Alternatives to Myndshft
Compare Myndshft alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to Myndshft in 2026. Compare features, ratings, user reviews, pricing, and more from Myndshft competitors and alternatives in order to make an informed decision for your business.
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RXNT
RXNT
RXNT is an ambulatory healthcare technology pioneer that empowers medical practices and healthcare organizations to succeed and scale through innovative, data-backed, AI-powered software. Our fully-integrated, ONC-certified suite of medical software—like Clinical EHRs, Practice Management, Medical Billing and RCM, E-Prescribing, Practice Scheduling, Patient Portal, and more—optimizes clinical outcomes and RCM for your practice. Used by tens of thousands of medical professionals—from large physician practices to medical billing companies—to drive growth, streamline business operations, and improve patient care across all 50 U.S. states. Our unified “Full Suite” system employs a secure, central database so your data passes through every product in real-time from anywhere, and more than 125 million prescriptions have been transmitted and over $7 billion in claims have been processed using RXNT. -
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Rhyme
Rhyme
Rhyme connects payers and providers intelligently inside the prior authorization workflow, reclaiming the time lost on back-and-forth efforts and returning it to the patient. Automating manual tasks is critical (that’s why we do it), but it isn’t enough. When the nuances of clinical decision-making require collaboration between payers and providers, Rhyme keeps your workflow clear, agile, and fluid. We created the largest integrated prior authorization network, to leave a disjointed system behind and replace it with intelligent collaboration. Deep relationships and connections to EHRs, payers, and benefits managers, all on one platform. No scrambling, no screen-scraping, no secondhand info. We meet providers and payers right where you are, in your existing systems and workflows. Connections are easy so we can adjust to you, not the other way around. Prior authorizations aren’t an add-on to our platform, they’re all we do. -
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Valer
Valer
Valer’s technology speeds and simplifies prior authorization and referral management by automating submissions, status checking, verification, reporting, and EHR synchronization across all mid-to-large-sized healthcare settings, specialties, and payers from one platform and portal. Valer is the all-specialty, all-payer technology solution designed around your needs, not ours. Unlike off-the-shelf products that limit specialties, service lines, and payer mix (that don’t even automate submissions), Valer is explicitly customized to fit your needs. Because Valer is so easy to use, the dashboard increases staff productivity, simplifies staff training, and measures staff and payer performance across all service lines to enable continuous improvement. Valer doesn’t just connect to some of your payers for some of what you need. We link to all payers for all specialties, service lines, and care settings with real-time payer rule updates. -
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Infinx
Infinx Healthcare
Leverage automation and intelligence to overcome patient access and revenue cycle challenges and increase reimbursements for patient care delivered. Despite the progress AI and automation is making in automating patient access and revenue cycle processes, there still remains a need for staff with RCM, clinical and compliance expertise to ensure patients seen were financially cleared and services rendered are accurately billed and reimbursed. We provide our clients with complete technology plus team coverage with deep knowledge of the complicated reimbursement landscape. Our technology and team learn from billions of transactions processed for leading healthcare providers and 1400 payers across the United States. Get quicker financial clearance for patients before care with our patient access plus a platform that provides complete coverage for obtaining eligibility verifications, benefit checks, patient pay estimates, and prior authorization approvals, all in one system. -
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Availity
Availity
Collaborating for patient care requires constant connectivity and up-to-date information. Simplifying how you exchange that information with your payers is more important than ever. Availity makes it easy to work with payers, from the first check of a patient’s eligibility through final resolution of your reimbursement. You want fast, easy access to health plan information. With Availity Essentials, a free, health-plan-sponsored solution, providers can enjoy real-time information exchange with many of the payers they work with every day. Availity also offers providers a premium, all-payer solution called Availity Essentials Pro. Essentials Pro can help enhance revenue cycle performance, reduce claim denials, and capture patient payments. Availity remains your trusted source of payer information, so you can focus on patient care. Our electronic data interchange (EDI) clearinghouse and API products allow providers to integrate HIPAA transactions and other features into their PMS. -
