Alternatives to Direct Care Innovations
Compare Direct Care Innovations alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to Direct Care Innovations in 2026. Compare features, ratings, user reviews, pricing, and more from Direct Care Innovations competitors and alternatives in order to make an informed decision for your business.
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1
RouteGenie
RouteGenie
RouteGenie is NEMT software built for non-emergency medical transportation operations that have outgrown basic dispatch software. It combines NEMT scheduling software, dispatch, routing, billing and fleet compliance in one platform, running 600+ fleets and 20,000+ vehicles across 46 states and two countries at roughly 50,000 trips a day. NEMT dispatch software built for multi-site scale. Operators run every location in one instance with role-based access, per-location configuration and a complete audit trail on every trip change — who cancelled a trip, when, and why. DispatchGenie builds and continuously re-optimizes routes with native multiload, so a 200-vehicle schedule rebuilds in seconds instead of being maintained by hand. Subcontractor vehicles appear on the same live map as owned fleet, which matters when your network is larger than your payroll. NEMT broker software, built in. ImportGenie runs 28 live broker and payer integrations — ModivCare, MTM, Veyo, Verida, SafeRide Health, Alivi, VectorCare, New York MAS, Uber Health, transit authorities and Medicaid health plans — importing trips and returning statuses automatically, with no re-keying. BillingGenie is full non-emergency medical transportation billing software: Medicaid billing, CMS 1500, broker billing, claim scrubbing and denial management in the same system, so billing is not a second platform. Enterprise administration. SAML2 single sign-on with Microsoft Entra ID, Okta, OneLogin and Google Workspace. Single-tenant deployment with per-customer data isolation. SOC 2 Type 1 attested. HIPAA-aligned controls, BAAs, encryption in transit and at rest, role-based permissions, and four portals: staff, drivers, payers and facilities, and passengers. Open REST API. Pricing that does not punish growth. Flat per-vehicle pricing with unlimited trips and unlimited users. No per-trip fees, no per-seat licensing. Cost tracks your fleet, not your trip volume or headcount — which is why high-volume operators and large agencies model lower total cost here than on per-trip or per-user platforms. RouteGenie serves large and mid-size NEMT providers, PACE organizations, adult day programs, regional transit authorities, brokers and Medicaid health plans. Providers running 80 to 170 vehicles have migrated here from legacy paratransit and NEMT platforms. No fleet minimum. 4.6/5 across 49 reviews. 13 consecutive SourceForge Top Performer awards. -
2
StoriiCare
StoriiCare
StoriiCare is an AI-powered EHR and care management platform for adult day care centers, assisted living providers, and care homes. Trusted by 300+ care providers across 11 countries, it combines clinical documentation, private pay and Medicaid billing, and family engagement in one easy-to-use system. Care staff document care digitally, replacing paper and reducing admin time. Administrators gain real-time oversight. Families stay connected through activity updates and shared care profiles. StoriiCare includes Skye, a built-in AI agent that helps staff draft progress notes, identifies patterns in care data, and guides documentation workflows — no technical expertise required. Clinically, it covers assessments, care plans, medication administration, ADLs, progress notes, and incident reporting. For billing, it supports private pay and Medicaid - invoicing, attendance, authorizations, and claims, all in one. Recognized for its ease of use and outstanding support.Starting Price: $650 per month -
3
NextAgency for Health & Life Insurance
Take44, Inc.
NextAgency is life and health insurance agency management software. Unlike insurance agency management systems built primarily for property and casualty agencies, NextAgency is designed for health insurance, employee benefits, Medicare, and life insurance agencies. • Life and health insurance agency CRM for prospects, clients, policies, renewals, and relationships • Marketing tools with email campaigns, drip marketing, and texts • Automated insurance agency workflows • Business analytics, dashboards, and reporting for agency performance and pipeline management • Compliance and disclosure tools with e-signatures and required insurance documentation • Optional insurance commission tracking with carrier statement imports, reconciliation, and sub-agent management • Easy to customize for how your insurance agency works • Top-rated support • Free Android and iPhone apps • Insurance agency software with transparent pricing, a 30-day free trial, and no long-term contract requiredStarting Price: $85 per seat per month -
4
CareTime
CareTime
Built for usability and power—CareTime is a cloud-based desktop and mobile software solution for home health, home care, and consumer-directed care markets. Find the best fit based on client requirements, preferences, distance, hours worked, and caregiver availability. Invite caregivers to accept a shift through text message or email. Shifts are filled on a first-come-first-serve basis. Track visits and automatically create billing and payroll data from check ins and check outs. Record visit notes and questions. Admins have the ability to see caregivers and visits on a map. Alerts notify if visits are missed, caregivers are late, authorized hours are running out and more. Create and send electronic claims to get paid by insurance, Medicaid, Medicare, and more. Batch claims can be created in an instant from all of your visit data. -
5
Battelle
Battelle
We provide insights that help healthcare systems better serve their patients. That’s why providers such as the Centers for Medicare & Medicaid Services (CMS) and the Defense Health Agency (DHA) choose Battelle to drive innovation and optimization. Battelle improves the performance of health systems, small and large. Our goal is to improve the performance of the healthcare system by solving the challenges needed to keep pace with the need for better information to guide clinical decision-making at the point of care. Our solutions improve patient outcomes and reduce unwarranted variation in healthcare delivery. We evaluate how different types of messages across communication channels perform and examine the effectiveness of proposed messages and materials. -
