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Service Center by Office Ally is a trusted revenue cycle management platform used by over 65,000 healthcare organizations processing more than 350 million claims annually. With it, providers can verify patient eligibility and benefits, upload and submit claims, correct rejected claims, check claim status, and obtain remits. With multiple claim types and submission options, providers can easily submit claims to any payer from any practice management system. Transactions are secure, ensuring the confidentiality of sensitive patient information. With no needed implementation, providers can quickly and effortlessly streamline their billing processes, increase their financial performance, simplify medical billing, and reduce claim rejections for faster reimbursements.

Open Practice is pleased to present OpenPM, our cloud-based RCM platform that has propelled the company through 17 consecutive years of double-digit growth. OpenPM connects all the disparate elements of the revenue cycle including; Scheduling & Registration, Billing, Clearinghouse, and Patient Payments/Collections. The result is highly automated accounts receivables management for optimized cash flow, and extensive reporting to help you proactively manage your organization. All of this control is securely hosted and delivered through the browser you already have, providing the perfect combination of security and availability. Medical billing software, revenue cycle management solutions, practice management software, practice management system, medical practice management, EMR integration, EHR integration, practice management scheduling, patient scheduling, online patient billing, patient billing, automatic patient billing and payments, patient payments, electronic patient payments.

AZZLY Rize is the premier clinical and business platform for addiction treatment and mental health organizations. As an all-in-one substance use disorder and mental health specific EHR, Patient Engagement and RCM platform, we serve small, medium, and large clinics. Key features for OUTPATIENT Programs include: scheduling, appointment reminder, Zoom telehealth, treatment plans, progress notes, assessments and surveys. For RESIDENTIAL programs: census, medication management, bed board, withdrawal management, DrFirst e-prescribing, EPCS, PDMP, labs. For all levels of care: alerts, patient engagement portal, electronic billing and claims submission built in. AZZLY Rize empowers your staff through its 5 star training and support services, its simplicity and automation. As a true all-in-one EHR/PM/RCM platform, improved compliance, workflow and accurate billing are achieved real-time. We proudly serve programs in over 33 states and are hosted in Microsoft Azure's private cloud network.

NewOrg's Complete Data Management platform for non profits is designed for organizations with multiple or complex programs. From Case Management to transportation, emergency services, housing, mental health, treatment, and more. NewOrg provides new service delivery options and reduces your costs by managing all your stakeholder relationships in one solution, including Client data and encounters with HIPAA secured Video Conferencing and internal messaging, Donor/Development management, Volunteers, customized event calendars, online registration/scheduling, payment processing, e-signatures, e-mail, SMS, robust custom reporting and more.

Athena Software is now Social Solutions. We make Penelope case management software, a cloud-based systems designed to help nonprofits and social service agencies save time and money, increase efficiency, and generate accurate reports in order to achieve their mission. Penelope's comprehensive set of features include smart forms, referrals, reports, scheduling, billing, collaboration suite, online dashboards, and more. With ClientConnect, your clients can participate more fully in their care. The portal gives them the ability to check messages from their providers, view their provider’s availability and schedule new appointments, pay online or check their account balance, review tasks, and keep their profile and contact information up to date.

SimplePractice is the leading practice management software for solo and group private practices. Practitioners can streamline their entire business from a single HIPAA-compliant platform. Features include integrated telehealth, insurance claim filing, a robust client portal, online scheduling, billing, credit-card processing, free appointment reminders, calendar sync, and so much more.

Virtual Examiner®, PCG Software’s flagship product, monitors the internal claims process of an organization to trend provider data for fraudulent and abusive billing patterns, and maximizes financial recoveries. PCG Software’s Virtual Examiner® allows healthcare organizations to enhance their current claims adjudication system with more than 31 million edits per claim. The software solution monitors an organization’s internal claims process to identify unclean claims and reduce payment for improper or erroneous coding to conserve premium dollars. Virtual Examiner® is more than a claims review solution with a focus on code combinations. It is a cost containment solution that evaluates the claim not only for abusive billing patterns but also identifies those claims that may involve third-party liability/coordination of benefits, case management opportunities, physician billing education and many other cost recovery reports.

