operations and reduces costs. Manages provider and client demographics, fee schedules and contracts, credentialing, customer service functions and claims repricing.
Plan Management Policy Generation Renewals Discounts Management User Management Document Management Payment history and management Various Business Report Broker and Agent Management Web-based solution for policy management, claims processing and insurance agency administration.
Software suite that provides healthcare payers with a total claims management solution to validate payment integrity and maximize savings. Software suite that offers healthcare payers a total claims management solution to validate payment integrity and maximize savings.
Web-based medical claims administration system that helps with multicurrency multilingual claims adjudication. Web-based medical claims administration system that helps with multicurrency multilingual claims adjudication.
SpyGlass Health Claims Management System helps claims payers improve accuracy and automation via an easy to use and powerful application. It is entirely web-based and offers reliable, adaptable, flexible, scalable, and open IT architecture, which substantially increases reliability and accuracy through automation, empowering you to maximize the return on your technology investment and includes HIPAA required ICD-10 and 5010 support throughout. Health claims software; web-based and made for HIPAA; easy, powerful plan setup drives high rates of auto-adjudication.
Risk and claims management software that tracks issues related to general liability, auto, P&C, incidents and professional liability. Risk and claims management software that tracks issues related to general liability, auto, P&C, incidents and professional liability.
Loan management platform for secondary markets. A true end-to-end platform for managing all loan processes from acquisition to exit. Loan management platform for secondary markets. A true end-to-end platform for managing all loan processes from acquisition to exit.
Cutting-edge technology platform, proprietary workflows, and unique rules-driven engine completely automates the claim handling process Cutting-edge technology platform, proprietary workflows, and unique rules-driven engine completely automates the claim handling process
Claims and benefits administration solution for health plans managing & processing. Provides the patented configuration feature. Claims and benefits administration solution for health plans managing & processing. Provides the patented configuration feature.
Claims processing and payment software with unlimited plans, on-line repricing and PPO fee schedules capabilities. Claims processing and payment software with unlimited plans, on-line repricing and PPO fee schedules capabilities.
Modular software with claim scrubbing, dashboard, eligibility verification, electronic remittance advice for large practice providers. Modular software with claim scrubbing, dashboard, eligibility verification, electronic remittance advice for large practice providers.
Claims adjudication and processing system that includes payee accounting, automated correspondence, anesthesia pricing capabilities. Claims adjudication and processing system that includes payee accounting, automated correspondence, anesthesia pricing capabilities.
Web-based modular claims management system that integrates with Bing Maps and MS Office, offers notepad templates, mobile access. Web-based modular claims management system that integrates with Bing Maps and MS Office, offers notepad templates, mobile access.
MedNeXt+ with its 2 subsystems - the Operational System and the Business Intelligence System - and its 6 interfaces is a complete, enterprise-wide health insurance solution that enables risk carriers to achieve fast time-to-market for new products, grow profitably, manage costs and improve service quality. MedNeXt+ is ideal for health insurers, TPAs, and Managed Care organisations as well as large self-insured companies who choose to administer their own group health programmes. MedNeXt+ with its Operational and BI systems and its 6 interfaces is a complete, enterprise-wide health insurance solution
Coupling BPM and Case Management tools and expertise, BizFlow has created frameworks supporting rapid application development of insurance core processes requiring structured and dynamic work interactions. Applications combine business rules, forms, data models, content handling, data repositories, system integration, and user interfaces to enable process automation for Sales, New Business, Underwriting, Policy Maintenance, Billing, Collections, Commissions, Customer Service, and Claims. Solutions for Sales, New Business, Underwriting, Policy Maintenance, Billing, Collections, Commissions, Customer Service, and Claims.
Act-isure is a flexible, modular medical and protection insurance system supporting product design/ management, policy sales/servicing (including channel and agency management), claims processing, provider management and financial management and reporting. Act-isure can be deployed either as an integrated whole or as a components in a complex enterprise landscape computing landscape in domestic and international insurance markets around the globe in multiple currencies and languages. Act-isure is a medical and protection insurance system supporting products, policy, enrolment & billing, claims & accounts management.
Deep-function workers' comp claims management software from a software provider with years of experience. Extensive data capture for quick reporting and intelligence. Diary and alerts that mobilize and focus the workforce on claims that need their expertise. Routine claims can be effectively and efficiently managed with rule-based, auto-adjudication facilities. Case management capabilities. Accurate, efficient payment and bill processing. Advanced business intelligence and executive dashboards. P&C claims management software for personal & commercial lines of business
ClaimsVision is PCIS' flagship multi-line claims management solution. This SaaS deployed solution leverages the latest technology to optimize the claims process for clients while giving them the most thorough reporting and tracking metrics available. Rapid Implementations (under 60 days) Architected for seamless interfacing Dashboard and Workflow designed to close claims faster "No Touch" FROI/SROI EDI reporting cuts down on time, costs, errors ClaimsVision PCIS' multi-line claims management solution. SaaS deployed, leveraging latest technology to optimize the claims process.