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NeuralRev
NeuralRev
NeuralRev is an AI-powered Revenue Cycle Management (RCM) platform that automates and accelerates end-to-end financial workflows in healthcare, reducing manual effort and errors while improving cash flow and operational efficiency. It automates insurance eligibility verification by connecting to clearinghouse networks in real time so patient intake and coverage checks happen instantly, and it handles prior authorization by assembling clinical and payer requirements, submitting requests electronically, and tracking approvals to reduce denials and delays. It also delivers real-time patient cost estimates by combining eligibility data with payer rules to improve transparency and upfront collections, and it streamlines medical coding, claim submission, claims processing, post-claim follow-up, and recovery, so teams spend less time chasing paperwork. -
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Arrow
Arrow
Arrow is a healthcare revenue cycle management platform that modernizes and streamlines healthcare payments by automating billing, claim operations, and predictive analytics to help providers and payers reduce administrative burden, minimize denials, and accelerate collections. It brings workflows, data, and AI together so teams can detect errors in claims before submission, manage denials with root-cause analysis and one-click fixes, and get detailed real-time claim status updates directly from payers. It simplifies the ingestion of Explanation of Benefits (EOB) and Electronic Remittance Advice (ERA) data into a centralized, user-friendly format, provides revenue intelligence with actionable insights into the revenue cycle, and monitors payment integrity to highlight underpayments or overpayments according to payer contracts. -
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Anomaly
Anomaly
Anomaly is an AI-powered payer management platform built for healthcare revenue teams to “know your payers as well as they know you.” It surfaces hidden payer behaviors by decoding complex rules and detecting payment patterns across hundreds of millions of healthcare encounters. The core engine, Smart Response, continuously analyzes payer logic, adapts to shifting policies, and embeds learnings directly into existing revenue cycle workflows to provide real-time denial prediction, assisted claims correction, and alerts to revenue risks. By integrating payer-specific insights into existing systems, users can anticipate revenue loss, negotiate payer contracts from a stronger position, and proactively correct or reverse denials before they impact cash flow. The system helps level the playing field between providers and payers by turning opaque billing logic into actionable intelligence and embedding it into day-to-day financial operations. -
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MD Clarity
MD Clarity
Boost your bottom line by automating patient cost estimates, payer underpayment detection, and contract optimization in one place. Spot patterns of underpayment by insurance companies. Ensure you are setting your chargemaster optimally. Assign investigations/appeals to staff and see task status, all in one place. Compare performance across payer contracts and renegotiate terms from a position of strength. Project out-of-pocket costs at a high level of accuracy, giving patients the confidence to make up-front deposits. Enable patients to make up-front deposits directly from their online estimate. Hold insurers accountable for the full amount they owe. Get the upper hand in contract negotiations. Reduce bad debt, cost-to-collect, & accounts receivable days. -
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Transform your revenue cycle with Oracle Health RevElate Patient Accounting. Our EHR-agnostic solution helps you optimize financial outcomes with clinically integrated, cloud-enabled billing workflows that provide automation and extensibility. With RevElate Patient Accounting you can: Limit workflow redundancies, using dynamically connected workflows and analytics to help optimize efficiencies Prioritize and collect on outstanding accounts receivable with embedded business rules to identify and assign work efficiently Establish an open and extensible framework to support workflows that flow across Oracle Health solutions, third-party technologies, and organizations at scale Help improve compliance and maximize reimbursements with embedded payer rules RevElate Patient Accounting brings together a unified view of clinical and financial information to give you enhanced visibility into patient activity and accounts.