USSI is proud to present its entire line of professional insurance software solutions designed and developed as an all-encompassing turnkey administration offering. USSI's comprehensive software solutions ensure that your insurance company is operating at the highest level in an ever changing and competitive marketplace. USSI's InsurancePlus Individual Life and Health Administration software solution manages books of business for traditional and non-traditional Life and Health insurance companies. Product lines supported include Whole and Term Life, Interest Sensitive, Final Expense, Annuities, Supplemental Health, etc. USSI's InsurancePlus Group Life and Health Administration software solution manages books of business for Group Health insurance companies, Self-Insured Funds, and TPA's. Supported plan offerings include Point of Service, Major Medical, Term Life, High Deductible, Traditional Indemnity, etc.

Startech Software’s TotalEclipse™ product is a fully featured single-database Claims Management & Medical Bill Review Software application. Representing the culmination of over three years of development and testing, TotalEclipse™ is designed by real claims adjusters, bill reviewers, and administration managers who use this mission-critical software to do their jobs every day. Many companies develop their software with the user in mind. TotalEclipse is developed with our users involved. The result is an application designed around real-world workflow with a strong focus on making easily available the information most often needed on the job. Eclipse offers the specific processing power, functionality and reporting capabilities you need to maximize productivity while controlling costs. The single-database backend is scalable for use with either the Microsoft SQL Server™ or Oracle™ platform.

Provide authorizations, claims processing and payment in real-time at the point of care. Enhance care coordination and improved outcomes to lower medical cost while streamlining administrative processes. Engage providers at the point of care to capture and share data in real-time resulting in an unparalleled exchange of health information. We partner with our clients to implement risk management strategies that result in better outcomes with lower costs. We strive to improve the user experience for everyone involved in the ecosystem. We deliver a minimum 3:1 ROI for our clients to allow them to optimize their resources. Conexia has developed a core technology platform (ONE) that is customizable to meet the diverse regulatory requirements and operational processes for each client in each geography. In most cases, our initial implementation is an overlay on the payer’s existing technology ecosystem to create real-time processes.

Claimocity was designed for busy clinicians who see patients in Acute Care or Step Down facilities. Claimocity is the first and only PM and RCM software designed exclusively for hospitalists. it is an All-In-One Mobile Billing & Practice Management Software App for Clinicians Who See Patients in Acute Care or Step Down Facilities. Clone previous notes in a way that other solutions, including EHR/EMRs, are not allowed to do. Combine and streamline two separate daily encounter documentation and billing processes in a way that saves significant time. Our note capture section can prepopulate the note with vitals and import elements from the chart. Support multiple complex templates inside a practice (calibrated encounter notes, procedure specific notes, single-section text based notes, or any combination of context-based pre-builds). Copy and paste any large available data groupings from third party available information sources directly into any text section and then sign and submit.

We offer upfront pricing with several options; monthly flat rate, per case, or a combination of both. Included at no additional charge is our Information at a Glance Dashboard, Customizable Task List, and Scheduler. This means all Case Information is available in one place without needing any additional software. Some of Teamworks IRO unique features. Simplified method to collect and maintain data for IRO, URA, Peer Review, Insurance Companies and Attorneys. At a glance, you will know what cases are due, what tasks are due, what documents are due, what payments are due, faxes and emails - System generated and easily managed. Task List - Automatically created for each new case. Reports - Case and financial reports generated by easy point and click. Case closing Report - Automatically generated and sent to the appropriate state agency.

A new and smarter way to process and settle claims. Modern, end-to-end solutions to settle claims for all lines of property, liability, and workers’ compensation insurance. ClaimRuler™ is a cloud-based claims management system designed specifically for I/A firms and Third-Party Administrators, CAT Adjusters, Insurance Carriers, Self-Insureds, and Municipalities. The platform supports end-to-end claims processing with built-in guided workflows, robust reporting capabilities, and a fully automated diary system to streamline the settlement of claims. ClaimRuler™ was purposefully built to service the needs of real people in the industry. Its functional and intuitive approach to design makes working with forms, lists, documents, and photos a simpler and more natural experience. From I/A firms, TPAs, and insurance carriers to municipalities and self-insured corporations, ClaimRuler™ adapts and scales along with your organization.

