Majesco ClaimVantage Alternatives

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.

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.

Ensure faster, more accurate mortgage and loan document processing automation with Parascript software; automate insurance document-based tasks for the intake and review of healthcare insurance data. Optimize health plan process efficiencies, increase data accuracy and reduce costs through document processing automation. Parascript software, driven by data science and powered by machine learning, configures and optimizes itself to automate simple and complex document-oriented tasks such as document classification, document separation, and data entry for payments, lending, and AP/AR processes. Every year, over 100 billion documents involved in banking, government, and insurance are processed by Parascript software.

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.

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.

Five Sigma set out on a mission to allow claims organizations to innovate. With the set of claims management tools and unique platform, Five Sigma's suite is what Insurers need to bring their claims operation to the rapidly changing world. With our suite of Claims-First Cloud-Native and User-Centric products, we enable adjusters to handle claims better and faster. With Automating administrative tasks, Adjusters can focus on making the right decisions, while the system takes care of everything else. Full end-to-end suite for claims management with in-system omni-channel communication platform, automated documentation, automated workflows, reporting and open APIs. Go live in weeks with the state of the art claims management platform. With the unique SaaS offerings and agile methodology, Five Sigma's solutions are deployed in weeks instead of months and with weekly upgrades, we enable carriers to continuously improve claims operations.

CoreLogic modernizes the global property & casualty insurance industry with flexible, collaborative and secure claims estimate technologies. We create world-class experiences that simplify business and improve lives. Claims Connect™ from CoreLogic® streamlines the claims process for everyone involved through an integrated digital ecosystem. Transform your workflow so your customer’s claims are resolved efficiently and more accurately. All your information is securely stored in one platform and accessible by everyone working on the claim. No more switching between different software to edit and review claim information. Create estimates or make changes within Claims Connect and it automatically syncs so that everyone can see the changes instantly. Keeping everyone involved in the claims process up to date with the information they need, when they need it, will make your claims resolutions simpler, faster, and more efficient.

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.

Antiquated on-premise systems are a liability. Streamline your claims operations and improve efficiency with Terra's Automation, Integration, and Intelligence. Terra's products include Claims Management, Policy Management, Benchmark, and an Ancillary Services Marketplace. Manage risk with Automation, Cloud-Native, Integration, and Intelligence! Terra is a Cloud-Native Risk Management Information System for Property & Casualty Insurance.

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.

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.

Snapsheet makes claims simple. We do this through a suite of innovative insurance software solutions which transform insurance companies' ability to seamlessly manage claims, reduce cycle time, increase appraisal accuracy, and deliver payments effortlessly. We started it all with virtual appraisals, and followed that up with our leading claims management system. Today we are driving an industry-wide movement in claims by delivering solutions that enhance customer experiences while our customers create innovative, data-driven claims organizations.

An analytics-driven claims and remittance management solution for healthcare providers who want to automate workflows, improve resource utilization, prevent denials, and accelerate cash flow. Increase your first pass claim acceptance rate. Our comprehensive edits package helps you stay current with changing payer rules and regulations. Heighten your staff’s productivity with intuitive, exception-based workflows and automated tasks. Your staff can access our flexible, cloud-based technology from any computer. Manage your secondary claims volume through automatic generation of secondary claims and explanation of benefits (EOB) from the primary remittance advice. Focus on claims that need your attention with predictive artificial intelligence into problem claims. Resolve errors faster, and avoid denials before submittal. Process claims more efficiently. Print and deliver primary paper claims, or add collated claims and EOBs for secondary claims.

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.

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.

FBCS Enterprise is a centralized system for guiding decisions about non-VA Purchased care to improve fee basis claims management and adjudication through efficient claims processing. A web-based solution, CTM Plus streamlines workflows and provides oversight to resolve consult and Return to Clinic (RTC) tracking pain points, and ensure patients are called and scheduled on time. Purchasing analytics help to reduce cost and waste, for greater overall accountability. Expired and recalled items are also monitored automatically to keep patients safer. Delayed or misplaced orders can have significant consequences for your bottom line and quality of care. Time spent sorting through paper records and scrolling through screens is time you won’t have for patients. Checking every patient for opioid prescriptions can be an exhausting, multi-step process. DSS PDMP streamlines everything into one simple step.

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.