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Paradigm
Paradigm
Paradigm Senior Services offers a full-service, AI-powered revenue cycle management platform specifically tailored to home-care agencies that bill third-party payers such as the U.S. Department of Veterans Affairs (VA), Medicaid, and other managed-care payers. It automates and streamlines every step of the billing and claims process: from eligibility/authorization verification, state- or payer-specific enrollment and credentialing, to submission of clean claims, denial handling, and payment reconciliation. It integrates with common agency management software and electronic visit verification tools to scrub shifts, verify authorizations weekly, and reconcile payments, reducing denials and minimizing administrative burden. Paradigm also supports “back-office as a service” for providers; even if they already have internal billing staff or scheduling software, Paradigm can take over claims processing as a specialized, expert billing department. -
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Hospice Tools
Hospice Tools
Hospice Tools is a hospice EMR and billing software platform built specifically for independent hospice and palliative care agencies. The system includes eDocs EMR, TimeKeeper, eBilling, web access, and mobile apps to support clinical documentation, care planning, IDG workflows, payroll, mileage tracking, claims, and compliance. Hospice Tools is designed by hospice professionals and focuses on workflows such as point-of-care charting, smart care plans, SNF room and board billing, HIS dashboards, and real-time claim status. Agencies can use the platform to chart from virtually any device, customize forms and reports, validate documentation, track staff activity, and manage billing across Medicare, Medicaid, and other payers. Its mobile apps give care teams secure real-time access to patient information, document signing, scanning, uploading, and chart updates from the field.Starting Price: $85 per user per month -
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Virtual Benefits Administrator (VBA)
Virtual Benefits Administrator
Virtual Benefits Administrator (VBA) is the industry's leading cloud-based benefits administration software solution. With a robust functionality and unlimited flexibility, VBA allows users to build and manage medical, vision, dental, disability, Medicaid, Medicare, Medicare Supplement, care management, long-term care health benefits, health savings accounts (HSAs), flexible spending accounts (FSAs), health reimbursement accounts (HRAs), and COBRA. -
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HEALTHsuite
RAM Technologies
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). -
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Approved Admissions
Approved Admissions
Approved Admissions is a secure platform that automates tracking of coverage changes for Medicare, Medicaid, and commercial payers bundled with real-time eligibility verification and coverage discovery. The platform's primary goal is to help providers minimize the number of claim denials due to a missed insurance coverage change and accelerate the billing cycle. Approved Admissions is using the innovative RPA (Robotic Process Automation) Bridge solution to ensure patient data consistency across multiple systems, and benefit coverage search. Key Features: - Automated eligibility verifications and re-verifications - Email or API notifications if any coverage changes are detected - Real-time verifications - Batch eligibility verification - Seamless integration with RCM, EHR platforms (PointClickCare, MatrixCare, SigmaCare, DKS/Census, FacilitEase, and many others) - RPA-powered cross/platform synchronizationStarting Price: $100 per month -
11
AxisCare
AxisCare Home Care Software
Designed for enterprise-level non-medical Personal Care and Medicaid agencies, AxisCare's award-winning, web-based scheduling and management software allows agencies to manage and grow with confidence. AxisCare's Scheduled Reports simplify reporting by automating generation with precise specifications, ensuring accurate data for critical business decisions. AxisCare's Veterans Affairs and Medicaid billing services streamline reimbursements. VA billing experts configure your system, prevent recoupments, and manage claim submissions with direct payments. Medicaid specialists deliver accelerated payments with clean EVV processing, reduce denials through claim scrubbing, and help explore additional revenue opportunities through waivers and MCOs. With robust scheduling, GPS Mobile App, EVV, hospitalization tracking, medication reminders, payment processing, and custom reporting, AxisCare is the easiest-to-use software in Home Care.Starting Price: $325 -
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CareJourney
Arcadia
CareJourney is a cloud-based healthcare analytics platform offering deeply comprehensive, clinically-relevant intelligence derived from one of the largest longitudinal claims datasets in the U.S., covering hundreds of millions of beneficiaries across Medicare, Medicaid, Medicare Advantage, and commercial populations and profiling more than 2 million providers. It empowers organizations to assess markets and patient cohorts to uncover opportunities for cost savings and better outcomes, build and grow high-performing networks, make smarter contracting decisions, identify referral patterns and leakage, and benchmark provider performance against peers. It also supports management of at-risk populations through segmentation models, helping organizations understand chronic condition prevalence, care utilization, and cost drivers. -
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WCH PMBOS
WCH Service Bureau