Enter gets Providers (doctors, practices & hospitals) paid faster than anyone in history. Enter processes health insurance claims and pays in 24 hours while automatically communicating and collecting patient responsibility with a white label collection engine, complete with payment plans. Enter is 30x faster at getting claims paid and 45x faster at getting patients billed at the same cost as existing medical billers. - $150mm+ of claims processed in just 1 year of operations. - $100mm credit facility actively being deployed for providers. - Revenue Cycle Management Partner for United Healthcare Nevada. - Enter supports a wide variety of specialties including ASC, Orthopedics, Neurology, Dermatology, Emergency Rooms, Behavioral Health, Pain Management and more. - Enter works with all commercial and government health insurance carriers. - Enter integrates with all EMR / practice management systems. - No monthly fees. No integration fees. - Enter is venture backed

Through our personal, high-touch service, Coronis Health can provide an unparalleled level of professionalism you won’t find anywhere else. We won’t just help you collect your revenue. We will help you financially grow while progressing this industry into the modern technological age. Coronis Health is a global revenue cycle management company offering specialized solutions to healthcare practices and facilities. By using industry-leading technology combined with high-touch relationship building, Coronis Health allows healthcare practitioners to focus on patient care, maintain financial independence, and cultivate financial success. Coronis Health is comprised of the best of the best in medical billing. Thoughts leaders and experts in every practice area utilize global resources, technology, and best practices to provide successful partnerships for customers.

ResolvMD is an experienced full-service medical billing company that processes all health service claims (AHCIP etc.) on behalf of physicians. Our goal is to make physicians as confident and competent in their billing as they are in their practice through surfacing data-derived insights and democratized knowledge. We have the most modern, cost-effective, and secure platform on the market for processing claims. Our target audience are physicians (mainly specialists such as emergency physicians, urgent care, plastic surgeons, anesthesiologists, paediatricians, general surgeons etc.). They need a billing agent to process their health service claims. They value time, trust, cost, efficiency and knowledge. We are targeting physicians in Alberta today (mainly in Calgary, Edmonton, Red Deer, Medicine Hat, Lethbridge, Okotoks and any other centre with a population in excess of 25,000.

Streamlining the claims process from end to end. Technology-driven, people-centric, and built on integrity. A robust claims service interaction platform for insurance carriers, MGAs, captives, and self-insured entities. Deployments, claims organization, and advanced file management at your fingertips. At Beagle, we understand the unique challenges faced by insurance service providers and independent adjusters when it comes to claims handling. Our core software functionality is designed to streamline the process, reduce costs, and provide rapid responses to your claims. Our technology brings efficiency and expertise to every step of the adjustment process. Express claims and inspection responses that reduce liability and drive efficiency. New policy inspections, policy renewals, and daily losses. Beagle was developed to handle the processes required on a daily basis. Streamlined claims handling by leveraging the latest technologies that enable a more efficient resolution.

Venue ™ Claims Management for Independent Adjusters provides end-to-end management of the entire claims processing workflow. Whether you are an adjustment firm, third-party administrator, insurance carrier, or a self-insured organization, Venue ™ is for you. The user-configurable interface allows for extensive self-customization of the claim system by an end client. Built-in web service interface that allows for real-time or batch data import, update and export to virtually any third-party data sharing source of ALL claim-related information. Integration with policy and billing systems allows real-time synchronization on all policy-related details, which may include critical policy dates and flags such as active fraud investigation and assumed policy. Comprehensive capabilities for every aspect of claims processing, including claim payments and recovery, reserves tracking, contact management, excess and trust accounts, forms templates, reporting etc.