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AuthParency
Oncospark
Prior Authorization with AuthParency Prior authorization is a growing administrative burden for healthcare providers. Our automated prior authorization solution, AuthParency™, is powered by AI and machine learning (ML). This advanced system can cut your team’s prior authorization time in half. It is also compatible with all EHR and practice management systems AuthParency helps: Analyze payers’ tendencies Reduce patients’ days to care Improve patient outcomes Stop losses from non-reimbursable services Identify financial toxicity burdens Analyze population health data Track disparities Pharmaceutical companies -
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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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Axora
Axora.AI
Axora AI is an intelligent, end-to-end claims engine that blends AI-powered automation with billing expertise - managing everything from eligibility to payment posting. But it’s more than automation. Axora AI prevents denials before they happen, adapts to payer rule changes, and prioritizes what matters - so you recover more revenue with less effort. 1. Manages your full claims cycle from start to finish 2. Flags denial risks before submission 3. Prioritizes actions that improve cash flow 4. Seamlessly fits into your EHR, payer, and finance systems 5. No migrations. No disruption. Just faster, cleaner paymentsStarting Price: $30/month -
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Veradigm Payerpath
Veradigm
Veradigm Payerpath is an end-to-end revenue cycle management suite of solutions built to assist organizations to improve revenue, streamlining communications with payers and patients, and boosting practice profitability for practices of all sizes and specialties. Eliminate missing information, incorrect coding, and data entry error to ensure clean claim submission. Ensure claims pre-submission are correctly coded, have no missing information, and are error-free. Compare performance against peers at the state, national, and specialty levels to optimize productivity and improve financial performance with advanced analytical reporting. Remind patients of their appointments and confirm their insurance coverage and benefits information. Automate the billing and collection of patient responsibility. Veradigm Payerpath’s integrated solutions are practice management (PM) agnostic, interfacing seamlessly with all major PM systems. -
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HealthRules Payer
HealthEdge Software
HealthRules® Payer is a next-generation core administrative processing system that provides transformational capabilities to health plans of all types and sizes. For more than ten years, health plans implementing HealthRules Payer have been able to quickly address market opportunities and stay in front of their competition. HealthRules Payer is unlike any other core administrative solution because of its use of the patented HealthRules Language™, an English-like vernacular that delivers a revolutionary new approach to configuration, claims processing and transparency of information. HealthRules Payer helps transform health plans looking to grow, innovate and compete beyond any other core system today. -
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RCM Cloud
Medsphere Systems Corporation
The RCM Cloud® “software as a service” (SaaS) model strives to replace resource-intensive medical billing processes with digital solutions that reduce manual processes and optimize workflow thru automation. This approach significantly improves operational efficiency and further allows the business to expand service delivery capacity with only minor increases in administrative staff. Leverage your investment in technology to grow and sustain your business as opposed to increasing the headcount necessary to expand. On the administrative side, RCM Cloud® and associated services are delivered via the powerful, proven and secure medsphere cloud services platform. RCM Cloud® modules include patient/resource scheduling, enterprise registration, in-stream payer eligibility checking, contract management, medical records, billing, claims, payer and self-pay collections, POS payment posting and bad debt which enable all types of healthcare entities to truly transform their revenue cycles. -
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Veradigm AccelRx
Veradigm
Veradigm AccelRx delivers a free, automated, comprehensive solution to help you streamline specialty medication fulfillment for your patients. With faster time to therapy comes better odds for medication adherence and positive outcomes, as well as fewer phone calls and faxes for your staff. Combining electronic enrollment, consent, prior authorization, and script into an all-in-one system, AccelRx can help your practice significantly cut time-to-fulfillment for all specialty drugs, with any payer. Automatically populate patient data on enrollment and other forms with the click of a button. A single user-friendly platform to help you transform specialty medication management. Enhance your management of most specialty drugs all in one place, including electronic prior authorization (ePA). Access your enhanced specialty medication management as part of your existing electronic health record (EHR) workflow. -
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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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BHRev
BHRev