WCH’s professionalism in medical billing, provider credentialing, CVO, office management combined with experience of our programmers has helped create a one of a kind medical billing program and practice management system. WCH is a registered vendor with Medicare & Medicaid. In addition, our software for medical billing, (PMBOS), is recognized by most major insurance companies such as GHI, Blue Cross Blue Shield and Value Options. PMBOS is an abbreviation of Patient Management Billing Operating System. It is an effective and efficient medical billing program. Everything starts at the front desk! The appointments screen is one of the features offered that allow providers and their staff to schedule as well as maintain appointments, patient’s data, ledger, authorization and much more. Maintain accurate patient history from the first visit by matching claims billed in accordance to the appointment schedule. -
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Office Puzzle
Office Puzzle
Office Puzzle is a cloud-based, all-in-one practice management and EHR platform built to help behavioral health and care agencies streamline operations by connecting every part of their workflow, from client intake and scheduling to documentation, billing, compliance, and payroll, in a single, intuitive system. It centralizes smart scheduling, automated session documentation with prefilled templates and AI text assistance, and secure client records so that session data, treatment plans, authorizations, and outcomes are easily organized and searchable. It includes real-time scheduling that avoids conflicts and applies authorization rules, electronic visit verification for Medicaid-ready compliance, and integrated billing and claims submission tools that pull directly from session data to reduce errors and speed reimbursement. Office Puzzle also supports secure document storage, e-signatures, role-based permissions, team management with credential and training tracking.Starting Price: $19.99 per month -
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OpenLoop
OpenLoop
OpenLoop is a fully white-label telehealth platform designed to help organizations launch and scale virtual care quickly and efficiently. It provides end-to-end telehealth infrastructure, including technology, clinical staffing, licensing, credentialing, and regulatory support. Built to integrate seamlessly with existing systems, OpenLoop supports both synchronous and asynchronous care models. It is trusted by millions of patients annually and operates across all 50 U.S. states. OpenLoop enables organizations to deliver branded telehealth experiences with scheduling, payments, and patient support included. Nationwide payer coverage, including Medicare and Medicaid, simplifies reimbursement and revenue cycle management. With AI-powered operations and 24/7 patient support, OpenLoop helps organizations scale care while maintaining quality and compliance.Starting Price: Free -
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Careficient
Careficient
Careficient is a cloud-based EMR software platform built for home health, hospice, home care, and palliative care agencies. The system helps agencies manage clinical workflows, intake, referrals, admissions, client health records, caregiver management, scheduling, point-of-care documentation, billing, payroll, reporting, and interoperability. Careficient is designed to reduce manual work, improve productivity, support regulatory compliance, and help agencies get paid faster. The platform can scale from a single agency to large multi-agency operations while supporting multiple lines of business in one connected EMR. Its module suite includes tools for claims management, Medicare claims automation, revenue cycle analytics, EVV, document management, partner interoperability, patient and family portals, and Medicare fiscal intermediary connectivity. Careficient gives care agencies a flexible EMR solution for improving operational efficiency, care coordination, cash flow, and compliance. -
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Axxess Home Health
Axxess
Increase your organization’s cash flow by processing claims from Medicare, Medicaid and all other commercial payers. Automated processing of all payer claims in real time from anywhere at anytime ensures your claims get processed and get paid faster. Automatically submit and track your claims from anywhere at any time with real-time claims status updates. You are assigned a dedicated account manager that is a certified health care claims manager. You even have their mobile phone number. Diversify your revenue sources and improve your cash flow with our automated, anytime, anywhere claims processing with complete visibility to all your electronic funds transfers (EFT) and payment projections. Process, track and fix claims in real-time to capture all your revenue while eliminating costly time-consuming processes. Automate Medicare eligibility verification and claims processing. -
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AveeCare
AveeCare
AveeCare is a cloud-based home care agency management platform that serves agencies across all 50 US states. The platform covers scheduling, patient management, caregiver coordination, billing, compliance, real-time visit tracking, and more. AveeCare's scheduling module uses AI to match caregivers to visits based on availability, geographic proximity, skill requirements, and patient preferences, with drag-and-drop editing and recurring visit support. Caregivers use a dedicated iOS and Android mobile app to clock in and out with GPS verification, view schedules, document visits, capture signatures, and receive push notifications. For billing, AveeCare supports private pay invoicing, Medicare, and long-term care insurance. The platform generates CMS-1500 forms and ANSI X12 837P/837I EDI files for claims, with support for 270/271 eligibility verification, 276/277CA claim status inquiries, and 835 ERA remittance processing. 180+ additional features .Starting Price: $6/month/user -
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EZClaim Medical Billing
EZClaim