KMR Claims Processing Manager is a state-of-the-art, fully integrated, customizable claims processing solution for TPAs, Self Insured and Claims Administrators. Our system includes a comprehensive Medical & Dental Reimbursement module, allows for electronic claims, integrates with Document Imaging systems, has the ability for debit card processing and is totally HIPAA compliant.

Expedited claims. Multiple interfaces sync with your corporate brand. Digitized data environment that can be accessed from anywhere, at any time. Health and Life processing via faster systems that aligns with your processing needs. Speeding up the claims life cycle to match the influx of your claims—while reconciling and resolving the more complicated claims at record velocity. It’s in. It’s out. No interruptions or claims processing delays. CLAIMSplus moves claims faster, working with employers, TPAs and insurers with robust in-the-cloud processing platforms. CLAIMSplusis in the business of optimizing processes and expediting medical claims through secure, reliable and efficient electronic claims management. More to the point, our technology—first and foremost—manages claims quickly and efficiently. We’ve asked our clients, and the timescale of the claim is the most important element for claims processing.

Discover why thousands of insurance adjusters and contractors chose our affordable, easiest-to-use Estimating Software for Property Repair and Claims Processing Solutions. Generate estimates, sketches, digital images, reports, and insurance forms with minimal training. Never pay for a technical support call again. Our friendly and knowledgeable support reps are ready to assist you. Simsol provides the most competitive rates in the industry, especially when you sign up for a year. ClaimsWire is a web-based solution for the electronic assignment, tracking, and exchange of property claim data designed for insurance companies. It integrates seamlessly with Simsol, and supports all property estimating platforms. It offers powerful management and review tools, built-in accounting, and much more.

Digital technologies are having a significant impact on insurance, and those keeping pace with this evolution are on track to maintain a competitive advantage. Traditional claim management tools, involving multiple systems, paper files and manual processes, are being replaced with cloud-native enterprise claim management platforms. The Majesco ClaimVantage Claims Management Software for L&H platform streamlines the claims process through the full life cycle of a claim, from intake through payment calculation, integrating multiple systems to improve the flow of information across your business. Improve the customer experience and drive operational effectiveness with accurate and timely claim decisions. Built on the Salesforce Lightning Platform, Majesco ClaimVantage Claims Management Software for L&H enables insurance companies and TPAs to modernize and optimize their claims operations today and into the future.

Innovator, connector and leader for the insurance industry. We have the most extensive straight-through processing platform within the UK. Explore how our digital platform addresses your business needs. Business transformation powered by increased agility and a digital end-to-end experience. Improved productivity fueled by adviser and consumer self-service capabilities. Higher customer lifetime value through proactive ongoing engagement with customers. Customer and Adviser Portals – users access policy documentation and update personal and policy details and features digitally, in real time. Components cover every facet of the user experience including full reinsurance reporting, external portal integration, and automated and clerical underwriting. Flexible deployment – from full end-to-end SSG Digital platform deployment, to discrete integrated individual components (e.g. underwriting only, New Business only).

FileTrac has a long-standing legacy of being the #1 claims management system in the industry. Building on this reputation, it has now evolved into FileTrac Evolve. This enhanced version is a crucial component of the Evolve Suite, a comprehensive platform designed to revolutionize your claims management process. FileTrac Evolve is a leading web-based claims management system for independent adjusters, third-party administrators (TPAs), managing general agents (MGAs), and insurance companies of all sizes. Comes with a built-in diary system with reminders and provides integrations with Quickbooks, Outlook, Xactanalysis, Symbility, LEDES, NFIP/NFS, and Google Maps, FileTrac Evolve helps businesses manage their adjusters while ensuring accountability to their customers. Other key features include time and expense tracking, invoicing, adjuster timesheets, image and video uploads, accounting reports, quick notes, and more.

Aquarium’s platform delivers the most comprehensive solution for insurance companies seeking a quick, simple and effective route to market. Our platform has a proven track record of delivering fast return on investment. It can be deployed with minimal impact within existing IT ecosystems and, as a cloud-based solution, is fully scalable to the needs of the business. The platform consists of several integrated service components, both technical and functional, that deliver a comprehensive, end-to-end solution. This component provides a single customer view of omni-channeled interaction across the web, SMS, email, phone and post. It ensures automated engagement through inquiry, follow-up, sales process, mid-term adjustment, renewals and claims management. Customer satisfaction can be measured through net promoter score generated via SMS and or email including keyword and sentiment analysis.