BHRev is a specialized revenue cycle management service and automation platform built for behavioral health providers that helps practices streamline and optimize their entire financial workflow from claims submission to payment collection with AI-powered automation, expert oversight, and industry-specific expertise. It focuses on the unique challenges behavioral health organizations face, including complex payer rules, documentation requirements, high denial rates, and evolving compliance standards, by automating up to 80% of RCM tasks while human experts handle exceptions, compliance checks, and more nuanced billing functions to ensure faster reimbursement and fewer administrative errors. It combines advanced automation with human review to handle critical steps such as insurance eligibility verification, claims processing and scrubbing, denial management and follow-up, and patient payment posting so clinics can reduce operational burden and increase cash flow. -
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MMIT
MMIT
MMIT (Managed Markets Insight & Technology) offers a comprehensive healthcare market access and analytics platform that centralizes high-value coverage, policy, restriction, payer, and real-world data to help life sciences and healthcare organizations understand and act on how therapies are covered, reimbursed, and accessed across the U.S. healthcare system. The MMIT Platform serves as a single point of entry where users can explore integrated solutions, including formulary, medical policy, and restriction intelligence, payer landscape and enrollment data, coverage search tools, API access, and analytics, organized by workflow and strategic priority to support commercialization, competitive analysis, and patient access strategy. It provides detailed insights into drug coverage status, restriction rules, payer behavior, and market segmentation, with features that help evaluate patient access barriers, inform field engagement, predict policy shifts, and integrate coverage data. -
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SSI Claims Director
SSI Group
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. -
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TriZetto
TriZetto
Accelerate payment while decreasing administrative burdens. With 8,000+ payer connections and longstanding partnerships with 650+ practice management vendors, our claims management solutions can result in fewer pending claims and less manual intervention. Quickly and accurately transmit professional, institutional, dental, workers compensation claims and more for fast reimbursement. Meet the shift to healthcare consumerism head on by providing a straightforward and seamless financial experience. Our patient engagement solutions empower you to have informed conversations about eligibility and financial responsibility while reducing hurdles that may impact patient outcomes. -
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symplr Payer
symplr
Save on costs, eliminate data silos, and deliver better outcomes for your members with a unified, automated provider data solution. symplr Payer provides a single source of truth for provider data that is consistently reconciled and validated against primary sources. It improves data quality, access, and transparency. Further, it eliminates duplicate requests for information, reducing provider frustration. Using symplr Payer as the enterprise-wide hub for provider data, payers can feed timely, accurate information to other downstream systems. Our highly configurable, end-to-end provider data management solution manages all pre-contract and renewal contract negotiations. Standardize and streamline your contracting processes, while capturing contract details such as sentinel events, trigger dates, configuration efforts, process steps, fee schedule info, and more. symplr Payer’s unique design allows your organization to consolidate contracting and credentialing. -
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Benchmark PM
Benchmark Solutions
Benchmark PM enhances patient engagement from initial intake through final encounter with features such as patient onboarding, easy appointment scheduling, customizable reminders, robust reporting, and user-friendly dashboards. For billing, Benchmark PM simplifies filing, processing, and follow-up with integrated claims management, an integrated clearinghouse, electronic billing, insurance verification, and a versatile payment portal. Benchmark Solutions operates as healthcare practices’ one-stop management solution, comprising of Benchmark EHR software, Benchmark PM software, and Benchmark RCM services. Benchmark Solutions' offerings come together to form a comprehensive electronic toolset that can streamline daily internal operations and increase revenue earned all while improving the overall patient experience. Each piece of the Benchmark Solutions suite is modular so it can easily integrate with other technologies already in place. -
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InvisaClaim
InvisaClaim
InvisaClaim is the most advanced all in one revenue platform. An AI-powered Revenue Cycle Management platform that automates denial management, appeals, prior authorizations, and No Surprises Act compliance for billing companies and RCM teams. Upload or Live Feed a denial letter or 835 ERA and AI extracts patient data, CARC/RARC codes, CPT/ICD-10, amounts, and deadlines, then generates payer-specific appeal letters in 60 seconds across 30+ payers. Modules: Denial Workbench, NSA/IDR (eligibility checks, QPA capture, GFE & IDR letters), Prior Authorization, Pre-Check AI, A/R aging, NPPES NPI verification, deadline alerts, and full audit trail. Connects directly to your clearinghouse and EHR. Integration partners: Change Healthcare/Optum (ERA, eligibility, claim status, prior auth), Availity (in progress), Waystar (Provider Access Request). EHR partnerships with Athenahealth in the marketplace pipeline, plus a FHIR R4 layer for Epic/Cerner. HIPAA Compliant, SOC2 & 25kStarting Price: $349 -