EZClaim is a medical billing and scheduling software company that provides a feature-rich practice management system specifically tailored for small to medium-sized provider office and outsourced medical billing firms. It also includes integrations with a number of EMR/EHR vendors. Whether you are a doctor, practice manager, or billing service owner, EZClaim Billing is designed with you in mind, simplifying your claims management from data entry to payment posting, and beyond. EZClaim primarily supports the following specialties, General Practice, Therapy, Vision, Surgical, Medical Specialties, Home Health Care, and Outsourced Medical Billing Services (RCM). However, the software is very adaptable and can be used for many other billing specialties. EZClaim’s billing software allows the creation of insurance payor lists for Medicare, Medicaid, Tricare, Clearinghouse payer IDs, governmental MCO’s, auto insurance, and worker compensation groups. -
20
Consensus Signal
Consensus Cloud Solutions
Consensus Signal delivers real-time health event alert notifications, connecting providers and care teams wherever patients receive care. Consensus has joined with the leading event alerting solution in the market. Our partner, Secure Exchange Solutions, provides a nationwide reach into EHRs and access to nationwide directory services to easily find the provider for each patient. This means we deliver notifications directly into the workflow of receiving providers EHRs without requiring costly interfaces. No need to upload lists of patients or even have an EHR, we can deliver readable alerts into existing email clients. The new Conditions of Participation (CoPs) require mandatory notification compliance for Medicare and Medicaid participating hospitals, including psychiatric hospitals and CAHs, to send electronic patient event notifications of patients’ admission, discharge, and/or transfer to their primary care provider. -
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Centauri Health Solutions
Centauri Health Solutions
Centauri Health Solutions is a healthcare technology and services company driven by our desire to make the healthcare system work better for our clients and to provide compassionate support for individuals in need. Our analytics-powered software enables hospitals and health plans (Medicare, Medicaid, Exchange and Commercial) to manage their variable revenue through a custom-built workflow platform. While our tailored support of their patients and members provides them with access to life-enhancing benefits. Our solutions include Risk Adjustment (Medical Record Retrieval, Medical Record Coding, Analytics and RAPS/EDPS Submissions), HEDIS® and Stars Quality Program Management, Clinical Data Exchange, Eligibility and Enrollment, Out-of-State Medicaid Account Management, Revenue Cycle Analytics, Referral Management & Analytics, and Social Determinants of Health. -
22
eRSP
Kaleida Systems
eRSP™ is the industry leading, cloud based, home care software featuring; client management, scheduling, billing, and payroll solutions that are easily tailored for companion care, special needs, assisted living, and skilled care services. eRSP™ is a highly customizable and feature-rich agency management software designed for the private duty home care industry. First deployed in 2002, eRSP™ is the original cloud-based home care solution. eRSP™ has grown up with the home care industry and offers both innovative features and experienced services. For agencies providing both private duty and skilled nursing care, eRSP™ is the perfect solution. The eRSP™ Medicaid/Insurance suite enables agencies to manage both business processes with a single integrated solution. We are committed to working with the Supported Living Community to provide a customized eRSP™ solution for agencies that provide supported and independent living services to those with developmental disabilities. -
23
CareRight
CareRight Technologies
CareRight allows caregivers to track and chart all ADLs, including exceptions. With customizable Service Plans and Assessments per resident, CareRight is incredibly flexible. For any type of care facility, great documentation increases accuracy, encourages compliance, reduces risk, and saves money. Replace paper forms and increase accuracy of documentation, complete ADLs quickly, increase Medicare and Medicaid reimbursements, easy-to-use, intuitive technology, monitors and promotes compliance through regulation, no more combing through paper charts for information. Touchscreen with kiosk, laptop or tablet, customizable Service Plans and Assessments, visualize data with great charts and graphs, input and Output monitoring, tracks meals, fluids, and snacks, holistic view of resident records, spots trends before an issue arises. Make generalized or specialized ADLs that can be assigned to a single resident or multiple residents at once. -
24
Phamily
Jaan Health
Reverse declining reimbursements with new monthly. Chronic Care Management revenue. Phamily makes CCM simple, scalable, and 5-10x more profitable. Chronic Care Management (CCM) is a new program from The Centers for Medicare & Medicaid Services (CMS) that: offers monthly reimbursement for the support you regularly provide patients between visits. Allows billing for everyday activities done by your staff, e.g. phone calls, refills, referrals, labs. Incentivizes a higher standard of care for patients with multiple chronic conditions. Offers an additional $42-$139+ per patient per month based on time and complexity. Chronic Care Management could be a lifeline. But without the proper tools, it’s a dead end. A typical provider can enroll 250 CCM patients and earn $125,000+ per year. However, most organizations actually lose money on CCM because they try a brute force labor-intensive approach using EHRs, monthly phone calls, and manual documentation. -
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STARSTrack
Ingenia Health
STARSTrack is an advanced healthcare quality analytics platform designed to elevate performance in Medicare Stars, Marketplace Stars, local Medicaid programs, and Commercial quality rankings by centralizing data, analytics, and actionable insights in one system. It offers full visibility into all factors that influence quality results with NCQA-certified quality measure calculations, support for HEDIS, Pharmacy Quality Alliance (PQA), CMS Operational, Medicaid Core Set, and customizable local measures, and proactive monitoring of prospective performance that helps analysts focus on outcomes rather than manual reporting. It delivers detailed built-in reports, centralized star score intelligence across all contracts, and the ability to review past performance, live trends, and predicted results to guide strategic improvement initiatives. -