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

The frequency of total loss claims continues to rise, now accounting for some 20 percent of collision and liability losses across the auto insurance industry. Yet, far too often, carriers’ total loss operations lack cohesive integrated digital workflows, leading to excessive costs, customer dissatisfaction, and poor visibility and oversight. Enter Total Loss ProTM from Vemark. It’s the one solution you need to transform total loss claims processing from a frustrating black hole to a well-oiled machine while allowing you to keep up with the rapid pace of change. Faster settlement for Improved policyholder experience and satisfaction. Higher employee morale from reduced frustration, and fewer tedious processes. Increased visibility and transparency for data-driven decision-making. Auto claims that result in a total loss are more complex than vehicle repair claims. Total Loss Pro is a cloud-based solution that improves all stages of this complex salvage vehicle workflow.

Seamless integration into existing claims systems. Automate processes and reduce costs. No longer is it a choice between saving costs and improving the customer experience. Better decisions with data-driven insights. Automate manual processes. Empower your claims personnel. Invest in your customers’ happiness. Seamlessly integrate incoming claims with your insurance core system. Tackle process inefficiencies with claim automation and watch your customer satisfaction skyrocket. Reduced manual claims incidence of low to moderate complexity by automating claims handling. Improved triaging and manual claims assignment increased case team effectiveness drastically. Decreased process time for remaining manual claims. Allowed a real-time claims settlement in significant amount of cases. Automated digital claims journey by applying FNOL-completeness check, coverage check, automated claims file creation.

Our goal is to digitize the data exchange between all claims handling participants: insurers, brokers, their customers, loss adjusters, and all others. Use our platform to account and share your claims or connect your claims system to our API hub to get integrated with your partners. Connect your claims system to our API hub to start exchanging the data with your partners. Direct integration of all claims systems is impossible, therefore information is exchanged manually. This slows down the process, increases costs and complicates claims process automation. The purpose of ClaimsControl is to enable digital data exchange for all insurance claims handling process participants. If you develop any solutions related to claims management, let's talk and find the ways how we could help you to exchange the data with other systems or how we can provide your solution to our users.

Claimable is claims management software for businesses that removes the headache of managing insurance claims. Increase your claims handling capacity by spending less time on admin. Stop searching shared folders and inboxes. Your claims data is just a few clicks away! Your data is securely stored in the cloud and is accessible from anywhere. No more paper! Be ready for an audit with a complete history of each claim at your fingertips. Keep track of your documents and access them whenever and wherever you need! Filter and report on your claims data, to drive productivity and stay informed. Label your claims to categorize and organize them to suit your workflow. Keep detailed notes on each claim and collaborate and share with your team. Assign tasks to your team and see at a glance which are due or completed. Build and manage your claims contact database, and find contacts in an instant.

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.

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.

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.

Automate the end-to-end claims journey, from intimation of the first notice of loss and fraud detection to claims adjudication, and finally claims settlement. Experience the flexibility of addressing various claim types differently, like death and maturity claims, while improving regulatory compliance and eliminating non-compliant penalties. Enable faster, accurate, and effective processing through data capture, payment tracking, salvage and recovery tracking, legal matter processing, monitoring, and more. Effective registration, adjudication, tracking, and management of claim submissions. Built-in, comprehensive business rules for automatically categorizing claims as “fast track” or “non-fast track”. Flexibility to add or modify stakeholders— garages, assessors, loss adjusters, surveyors, investigators, claim officers, etc.

Connect everyone in your property claim. ClaimLogik connects everyone in a property claim from first notice of loss through to completion. Property assess & repair ecosystem. We connect everyone in your property claim from start to finish. Stakeholder Management. ClaimLogik connects EVERY stakeholder in a claim with real time access, to complete tasks and manage activities at the right time, in the right order and with complete transparency. All stakeholders have access to workflow modules that have been customized to enable them to track, manage and complete tasks throughout the claim. Stay connected. All stakeholders connected on one claim. Complete transparency on claim status for all stakeholders. Line of sight for all activities across the entire claim. Digital contracts between Insurer and supply chain. Service level agreements with all suppliers and trades KPI management to measure and compare supplier performance. Automated exception management when tasks fall outside SLAs

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

Claims Manager is a comprehensive, integrated RIMS system built to streamline your process from FNOL to settlement. A unique, configurable business rules engine automates workflow, reduces manual and duplicate work, saves time, and improves outcomes for all stakeholders. Claims Manager’s integrated solutions streamline workflow by helping you administer, adjust, and report your property and casualty claims. Claims Manager is a versatile, and simple to use Risk Management Information System that offers tomorrow’s solutions, today. Its intuitive interface seamlessly integrates with an automated workflow that is accessible anytime, anywhere, from any device. Letting you easily capture, benchmark, administer, and report claims for all lines of property and casualty insurance.