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talkEHR
CareCloud
The world’s first EHR software that understands you. Interact with talkEHR by utilizing Alison an AI powered voice assistant. talkEHR is an electronic health records software that understands you. Doctor can now spend less screen time and focus on patient interaction. Whether you’re a solo practice or part of a multi-specialty group, talkEHR will work for you. Our software is ONC-ACB Certified to the latest standard, ICD-10 compliant, MACRA/MIPS Certified ready that seamlessly connects patients, payers, labs, and other members of the healthcare team. Choose from a range of integrated mobile health apps to extend the core functionality of talkEHR and remove mundane tasks from your practice. talkEHR mimics the natural workflows of physicians, which makes it incredibly intuitive and easy to use. talkEHR has been built on cutting-edge technologies and architecture, which makes it highly responsive. -
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Vetriq
Vetriq
Vetriq is a healthcare revenue cycle automation platform designed to eliminate manual processing tasks involved in payment posting, remittance handling, and financial reconciliation for medical organizations. It focuses on automating the workflow around Explanation of Benefits (EOB) documents, payer correspondence, and bank lockbox deposits, converting incoming payment information into structured electronic data that can be automatically posted into revenue cycle management systems. Instead of requiring healthcare organizations to replace their bank, lockbox provider, or existing RCM infrastructure, Vetriq integrates with current banking relationships and practice management or EHR systems, layering automation on top of existing workflows. Vetriq’s automated processing engine transforms paper EOBs into standardized electronic remittance files such as 835 formats, eliminating the need for manual data entry and significantly reducing administrative workload.Starting Price: $22 per hour -
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fhirstation
Iron Bridge
Built on FHIR v4 with native FHIR data models and RESTful API. USCDI v1 is compliant and can store and service full USCDI v1 to patients and partners. Export electronic health information safely and securely for patient access. Plug your EHR, Payer System, or any HIT into fhirstation for instant Final Rule compliance. Fhirstation is a turn-key scalable, secure, multi-tenant Software as a Service (SaaS) solution for electronic health record (EHR) vendors, health plans, hospitals, providers, and any other entities that must provide patient data through the United States Core Data for Interoperability(USCDI) v1 FHIR v4 API and electronic health information export for the HHS final rule and CMS interoperability rule. Fhirstation breaks down information blocking by enabling information exchange between patients, health IT developers, health systems, EHR vendors, and payers. SMART on FHIR ready for patient access applications of the future. -
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Certive Health
Certive Health
Certive’s Revenue Integrity Analytics platform is based on a unique blend of data science, clinical expertise, and administrative process knowledge. Certive Health’s experience base ensures the integrity of the hospital’s revenue and compliance of its processes. The core of Certive Health’s Revenue Solutions offering is built on its Revenue Integrity Analytics™ platform. Extended technical capabilities in analytics, workflow, and marketing automation combined with clinical and payer side experience helps our clients reduce costs, improve outcomes, and increase patient satisfaction.Starting Price: $1000.00/month -
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Oracle Health
Oracle
Connected technologies and unified data empower individuals and enable the health ecosystem to accelerate innovation and influence health outcomes. Oracle Health is building an open healthcare platform with intelligent tools for data-driven, human-centric healthcare experiences to connect consumers, healthcare providers, payers, and public health and life sciences organizations. With the largest global EHR market share, we are able to bring data together to enable clinicians, patients, and researchers to take meaningful action, advance health, and work to improve outcomes worldwide. Rated the largest revenue cycle management (RCM) leader by IDC MarketScape, we provide timely, predictive, and actionable health insights to automate processes, optimize resources, and drive efficiencies. Accelerate innovation, benefit from flexible infrastructure and platform resources, and drive clinical intelligence through our open, extensible ecosystem of partners and technologies. -
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Inovalon Payer Cloud
Inovalon