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Virtual Employee Network (VEN)
Relocation Management Worldwide
RMW utilizes our cloud-based GSA FedRAMP authorized Virtual Employee Network (VEN) to fully automate/modernize permanent change of station operations across the federal government. Our intuitive software allows stakeholders (traveler, approving officials, travel office, HR office) to work collaboratively to build travel authorization (TA), amendments, manage HHGs, and allow employees to self-initiate voucher submissions via Q&A interview. VEN utilizes APIs to auto-calculate TA cost estimate and PCS voucher payments. A travel portal allows travelers and travel office to submit and process vouchers via automated workflow. Report module gives agencies visibility into all relocation associated expenses (obligation, voucher disbursements, HHGs invoicing) and taxes (WTA, FICA, Medicare, State, Local, W2) that support audit readiness and used for decision support and metric analysis. VEN business rules are configured IAW FTR, JTR, DSSR, and FAR regulations along with agency specific policies. -
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Nestaid
Nestaid
Nestaid, an AI Native Operating System for home care agencies with AI Employees built in. Home care agencies, non-medical, Medicaid HCBS and waiver, and private-duty agencies, use Nestaid to run their daily operations: scheduling caregivers to client visits, electronic visit verification (EVV), care plans, client and caregiver records, hiring, billing, payroll-ready timesheets and reporting.Nestaid ships a set of AI agents that do routine operational work for the office like your own staff: answering the agency's phone line, filling shifts when a caregiver calls out, following up on missed clock-ins, screening job applicants, generating care plans and compliances. -
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HHAeXchange
HHAeXchange
HHAeXchange connects the dots between payers and providers for improved patient outcomes. Grow your business, streamline workflows, and improve patient outcomes with our enterprise homecare management software. HHAeXchange’s comprehensive homecare provider platform offers an enterprise solution for all of your agency’s needs, from referral and intake management to scheduling, billing, and compliance. Our easy-to-use system is designed specifically for Medicaid Managed Care, Commercial LTC, Consumer Directed, and Private Pay services. We are the industry leader in connecting providers and payers for successful communications, collecting confirmed visits, creating claims, and providing workflow efficiency tools to help providers optimize their operations and grow their business. -
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Inovaare
Inovaare
As an industry leader of health plan solutions that drive digital transformation in healthcare, Inovaare automates complex Medicare, Medicaid and Commercial appeals and grievances (A&G) and Compliance Program Effectiveness (CPE) workflows. Its configurable cloud-based modules compile real-time data across internal and external departments, creating one compliance management system. The HIPAA-compliant platform integrates the most current, best-practice regulatory processes to help health plans efficiently meet their unique business requirements, sustain audit readiness, reduce non-compliance risks and lower overall operating costs. Inovaare’s industry-leading Appeals & Grievances and Regulatory Compliance health plans solutions automate time-consuming manual compliance processes to ensure higher CMS reimbursements, reduced compliance audit risks, and lower operating costs. Configurable software that optimizes risk identification, supports operations and displays intuitive analytics. -
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Newgen Appeals and Grievances
Newgen Software
Resolve members’ appeals and grievances while complying with regulatory guidelines and adhering to state-level and CMS (Center for Medicare and Medicaid Services) guidelines. Optimize resources and reduce turnaround times by leveraging our rule-driven engine to prioritize and route all service requests. Capture all decisions, notes, and exceptions within the system for future reference and audits. Automate your service requests processes to future-proof your organization, stay on top of regulations, and guarantee member satisfaction. -
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Silna Health
Silna Health
Silna Health’s Care Readiness Platform handles all prior authorizations, benefit checks, and insurance monitoring upfront to make sure patients are clear to receive care while providers gain capacity to focus on treatment. Its AI‑powered engine manages the entire prior authorization workflow, from tracking upcoming authorizations and sending weekly reminders to submissions and follow‑ups, automatically applying industry‑proven rules and escalating exceptions for human review. Specialty‑specific benefit checks verify coverage, accumulations, authorization requirements, and visit limits in real time, delivering accurate quotes at intake. Continuous insurance monitoring flags lost coverage, detects new plans, and safeguards against eligibility lapses. Designed for zero extra headcount, Silna ingests data directly from EMRs and practice management systems, offers configurable rule sets and strategic guidelines, and presents clear dashboards with incremental revenue insights. -
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Veritable
314e Corporation
Veritable accelerates patient insurance eligibility verification and claims-status checks by providing instantaneous results in a clean, intuitive interface. It supports real-time, batch uploading of patient lists to verify eligibility across more than 1,000 payers (including national Medicare and all state Medicaid) and multiple service types. It also enables tracking of claims status, from submission through reimbursement, so practices and billing companies can proactively identify issues to reduce payment delays and denials. Key benefits include automating eligibility and claims workflows to reduce manual entry and phone calls, improving front-desk patient experience by validating coverage and copayments at check-in, and offering seamless integration for both technical and non-technical users with strong data-security controls. It includes a “Code Explorer” for instant lookup of ICD-10-CM, ICD-10-PCS, HCPCS Level II, and CPT codes.Starting Price: $50 per month -