ClaimPilot is a streamline web-based claims management system that allows you to manage all of your claim files as well as your organization. ClaimPilot offers solutions for Independent Adjusting Agencies, Third Party Administrators, Self-insured Companies, Public Entities, and more! Managing a claim through ClaimPilot is easy & intuitive. ClaimPilot offers custom built step-by-step workflow that is geared for speed and simplicity. Our automated process allows you to manage your claims better. Web-based claims management system with features such as functional security and reporting.
BriteCore was built from the ground up using the latest modern technology. Deployed using the Amazon Web Services cloud, our enterprise-level software is continually updated to guarantee maximum security, efficiency, and durability at scale. Over 40 insurance carriers, MGAs, and start-ups rely on BriteCore to increase speed to market, improve competitive position, and support growth. All-in-one policy administration and insurance processing system designed for P&C carrier, MGA, and InsureTech companies.
Intellect Claims is an industry proven solution that spans life, disability health, critical illness, long term care and annuity. Intellect Claims takes all of the elements that make claims processing so complex managing a large amount of information, multiple work streams and intricate calculations and brings them together in a single intuitive environment. Role based user interfaces provide users with the tools, information and functions to easily handle a claim in one place. Intellect Claims provides comprehensive proactive claim management for life, annuity, disability, critical illness and long term care.
A complete claims management software solution for insurance Claims, Property Claims, Workers Compensation Claims. A complete claims management software solution for insurance Claims, Property Claims, Workers Compensation Claims.
Leading claims management system to optimise your claims handling. Exceptional reporting and automation help reduce claims burden. Leading claims management system to optimise your claims handling. Exceptional reporting and automation help reduce claims burden.
FBCS is a powerful software solution that simplifies the administration and tracking of claims. Recent upgrades to the application centralizes data and further automates the adjudication process. FBCS is a powerful software solution that simplifies the administration and tracking of claims.
Web-based claims processing solution that helps with managing revenue cycle and scheduling patient appointments online. Web-based claims processing solution that helps with managing revenue cycle and scheduling patient appointments online.
Claim scanning and document storage solution for healthcare industry. Works with a variety of scanners and databases. Claim scanning and document storage solution for healthcare industry. Works with a variety of scanners and databases.
AI powered customer engagement solution that pushes personalized recommendations to clients and guides them to perform desired actions. AI powered customer engagement solution that pushes personalized recommendations to clients and guides them to perform desired actions.
Platform manages real-time, shared benefit accumulators; ACA cost-sharing reduction subsidies; CDH plan designs (HRA) for payors. Platform manages real-time, shared benefit accumulators; ACA cost-sharing reduction subsidies; CDH plan designs (HRA) for payors.
Automated process for interrogating payor portals to identify denied, pending or unprocessed claims in real time for fast reimbursement Automated process for interrogating payor portals to identify denied, pending or unprocessed claims in real time for fast reimbursement
Improve Care Quality: We partner with our clients to implement risk management strategies that result in better outcomes with lower costs. Operational Excellence: We work directly with clients, leveraging best practices and technology to achieve operational excellence through automation. Improve User Experience: We strive to improve the user experience for everyone involved in the ecosystem. Optimize Resources: We deliver a minimum 3:1 ROI Real-time healthcare administration solution designed to make administrative tasks easier.
ClaimBook is a Revenue Cycle Management (RCM) solution, built to enable effective hospital insurance claims management. ClaimBook integrates with Hospital Information Systems (HIS) and billing systems of healthcare providers and brings in all TPA communications to a single platform with a proprietary intelligent email parsing technology. ClaimBook, thus, comes with the promise of a stress-free insurance desk, improved TPA accountability, reduced revenue leakage, and positive patient experience. ClaimBook helps hospitals by accelerating the overall discharge process of insured patients, enhances Hospital revenue collection.
Claims management and processing solution to help reduce business costs and the time spent during the insurance claims process. Claims management and processing solution to help reduce business costs and the time spent during the insurance claims process.
Our robust electronic claims administration systems are tried and true, giving our clients the type of transparency Our robust electronic claims administration systems are tried and true, giving our clients the type of transparency
The Optiform eobXL processing solution achieves unsurpassed data accuracy and processing speed. As a result, this powerful system has been proven to process EOBs more accurately and more efficiently than manual data entry simplifying the collection of data and reducing the cost. The eobXL software locates data using key value pair structures that allow data to be located and extracted wherever it is positioned on a page, even through multiple pages of a document. Minimize costs associated with processing paper EOB forms using the best components in pattern recognition technology.
Create your free account, register and share the claims with your partners - insurers, brokers, loss adjusters, and others. Create your free account, register and share the claims with your partners - insurers, brokers, loss adjusters, and others.
Correspondence enables insurers to create, approve and deliver regulatory compliant, accurate and personalized claims correspondence. Correspondence enables insurers to create, approve and deliver regulatory compliant, accurate and personalized claims correspondence.