Improve clinical quality metrics, risk score accuracy, patient and provider engagement, patient outcomes, operational transparency, and economic performance, all with one comprehensive suite of software solutions. The Inovalon Payer Cloud transforms traditional workflows into data-driven processes that support your health plan’s key objectives. Backed by industry-leading analytics capabilities, our converged SaaS solutions deliver the member-centric insights and speed, accuracy, and flexibility you need to stay ahead in this diverse, ever-changing marketplace. Inovalon's SaaS suite of healthcare payer solutions delivers member-centric insights and actions to help health plans measure, manage, and improve healthcare outcomes, economics, and quality of care. Payer solutions to improve member care and outcomes while achieving greater operational performance and efficiency with sophisticated analytics and dynamic business intelligence. -
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Droidal
Droidal LLC
Droidal is an AI-powered revenue cycle management platform that helps healthcare organizations reduce costs, increase revenue, and improve patient experiences. By leveraging Generative AI and large language models (LLMs), Droidal automates complex billing, claims, and payment workflows with precision and speed. The platform processes over 2 million claims monthly across 1,800+ locations while maintaining coverage for 3,500+ payers. Its AI agents streamline operations for hospitals, clinics, and care providers — cutting denials, accelerating payments, and boosting cash flow. Designed for seamless integration, Droidal enhances productivity without replacing existing systems or workflows. With enterprise-grade compliance and a subscription-based model, Droidal delivers measurable ROI while freeing up staff to focus on patient care. -
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TELCOR RCM
Telcor
Whether you are an independent reference lab, a pathology practice, an outreach lab or a public health lab, TELCOR RCM billing software provides the tools to overcome tough billing challenges and improve profitability. Perform claim submission, claim monitoring, remittance processes, AR management, client and patient billing, and much more for multiple NPIs all in a single revenue cycle management solution. Minimize billing staffing needs and maximize revenue cycle productivity by using the right tools to automate daily billing functions such as claims submission, collecting patient information, as well as generating revenue cycle management financial reports. Eliminate labor-intensive manual adjudication processes by processing electronic payments received from your payers via 835 ERAs or from your bank via lockbox payment files. Send quick and easy-to-understand billing communication to patients, simplify your patient billing process, and make it easier for patients to pay. -
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Zuub
Zuub
Zuub is an AI-powered dental revenue cycle management platform designed to optimize dental practices' revenue cycles by automating key administrative tasks. The platform offers features such as real-time insurance verification, digital treatment plans, online payments and accounts receivable management, and digital consent forms. By integrating seamlessly with existing practice management systems, Zuub reduces manual processes, enhances efficiency, and improves patient transparency regarding procedure costs and coverage. The platform supports over 350 insurance payers, allowing practices to complete insurance verifications in less than five seconds. Additionally, Zuub's digital treatment plans facilitate patient understanding and acceptance, while its partnership with Sunbit provides flexible patient financing options. -
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Aroris360
Aroris Health
Aroris360 is a healthcare-focused contract management platform designed to digitize, organize, and analyze payer contracts to improve revenue visibility and performance. It transforms paper-based agreements into a searchable digital library, enabling instant access to contract terms, side-by-side comparisons, and automated compliance alerts that streamline renewals and strengthen negotiation strategies. It centralizes payer contracts, fee schedules, and claims data into a single system, integrating directly with clearinghouse files to process real-time payment data and maintain a comprehensive claims history. It provides advanced analytics that break down payer mix, code utilization, and revenue patterns, allowing organizations to identify discrepancies between contracted rates and actual payments, uncover underpayments, and highlight opportunities for optimization. -
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SKYGEN’s Provider Data Management (PDM) is an on-demand solution that helps healthcare payers strengthen provider network management and provider relationships. PDM also strengthens payers’ ability to effectively build provider networks, improves provider and member satisfaction, and lowers administrative costs. It’s a smart solution that helps payers and providers meet the needs of today’s technology-savvy healthcare constituents. Lower contract acquisition costs via fast, efficient, paperless provider recruitment and supplemental network rental. Lower credentialing costs and improved provider satisfaction through online credentialing. Eliminating expensive outreach by automating provider self-verification and ensuring accurate and verified provider data for online directories. SKYGEN powers dental and vision connectivity solutions that inspire clients to move confidently into the future by employing technology that creates unparalleled efficiencies.