Meet the challenges of value based care—no matter your current EHR. Get a clear view into your patient population with aggregated multi-source data and an easy-to-navigate visual display. Use insights based in data to better manage chronic conditions and care transitions, prevent illness, lower costs, and implement care management. Facilitate care coordination with tools that encourage a proactive approach, including a pre-visit dashboard, risk stratification, and automated tracking of admission, discharge, and transfer events. Put care management in operation. Extend physician reach. Foster critical interactions with patients and valuable follow-up in between appointments. Identify patients with the greatest risk for high-cost utilization, using the Johns Hopkins ACG system for risk stratification. Accurately assign resources where intervention is needed most. Improve performance on quality measures. Participate successfully in value-based payment programs and optimize reimbursement.

Zentist is a platform that uses advanced technology to simplify and automate insurance revenue cycle management (RCM) for dental practices. At a time when dental businesses lose an estimated $2.1 billion due to legacy billing systems, Zentist leverages robotic process automation (RPA) and machine learning to place otherwise tedious billing tasks on autopilot. Zentist’s platform is fully and easily scalable to meet the more complex billing needs of the modern dental industry—which has been marked by aggressive consolidation and unprecedented pressures for RCM scaling. Its software minimizes human error, maximizes insurance payout, provides advanced analytics on revenue, and improves the patient-provider relationship.

The most intuitive practice management and client-centric EHR software for mental health and substance abuse treatment professionals, BirchNotes is built to help you grow and manage your practice with ease. An EHR is designed with a behavioral health therapist in mind. Features and tools chosen and tailored for both substance abuse and mental health professionals. Your EHR, billing, insurance, scheduling, and telehealth are all in one integrated solution. No need for multiple log-ins, systems, or additional tools! No matter your practice setting or size, BirchNotes offers the flexibility and scalability to meet your needs. Our workflows are insights are configured to best suit your practice. Easily manage your practice with our smart workflows, automation, and customizable settings to help save you time and focus more on what matters to you. A better solution for better outcomes. Group, telehealth, and recurring appointments are fully supported, plus customizable calendar views.

PlanXpand™ is Acero’s proprietary transaction processing engine, one that powers each of our products for health benefits administrators. Leveraging this engine, clients may choose to implement Acero’s products concurrently or incrementally. In addition to selecting one of our standard products, administrators also may choose to utilize PlanXpand™ to develop a custom solution to extend existing system capabilities. Acero’s unique, integrated solutions feature Service-Oriented Architecture, allowing health benefits administrators and insurers to add features and functions to existing adjudication platforms. At the same time, our sophisticated design and engineering enables real-time adjudication of every type of claim, all in direct interaction with the core claims system, resulting in more accurate processing, more satisfied customers and less need for claims adjustments.

ALYCE is specifically designed for self-insureds, municipalities and small TPAs handling Workers’ Compensation, Auto Liability, Auto Property, General Liability, and Property claims. ALYCE has an intuitive design with important data elements on the main claim page, including the claim’s financial summary, with all of the other important details available with a quick scroll or a single click. Multi-tiered infrastructure for employer reporting requirements, based on locations and departments. Recoveries, including salvage, subrogation, and excess carrier payments. Automated scheduled and repeating payments with diary alerts. Automatic diaries based on events, time lines, and financial transactions. Automatic generation of form letters to claimants, lawyers, and other claim parties.

CaseworksPro is an affordable web-based claims administration system designed to support a wide range of claim processing requirements. Developed by Insurance Technology Solutions, CaseworksPro is purpose-built for carrier claims departments, self-insured retentions (SIRs) and third-party administrators (TPAs). This easy-to-use solution offers a host of features that include SIR client-centric workflows, policy data capture, one-ff and scheduled payments, user-defined access permissions, check printing, electronic reporting, and NCCI and ISO stat code capture.