Claims management software that is ideal for claims, complaints and customer service. Settle claims quickly, reduce the cost per claim and manage claim load with trend analysis, fraud detection and intelligent reporting. Easy cloud-based access one central resource for real-time information sharing and actioning. Built-in report generator to create your own ad-hoc reports and intelligent MI through to heatmaps, dashboards, and trend analysis. Our systems have no restrictions built-in, maximizing your ability to link with any of your back-office systems. Microsoft-based enterprise technology that scales with your business. Less onboarding time means your team can hit the ground running. Empower your managers with automated and “real-time” reporting. Smoother onboarding for legacy systems and multiple technology requirements. Multi-sector expertise for easier discovery, development, and integration.

CaseGlide is driving the revolution in claims litigation management. Gone are the days of disconnected and siloed claims systems, manual and inefficient workflows, and hundreds of emails passing between defense counsel and claims teams containing unstructured case data. With CaseGlide you can focus on strategy, data, and driving efficiency to improve your litigation management program. Our clients better predict and manage their case outcomes, assign the right attorneys to the right cases, work cases more strategically, and significantly reduce their litigation costs. As your defense attorney partners work your cases in the platform, integrations allow you to push important case data to your claims system, data warehouse, document management, or accounts payable system. It’s simple: the longer a case is open, the higher your costs.

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.

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.

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.

EMSmart™ claims processing technology raises the bar and your bottom line. At EMS IMC our priorities are clear, to employ a compliant, accurate, and efficient system to manage an increasingly complex billing process while quickly maximizing your revenue. For clients across the country, EMS IMC has done just that with a new solution called EMSmart™ which frees you to focus on the important work of patient care, while having confidence that the maximum amount of revenue is being collected in a compliant manner. EMSmart™ is our new, proprietary claims processing platform that delivers the industry’s best rules­based process automation while retaining human judgment at the appropriate points in the revenue cycle process. EMSmart™ is our internal processing engine, but we’re excited to share this information with you so you can have confidence that your claims are in the industry’s best hands, both human and automated.

HM Health Solutions provides an end-to-end solution to health plans. Get the support you need and business outcomes you want from one comprehensive health plan administration platform: the Enterprise Health Solution. Platform applications and tools manage functions from sales through enrollment and billing, including claims, provider and clinical management, and customer service. The Enterprise Health Solution (EHS) is the only proven end-to-end solution, and can move your member seamlessly from enrollment to claims payment. You’ve heard others claim to offer a fully integrated solution. What they don’t specify is that you may need to purchase all modules in sequence to achieve this integration. On the Enterprise Health Solution, health plan administration has always been the one and only focus. No other company rivals our expertise in the health plan payer space.

ScanNStore is a full-featured electronic document storage and retrieval system in a small package. It's the perfect solution for increasing productivity by electronically organizing and managing paper files. ScanNStore lets you and your staff quickly scan, index, store and retrieve your claims, attachments, remittance notices, and other documents. You can search by multiple indexes and display claims and all related information on-screen, as if you are looking at the original paper. Where instant access to the right claim information is critical, ScanNStore is the right solution. Contact us to download and try out a fully functional multi-user version of ScanNStore for 30 days. Volume seat licensing and vendor discounts available. Supports a wide variety of TWAIN scanners and production level scanners including HP, Fujitsu, Ricoh, Bell & Howell and Panasonic. Supports single page or multi-page batch scanning, automated document feeder, page size, contrast adjustment, 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.

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.

The Whitespace Platform is the truly digital platform for the global (re)insurance marketplace. Contracts created and processed using Whitespace are made entirely of data. When digital data is used as the vehicle for risk transfer (not Word or PDF documents), the potential benefits of digital transformation of your business become realizable. And the possibilities are endless. Increases in speed, accuracy, availability, and quantity of in-depth data for risk analysis, all provide significant benefits to Brokers and Carriers. Above all, insurers act in the interests their customers, for whom a digital connection can mean real-time access to the risk placement, quicker payments and faster responses on claims. The complete end-to-end process is supported; with Whitespace, brokers and underwriters create risk submissions, collaborate on contracts, communicate via real-time instant messaging, request and provide quotes, bind, sign and endorse (re)insurance contracts digitally.