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Turquoise Health
Turquoise Health
Turquoise Health delivers a comprehensive suite of solutions built around healthcare price-transparency and contracting workflows, offering modules such as Clear Rates Data (which aggregates over a trillion provider, payer, professional, drug, and device rate records covering institutional and professional services) and Clear Contracts (a centralized cloud application that supports contract creation, negotiation, and storage for payers and providers). It also includes Compliance+ to help organizations remain compliant with machine-readable file requirements and Good Faith Estimate rules, Analytics tools to benchmark and query market-level rate data, Custom Rates extracts tailored for specialty healthcare segments, Standard Service Packages (pre-built bundles of common procedures), Search and Care Search dashboards for rate discovery and comparison, and a Turquoise Verified program enabling providers and payers to publish and manage price transparency data. -
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Biofourmis
Biofourmis
Biofourmis is a technology-enabled care delivery company that partners with health systems, hospitals, and payers to revolutionize the delivery of care across the continuum. Their connected technology platform enables personalized and scalable care delivery, extending care beyond traditional settings. Biofourmis offers solutions designed to provide high-quality care in patient's homes. Their platform integrates continuous and episodic data collection, FDA-cleared AI-enabled analytics, and in-home service coordination to manage patients and improve outcomes. Biofourmis has partnered with over 50 global health systems and payers to expand access to care and therapeutics in their communities. Biofourmis addresses challenges impacting the health and pharmaceutical industries today across the continuum from drug development to care delivery. -
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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 -
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Payer
Payer Financial Services
Pioneering online B2B payments. Enterprise payments. No matter how big or small the purchase is, Payer can do it. Endless opportunities with Payer. Digitise your business, globally. Whether you have local, regional or global ambitions, Payer is the online B2B payments partner you need because we can easily future-proof how you manage payments online. We are designed for the new era of B2B e-commerce. Automated online B2B payments experiences. Our system is designed to seamlessly integrate with your customers’ journeys. Payer does this by giving you complete UI freedom. Automated online B2B payments result in workflows with little manual work, for you or your customers. Seamless integration with your ecosystem. We are specialized in online B2B payments and know first hand the complexity that comes with having multiple system suppliers in your ecosystem. Payer can easily be integrated into your ERP and bookkeeping systems so you can reduce administrative costsStarting Price: $800 per year -
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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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Post Acute Analytics
Post Acute Analytics
Post Acute Analytics (PAA) leads the transformation of care delivery to improve patient lives by actioning real-time insights across a connected healthcare system. This is possible by implementing our AI-based, turnkey integration solution – PAA Anna™ Platform – with healthcare providers’ and payers' systems. Anna permits total transparency of their patients’ journeys through post-acute care in real-time and enables proactive intervention to prevent negative quality and cost events from occurring. Through proprietary analytics, turnkey integration engine, and medical leadership, our solutions ensure that providers and payers can make real-time decisions that improve patient outcomes while reducing total cost of care. -
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CureAR
TechMatter
CureAR is an AI-powered medical billing and revenue cycle management software designed for in-house billers, billing companies managed-service providers and DME companies. The software consolidates eligibility verification, charge capture, AI-assisted coding suggestions, claim scrubbing, electronic claim submission, ERA ingestion, and automated payment posting into a single cloud-hosted system. It is configurable for specialty billing rules and supports multi-tenant operations for practices that handle multiple client accounts. Key Features: AI-assisted coding and claim scrubbing: Machine learning highlights likely coding errors and applies payer-specific validation rules before submission. Real-time claim status and alerts: Tracks claims from submission to adjudication and surfaces exceptions for prioritized follow-up. ERA ingestion and automated posting: Electronic remittance advice handling with configurable reconciliation workflows reduces manual posting effort.Starting Price: $129/month/user -