5thPort is a digital patient education, engagement and eConsent platform. It can be used across individual practices, hospitals, health systems, and in clinical research. The platform utilizes high quality, prescriptive multimedia and teach-back to educate patients and their caregivers on their diagnosis, care plans, risks and benefits of recommended procedures. Once the patient is well-informed, our digital eConsent process helps to facilitate a meaningful conversation with your healthcare provider. With 5thPort, achieve the following results: 1. Save 15 to 20 minutes per consult (without spending any incremental effort) 2. Enhance the patient experience 3. Reduce patient stress on the day of their appointment 4. Empower patients to actively participate in their healthcare conversations with their provider 5. Reduce nurse burnout

A really easy to use Practice Management Software for Chiropractors. It includes Electronic Health Records (EHR), Billing as well as ability for patients to schedule appointments online. zHealth offers fully customizable SOAP Notes with ability to click, type or dictate SOAP Notes. Give patients a modern experience at every touchpoint in your practice with zHealth software. The end result? Happier patients and more business. Innovative products in zHealth software will help you manage everything from appointment scheduling, notes, billing, payment, and more. More personalized. More modern. More efficient. zHealth software is designed to help you manage and grow your practice and patient connections. Our one-on-one meetings and group calls help you better understand our zHealth software and discover easy ways to manage your practice with our chiropractor software.

Simple Interact is a Software as a Service (SaaS) company that serves medical practices, groups, and hospitals. We speed up your patient workflow while reducing your staffing needs. We do this by automating repetitive tasks that staff has to otherwise perform. Intake, Image capture(Insurance card, Driver’s license, Selfie), Medical history, Screenings, Legal, Informed consents, Initials, eSignature, Educational marketing. Automated filling of cancelled appointment slots, Appointment request forms, Referral request forms, and Request management. Patient self-sign-in with address/insurance verification, virtual waiting room, and Telehealth reminders and consent.

CaseTrakker products provide a comprehensive care management solution designed to ensure that your team always has up-to-date information and the tools to manage their members efficiently. CaseTrakker's comprehensive care management software includes an extensive collection of tools to meet all of your health management software needs - from care management to utilization review and everything in between. Our products provide the tools necessary to streamline core business operations and increase efficiency without compromising care management outcomes. CaseTrakker portals provide custom branded secure browser-based access to CaseTrakker data. portals offer a tailored experience and collaboration between members, providers, clients, and care management staff from any device.

The financial and administrative challenges facing healthcare providers are daunting. Waystar’s technology platform simplifies and unifies healthcare payments across the revenue cycle. We empower healthcare organizations to automate manual work, gain insight into processes and performance, and ultimately collect more revenue. At Waystar, we know there’s a better, more efficient way forward. Let’s climb the mountain ahead of us to reach new heights in healthcare. We know that adopting new revenue cycle technology can seem like an obstacle. Whatever your existing systems, our cost-effective technology is compatible and gets up and running quickly. Our single sign-on platform lets you manage commercial, government and patient payments all in one place, so you can consolidate vendors and eliminate the hassle of multiple systems. Give your staff intuitive solutions that will make their jobs easier and their workflows more productive.

We do this every day-worldwide-in 43 countries! We show our customers how to collaborate. Case management is a collaborative process. Collaboration is cooperation. It is a melding together of all components into a logical flow. It means assessing, planning, coordinating and facilitating the delivery of support and services. It means meeting the needs of those providing services and those who require the services. Alcea Casetrack provides a completely customizable solution to manage all of your case management needs. You track complex interactions, with a collaboration of all resources, including documentation and eventual outcomes. Learn how Alcea CaseTrack can improve how your business collaborates. Whether it is for private or government institutions, in the medical, audit, legal, social (human rights) or other fields, the collaboration of individuals (from case workers, managers and clients, complainants to respondents) make case management a difficult environment to manage.