Curacel’s AI powered platform enables insurers track fraud and automate claims seamlessly. Collect your claims from your Providers in real-time and easily auto-vet the claims. Curacel Detection helps you detect and curb fraud, waste and abuse in the Claims Process. Collect claims from their providers and prevent fraud, waste and abuse in the claims process. We studied the Health Insurance industry to understand where the most value is lost by Insurers. This was identified to be the Claims Process. The Process is mostly manual and is fraught with a lot of fraud, waste and abuse. Our solution, driven by AI, helps to curb wastage and make the Insurer more efficient, thereby making them unlock hidden value. ravel insurance is peculiar in that it is built on on-demand policies that cover relatively short periods of time. Should a policy holder want to make a Claim, both the insurer and the insured want claim settlement to be as efficient and accurate as possible.

Insurance payment posting, like so many other tasks, falls under the proverbial 80/20 rule. The 20% of your payments that are still posted from paper EOBs take 80% of the overall payment posting work, if not more. Not so with POWEReob. POWEReob is a combination of free software and a pay-per-transaction service that will convert the paper EOBs you still receive from some payers into electronic remittances files in the ANSI 835 or NSF format. These files can then be used for automated payment posting to your practice management software, electronic secondary claims billing and denials management. POWEReob can work with any practice management that accepts remittance files from 3rd party sources (not just from their designated clearinghouse). For those that don't, we'll work with your practice management or clearinghouse so you, too, can benefit from the labor savings resulting from 100% electronic remittances.

HealthAxis equips payers, providers and health organizations with integrated solutions from an advanced claims processing system and TPA services to actionable analytics. We streamline operations and improve client and patient outcomes. As healthcare becomes more technologically enabled, it remains inhibited by coordination challenges, legacy technology, and information management. We strive to bring innovation and a growth mindset to all struggling with these challenges. Our client philosophy is to serve as a complete business partner. HealthAxis believes our success does not stem from selling our solutions but from our business partners’ sustained success and growth. We enable our partners to add value to the communities they serve. As they build their membership and scope, we flourish with them. Every level of our team understands our responsibility to help unlock our partners’ potential.

Elevate your claims management process and decrease denials through unmatched edits and an industry-leading clean claim rate. Health systems require access to technology that facilitates accurate claim submission and rapid reimbursement. Claims Director, SSI’s claims management solution, streamlines billing practices and provides visibility by guiding users through the electronic claim submission and reconciliation process from beginning to end. As payers change or modify reimbursement criteria for services, the system actively monitors and incorporates these changes and requirements. And with a comprehensive mix of edits at the industry, payer and provider levels, the solution aids organizations in making the most of reimbursement efforts.

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.

ClaimBook enables faster settlement of insurance claims, improved accountability and fewer rejections. It is well equipped with the features to address every part of the claims and evidence submission. ClaimBook supports international patient treatment with dedicated workflows, therefore enabling medical tourism. A built-in Rules Engine that disallows incomplete submissions, and knows what information and documents need to be submitted. This results in error-free submissions that are complete and guarantees that it is pre-authorized. ClaimBook's Smart Data Extraction can read documents uploaded to extract relevant data from the Hospital's Information System (if integrated with ClaimBook) to prevent the need for manual entries. ClaimBook also features Integrated Emailing by creating a virtual inbox in your dashboard. Withing the dashboard, emails can be composed, the design feature is similar to Microsoft Outlook.

Imagine a standalone, incident-based claims-management system, with a 100-percent success rate on implementations. Imagine streamlined claims operations. Imagine tracking all claim activities, documents, and financials. Imagine clean screens and unlimited depth hierarchies that make your data easily accessible. Imagine a claims management system that contains everything from workflows and reminders to reporting and analytics.

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.

Lower costs by administering claims with unparalleled efficiency and accuracy. With 500+ global customers and counting, Ventiv is one of the premier leaders in the risk management, insurance claims and advanced analytics space. Helping some of the biggest brands on the planet with products like our industry leading risk analytics solution.

Built with insurance claims and risk management in mind, our software features live dashboards, detailed reporting functionality, business intelligence tools, and the latest security technology. FileHandler Enterprise™ has become the benchmark for claims administration and risk management information systems (RMIS) in the industry. Our intuitive claims management software is great for third party administrators (TPA's), insurance carriers, risk pools, risk management companies, and a variety of other business professionals looking to make better and faster claims management decisions. No matter your size, our software is scalable from one employee to thousands. FileHandler Enterprise™ software will help you manage and close claims quickly, process payments to parties or vendors, and provide advanced reporting necessary to manage your business.