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LexisNexis Provider Integrity Scan
LexisNexis
To prevent the risk, Centers for Medicare and Medicaid Services (CMS) has established requirements to validate their networks. As Pharmacy Benefit Managers (PBMs) bear the brunt of this risk assessment, the need for accurate, actionable information has never been greater. LexisNexis Provider Integrity Scan automates a variety of provider verification searches and ongoing monitoring options by checking against multiple files and lists and provides automatic red flag alerts for a wide range of high-risk indicators. It has the capability of screening and verifying pre-enrollment as well as monitoring post-enrollment to detect and prevent criminal activity. LexisNexis Provider Integrity Scan is designed to help reduce health care payers' and PBM's costs by identifying potentially fraudulent providers and businesses enrolled or attempting to enroll in health-related programs. Our solution gives users the ability to efficiently process multiple searches and obtain critical information. -
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SmartEMR
SmartEMR Solutions
SmartEMR is a Web-based electronic medical records solution that enables physicians to record patient encounters and test interpretations quickly and easily. It's tailored to the physician's workflow to ensure a smooth, natural interaction while creating reports that are compliant with the Centers for Medicare and Medicaid Services (CMS)* for coding and reimbursements. SmartEMR also works as a medical billing software, facilitating reimbursement by using our CMS-compliant Superbill generation module. Your electronically submitted claims will be processed with a higher priority ensuring faster turnaround time for reimbursement. SmartEMR will improve your cash flow, by reducing costs and streamlining the entire process for reimbursement.4 -
35
Newgen Medicare Enrollment
Newgen Software
Efficiently manage your enrollment processes, eliminate paper-based transactions, and capture member information on the go by leveraging our integrated, mobility-based enrollment solution, built upon our enterprise mobility framework. Streamline your end-to-end processes, including enrollment, reconciliation, and service, to reduce errors and eliminate the need for manual intervention. Unified view of assigned leads, pending items, alerts and notifications, etc. Smart prospecting capabilities, including task scheduling, follow-ups, and lead assignment and search. Remote and offline application processing and enrollment. On-the-go access to information for improved enrollment turnaround times. Scope of appointment capture per the Centers for Medicare and Medicaid guidelines. Dynamic mobile forms for on-the-go capture of enrollees’ information and signatures. -
36
King of Time
Huubap Pte. Ltd.
King of Time, a cloud-based time attendance management system that provides simple and advanced attendance management using only a PC and the Internet. You can manage the data in real-time on the browser, so it is possible to realize "work efficiency" and "cost reduction". Features alert: Overtime management. Various overtime calculation standards (regular / holiday / extra overtime) can be set for different employees, with different work rules, from part-time workers to full-time employees. Shift management. You can view, modify, and check work hours in real-time. Employees can input their preferred work hours from their computers or mobile phones. Administrative authority. KoT administrator can create a general administrator with appropriate authority which consists of divisional authority, affiliation authority, and employee-type authority. These authorities can be combined with each other. Application approval. We have approval functions for 5 applications.Starting Price: $500 per user, one-time payment -
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Inovalon Eligibility Verification
Inovalon
Eligibility Verification Standard streamlines patient access and billing workflows by enabling staff to assign and prioritize patients/residents, payers, and tasks during eligibility verification. This technology goes beyond basic eligibility needs, providing a dashboard to confirm, manage, and store every inquiry. Speed up eligibility verification processes with automated enrichment of incomplete or incorrectly formatted transactions from the payer. Perform multiple eligibility inquiries at once with batch file uploads that verify Medicaid, Medicare, and commercial coverage quickly and efficiently. Easily assign tasks to team members, apply follow-up flags, and create eligibility documentation for future reference. Manage patients between batches and resolve issues with just a few clicks. Save time and ensure coverage accuracy with one cloud-based, all-payer health insurance eligibility verification software that empowers staff to manage benefit inquiries however, works best for them. -
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CubHub
CubHub Systems
Whether you offer pediatric nursing, pediatric therapy or caregiver services, Cubhub is here to make your team more efficient and the days run smoother. As experts in the Pediatric Home Care industry, we understand how you operate on a daily basis – we know your pain points, your frustrations, and exactly what you want and need from a home care EMR solution. Specially designed for Medicaid-focused agencies, Cubhub is the first and only pediatric EMR that handles both scheduling and charting, but that’s not all. Cubhub provides the functionality you need to operate efficiently in just about every area of your business – from billing and scheduling to charting and documentation. No more dead space or workarounds – Cubhub’s customized boutique software works to perfectly suit your agency’s needs. Not the other way around. Let Cubhub take a bit off your plate so you can focus on what matters most, building an exceptional team that provides remarkable care to clients. -
39
CareVoyant
CareVoyant, Inc.