A1 Tracker is presented by the vendor as a robust & configurable risk management software offering either stand-alone or fully-integrated risk management software covering many business segments across an organization. Claims & Incident Management Claims & incident reporting for claims of any type: injuries, medical, commercial, customer, insurance, work comp, asset, auto, liability. Risk Management & Threat Assessment: Risk register for tracking risks at any level in an organization, including by entity, project, asset, contract, vendor, division, business, unit, region, and more. Real-time risk reports & heat maps, dashboard metrics, alerts, & notifications. Contract Management: Contract module for tracking contracts of any type with vendors, employees, customers, and any other parties. Insurance Policies & Certificates: Policies & certificates of insurance tracking with reminders & renewals. For agencies & carriers policy management includes tracking clients.

Bridge is an award-winning enterprise patient engagement solution for healthcare organizations. The platform allows companies to replace their existing EHR’s patient portal, connect multiple health IT systems, consolidate patient engagement tools, and launch a digital front door. Scalable and easy to deploy, the solution is ONC 2015 Edition Certified and available as a client-branded web application and mobile app for Android and iOS. Bridge streamlines the patient experience by automating the entire care journey. Patients are kept engaged with customizable electronic communications, and multi-platform access to health, financial, and appointment information. Features include self-scheduling, health information access, secure patient-provider messaging, mobile intake, bill pay, telemedicine and much more. With a fully-documented and free API, healthcare organizations can easily create their own interfaces, add-on features, and run advanced reports.

AGO Insurance Software, Inc. has been a recognized leader in software and services for property and casualty insurance firms, and we have provided proven, cost effective business solutions to insurers of all sizes. Our products include solutions for policy administration, claims processing, accounting, bureau reporting and expert systems. Our software can streamline your operations, making your business more efficient, productive and profitable. Our System is designed in a modular fashion which can be installed as a completely integrated system or separate modules that can be licensed individually. This provides the flexibility of collaboration with existing legacy or third party systems.

The market's most powerful and accurate solution for claims processing. CyberSource Medical Claims Scanning Solution, a complete turn key system for HMO, PPO, TPA, or Self Funded Organization, is installed at your location for automated data entry of CMS-1500, ADA-2006 UB-04 and enrollment forms. Using advanced "intelligent" features combined with your business rules, CyberSource recognizes, validates and formats the data from medical claim forms. Fuzzy Matching performs an intelligent search of your member and provider database correctly identifying the exact match. The matched data is then utilized to verify and correct data on the medical claim before being passed through to adjudication. The combination of industry-leading OCR efficiency, your business rules and “Fuzzy Matching” results in exceptional accuracy of the data from your medical claims forms.

Filing claims are complex and critical processes. More than 60% of people do not file complex due to its complex processes and time taking nature. Artivatic’s dedicated claims platform for each insurance vertical helps insurance businesses to enable digital claims journeys, self-claims processing, automated assessment, risk & fraud intelligence and claims payout. ONE PLATFORM FOR ALL YOUR CLAIMS NEEDS. End to End Claims Automation and Assessment Platform AUTO CLAIMS – HEALTH CLAIMS – TRAVEL CLAIMS – ACCIDENTAL CLAIMS – DEATH CLAIMS – FIRE CLAIMS – SME CLAIMS – BUSINESS CLAIMS – COMMERCIAL CLAIMS

Empower your employees to drive productivity and reduce the total cost of risk with the RMIS built to deliver insight and results. Active risk management is a strategy where you empower your employees to more productively manage risk by leveraging technology that is centralized, connected, scalable, and data-driven to deliver results. Successfully decrease accidents, claim lag time and case duration using Aclaimant’s centralized system that connects your risk management office to incidents in the field. Reduce the cost of claims through better prevention and better mitigation to ultimately improve your insurability. Better utilize superior risk and safety talent with mobile-first, modern technology and automation. Aclaimant keeps your team focused and improves talent appeal, morale, and retention. Get access to case studies and content to better understand how you can put the Aclaimant platform to work for you and your team.