CareVoyant for Home Care is an integrated enterprise-scale software platform for Home Health Care Agencies offering one or more home-based services – Private Duty Home Care, Private Duty Nursing, Non-Medical, Personal Care, Home and Community Based Services (HCBS), and Home Health - under ONE Patient and ONE Employee, making it a Single System of Record. CareVoyant improves your agency's operational efficiency and bottom line through proactive validations, alerts, and exception-based management. CareVoyant functions - Intake, Authorization, Scheduling, Clinical, Financial, Care Coordination, Reports and Dashboards – improve operational efficiency and bottom line of your home health care agency by eliminating duplicate data entry, streamlining workflow, improving quality of care, and optimizing reimbursement. CareVoyant CV Mobile is an easy to use and integrated platform to meet disparate EVV requirements for multiple states with a standard interface to state aggregators.Starting Price: $500 / month -
40
Webroster.net
Webroster
Access Webroster care rostering allows over 300 care businesses (including Local-Authority Reablement services) to deliver an efficient, compliant, and quality service. Including worker and client management, powerful rostering, payroll, billing, monitoring and self-service. It is an easy-to-use, scalable, and powerful solution in the Access Care Suite. An easy-to-use smartphone app that gives field-based staff on-the-go access to information about bookings, visits, and clients. Provide staff with access to their daily and weekly roster, with changes and updates communicated in real time. Ensure data is always secure with SQL Cipher encryption technology and if a staff member leaves or a phone is lost, all data can be wiped from the phone remotely. Using artificial intelligence, Optimiser simulates the decision-making process of a care coordinator to create schedules optimised to your company’s values.Starting Price: $93 per month -
41
Expertise Matrix
Int64 Software
Expertise Matrix (EMX for short) is a leading Skill Matrix management platform from Int64 Software for businesses who want to gain a better grasp on the breadth of skills available to their staff. It can your personnel track their own skills and help you when organizing professional development reviews (PDR), monitoring skill progression, and identifying skill gaps and at-risk areas. We have spent a great deal of time putting every part of the Expertise Matrix interface under a microscope and tweaking many parts of it to make it easier to read, more intuitive, and quicker to gain fast insight into your skill management processes. Our subscription payment system has been updated to comply with the upcoming European Banking Authority’s Payment Services Directive (PSD2) requirements for Strong Customer Authentication (SCA) to better protect your bank details. We have removed our static demo logins and are replacing them with a fully enabled 30 day triall.Starting Price: $36.45 per month -
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ABN Assistant
Vālenz
For providers, medical necessity denials cost thousands to millions of dollars every year in write-offs, plus costly staff time researching and appealing denials and responding to patient concerns. For payers, the same is true on the other end of the claim management spectrum: Paying for medically unnecessary procedures and treatments – and time spent working on denial appeals – raises costs without improving outcomes. And of course, for the patient, there can be unnecessary copays and other out-of-pocket costs, not to mention a poor patient experience involving costs and moments of care they did not need. ABN Assistant™ from Vālenz® Assurance delivers the prior authorization tools providers need to validate medical necessity, print Medicare-compliant ABNs with estimated cost, and stop over 90 percent of medical necessity denials by verifying necessity before care is delivered to the patient.Starting Price: $1039.00/one-time/user -
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Biscom Secure File Transfer
Biscom
Digital Transformation by Biscom. Solving the real-world complexity of fax and secure document delivery for the most highly regulated industries. Biscom is trusted by the world’s largest healthcare, financial, and government enterprises. Our solutions. Fax On-Prem. Hybrid. Cloud. Secure, Reliable, Scalable Fax Software and Fax Servers. Mission Critical Workflows. HIPAA, FERPA, SOX. Secure File Transfer (On-Prem. Cloud). Secure Email and Document Delivery. Secure Large File Transfer. Secure Collaboration. HIPAA, SOX, GDPR compliant. Biscloud/SMB (On-Prem Cloud). Biscom Fax Solutions for Smaller Businesses. Secure Document Delivery Solutions for Regulated Industries. Healthcare, Hospitals, Labs, Home Healthcare, Rehabilitation Centers, Visiting Nurse Associations, Pharmaceutical Companies, Mental Health Facilities, Pharmacies, Drug Development, Medicaid and Medicare. Financial institutions, Investment, Commercial, and Retail Banks, M&A Consultants.Starting Price: $120 per user, per month -
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AssuriCare
AssuriCare
Clients get the care they expect, when they expect it, and at the right cost. Caregivers get the information they need in one secure location. And you get unmatched visibility and control over the entire process. We simplify agency operations through smart scheduling, easy electronic visit verification, fast billing, and accurate data whenever you need it. We make billing insurers and Medicaid a snap, which lets you focus on what matters most - growing your business. We enable simple approvals, automated client billing and collection, fast timesheet approvals, and accurate caregiver reimbursement. Electronic visit verification is more than just a box to check. With the right platform, EVV is a powerful tool that can unlock efficiency, profitability and insights for your agency. AssuriCare’s EVV platform is accessible by mobile app and telephony, making it easy for clients, caregivers, and agencies to get all visit details.Starting Price: $149 per month -
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GP Connect
NHS Transformation Directorate
GP Connect is an NHS Digital interoperability service that enables authorized clinicians and care professionals to securely access and share patient information held in GP practice clinical IT systems across health and social care settings so patient care can be safer, faster, and better coordinated without chasing paper or manual phone calls. It exposes APIs that let approved applications retrieve up-to-date clinical records, view documented encounters, medications, immunizations, and problem lists, and manage appointments and referrals without separate logins, bringing GP record data directly into systems used in hospitals, urgent care, community services, pharmacies, and social care. It operates as an intermediary between GP practice systems (the providers) and consumer health/care applications so that patient data is shared only for direct care purposes under role-based access controls and data sharing agreements with audit trails and governance built in. -
46
ImagineMedMC
Imagine Software
Manage your members' healthcare and networks with a cloud-based healthcare delivery system. Automate claims processing for managed care organizations. Includes eligibility, referral and authorization processing, provider contracting, benefit administration, auto claims adjudication, capitation (PCP and Specialty), EOB/EFT check processing, and EDI transfers and reporting. Deploy as a cloud solution or an in-house system. Ideal for managed care organizations (MCOs), independent physician organizations (IPAs), third-party administrators (TPAs), preferred provider organizations (PPOs), and self-insured groups. Streamline the complexities of administrating eligibility, referral authorization and claims processing. Features and functions maximize data integrity while reducing data entry. -
47
MITC Cloud
MITC
Since 1990, MITC has provided market-specific solutions backed by world-class implementation, integration, project management, customization, and support services. MITC is an affordable workforce management software system that can help you overcome the challenges facing your organization and streamline procedures to boost operational productivity. Thousands of managers and employees use MITC to streamline administration, control payroll costs, reduce overtime, reduce compliance risk, and enhance customer service. Whether you have 10 or 10,000 employees, MITC has flexible and scalable solutions to address your needs. Agencies today are beset with a host of new problems, such as higher turnover, rising payroll costs, restricted funding, unfunded mandates, new regulations, and growth in HCBS and managed care. Designed for providers serving I/DD and behavioral health communities, Agency Workforce Management supports all the needs of agencies. -
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Cortex EDI
Cortex EDI
Cortex EDI provides medical, institutional, and dental practices with all the services they need to increase efficiency in the workplace. Our free medical billing software and claims clearinghouse software can help you streamline your workplace processes. We have the user-friendly tools you need to help you manage client billing and save you time. Our tools also provide you with such necessities as patient eligibility verification for private health insurance, Medicare, and Medicaid. We provide our free medical billing software to medical, institutional, and dental practices with no signup fees and no contracts. Sign up today to receive free training on how to properly use our practice management and medical claims clearinghouse software. Consolidate your various EDI service needs with Cortex EDI today to start streamlining your workplace processes. Cortex EDI is a leading clearinghouse and practice management software vendor for electronic medical transactions. -
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TL LeadManager
TargetLeads
TL LeadManager® is our lead management system designed exclusively for Life and Health Insurance Agents. Managing your Medicare Supplement, Long Term Care, Final Expense and Annuity leads has never been easier. If you don't have or don't love your current lead/contact management system, you need to check out TL LeadManager. This feature rich, easy to use contact management system, CRM, is designed to minimize the time you spend working leads and maximize your selling time. Reduce your paperwork, be more organized than ever before and start selling more policies. Used in conjunction with TargetLeads® we can make your direct mail marketing efforts as seamless as possible. Whether using Turning 65 lists for Medicare Supplement or any other kind of insurance leads, TLLM will allow you to manage, follow-up and run reports on all of your campaigns.Starting Price: $40 per month -
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WatchKeeper
WatchKeeper International
Visualize, track and protect critical operations. A unified platform to map your assets, visualize risk events, be alerted in real-time and take action to protect your operations. WatchKeeper allows organizations and government agencies to proactively identify risks before they threaten critical operations. Corporate Security. Global awareness of risk events in relation to assets and employees. Carry out duty of care and gain a competitive advantage. Government. Anticipate, identify and contextualise threats to expatriates, strategic business interests and tourist hotspots. Minimize disruption to critical national infrastructure, business investments and prevent loss of life. Smart Cities. Synchronize IoT sensors and devices into a single operating system to monitor transportation systems, utilities and public safety authorities. Logistics & Supply Chain.