The FACTS® family of products supports multiple lines of business within a single information system: Health, Indemnity, TPA, PPO, HMO, PHO, IPA, MSO, Group Administration, COBRA, Section 125-Integrated Flexible Benefits, and Workers' Compensation with Integrated Managed Care for 24-hour coverage. From the inception of HIPAA, the FACTS® system infrastructure has been based on HIPAA-compliant solutions. FACTS® is fully committed to ensuring a clear and easy path to HIPAA readiness - well ahead of the federally mandated compliance deadlines. FACTS® fully integrated, interactive Internet and voice-based systems empower healthcare administrators and professionals with 24 x 7 access to claims and benefit information, and real-time transactions such as EDI claim uploads, through the Internet. Improve your risk and insurance management.

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. RAM’s Medicare Advantage-in-a-Box offering is unique in the industry; the product of RAM’s extensive experience in Medicare Advantage and an unwavering commitment to changing our industry. HEALTHsuite Advantage™ and eHealthsuite™ are the cornerstones of our pre-configured Medicare Advantage-in-a-Box offering. HEALTHsuite Advantage is a fully integrated suite of modules providing our clients with an unmatched solution to administer their Medicare Advantage and Special Needs Plans (SNP’s).

Liability claims management software solutions from Recordables. Software solutions to improve claims management including General Liability, Auto, Property, Incidents, and more. Recordables Liability insurance tracking software organizes incidents and claims that include auto, property, and general liability policies. Tracking all liability and risk incidents and claims, TrackAbility provides comprehensive liability claims tracking software solutions Benefits of TrackAbility liability claims management include start to finish injury liability claims management from incident through completion. Create customizable liability claim types with user-selectable criteria. Safety professionals and field users can collaborate on claims and reports, continuing to add pictures and videos for incidents or claims. Receive a holistic view of financial data necessary for claims management, such as payments and losses based upon individuals, locations, policy specifications, and other data.

Claim Leader develops and provides technology solutions to automate the communications and workflow processes across the business enterprises of insurance claims organizations. Our software solutions allow to simplify your operations, while providing superior productivity through an advanced, and integrated web platform. Feature-rich modules within Claim Leader systems create a simplified workflow for internal administrators and on the field users. Management tools allow internal users to dispatch assignments to field staff, sort workload, pinpoint files for review, and streamline workflow.

Take control of your business operations by automating business processes, consolidating information, and creating real-time, actionable insight into your business ecosystem. Caseblocks comes with ready-made solutions and built-in flexibility to change whenever your organization needs it. Customer information is highly sensitive, including personal, medical, and financial information. We invest heavily in education, technology, and monitoring to ensure your data is held safely and securely in the Caseblocks cloud. We recognize that many organizations prefer to keep business and customer information within their own data center. Case blocks is available for an on-premise installation. Work smarter by automating custom processes on the Caseblocks Cloud. Caseblocks is a modern platform for the automation of operational business processes, where important processes can be configured and rolled out quickly.

Auto insurers need tools to simplify physical damage claims processing from the first notice of loss (FNOL) to settlement. Mitchell WorkCenter is an open, end-to-end modular solution that allows you to configure the modules and integrations specific to your unique business needs. Achieve better outcomes through improved accuracy and efficiency, while lowering the total cost of ownership. Our platform provides you with the ability to send and receive all information straight into your claims management system. With a proven track record of projects implemented in 90 days or less, your IT department will find integration with Mitchell WorkCenter simple. No two businesses work the same way. With WorkCenter, you can configure and manage your software based on your business needs. Access our entire suite or select certain features that best fit into your claims management workflow.

PayorLink solutions offer more than just medical claims management on behalf of employers to take on a comprehensive platform approach in providing better employee benefits to reduce healthcare costs, promote healthy lifestyle, lifetime health and improve workforce productivity in the process. Rising employee health costs is a worldwide phenomenon and a growing concern for both payor companies and provider entities alike. PayorLink™ is designed to reduce payor health cost, motivate staff productivity and optimize provider claims quality resulting from in part, information exchange efficiencies directly between payor companies and affiliate provider clinic, medical centre or hospital. Enhanced with Employee Health Profile and Assessment tools for staff wellness and productivity realization.