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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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BillFlash
NexTrust
Eliminate headaches when you choose BillFlash as your one-stop shop for Billing & Payment Services that work together for you. Send cost-saving paperless bills securely online through our site MyProviderLink.com. Customize accepted payment methods and messages. Expedite online payments through MyProviderLink.com. Payers (patients or customers) pay you online at our site MyProviderLink.com. Payers can send messages to you with their online ePay. ePays are included in your consolidated Payments Report. Send professionally printed bills via USPS First-Class Mail. Customize accepted payment methods, messages, and color. Simplify processing with payment coupons and return envelopes. Process walk-in, mail, and phone payments. Payers can see OfficePays online at MyProviderLink.com. OfficePays are included in your consolidated Payments Report. BillFlash integration with your Billing Application further reduces the steps for you to complete your work. -
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Talix
Talix
The Talix platform powers intelligent workflow applications that enable risk-bearing healthcare organizations to succeed in the age of value-based care. Our workflow solutions for payers and providers require intelligent underlying technologies to work in unison and at scale. We’ve engineered the Talix Platform to support the needs of thousands of end-users, anywhere in the world simultaneously. Moreover, our platform architecture enables multiple SaaS application solutions in order to harness the efficiencies derived from being able to process millions of patient charts and encounter data. The Talix Platform is comprised of several technology components, intricately linked, to power software applications at scale for healthcare payers and providers. These components form the building blocks of artificial intelligence (AI). -
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Infosys HELIX
Infosys
Driving AI - first as a business strategy for payers, providers and PBMs with products and platforms which are built on AI and runs on cloud. A “healthcare digital platform” is the integration of applications and emerging technologies to provide a tailored healthcare solution that drives business outcomes—a significant modern and accelerated approach to disintermediate legacy core administration processing systems (CAPS). To better understand the role of digital platforms and emerging technologies in achieving business objectives, the impact of digital platforms on healthcare payer KPIs, and the relative attractiveness of healthcare platforms, Infosys, in partnership with HFS, reached out to 100 C-suite healthcare payer executives in US. -
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MantraComply
MantraComply
MantraComply is a provider credentialing and enrolment platform. We deliver comprehensive services in provider credentialing, payer enrollment solutions, license verification, hospital privileging, and healthcare compliance management. Trusted by thousands of providers, health plans, payers, group practices, and digital health companies, MantraComply ensures faster provider onboarding, reduced denials, and improved regulatory compliance. Our model integrates AI-driven insights, customizable credentialing workflows, and 24/7 expert support, enabling providers and organizations to stay compliant while focusing on patient care. MantraComply is proudly backed by $15M in funding from Impanix Capital. -
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HGS Healthcare
HGS Healthcare
For decades, our healthcare clients have relied on us to effectively solve their critical business needs. HGS Healthcare Technology uses a holistic consulting approach to identify the root causes of healthcare payer and provider pain points, analyze the issues, and provide a complete solution that encompasses people, process, and technology platform improvements. Equipped with a strategic solutions mindset, our core focus is on what most benefits the client. Using a custom solution roadmap, our operations and technology experts will propose the appropriate adjustments for improving efficiency, engagement, data management, and overall processes. Proven strategies to engage members with better experiences. HGS integrates or works with your systems with custom tailoring to your exact needs. -
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Optum AI Marketplace
Optum
Optum AI Marketplace is a curated ecosystem of AI-powered solutions designed to transform healthcare by providing payers, providers, and partners with tools to deliver better outcomes efficiently. It offers a diverse range of products and services across categories such as patient & member engagement, eligibility & claims, care operations & management, payment & reimbursement, and analytics & insights. Notable offerings include the prior authorization inquiry API, which enables payers to check a patient's prior authorization status in real-time, and SmartPay Plus, an e-cashiering payment platform that simplifies patient payments and streamlines the collection process. Additionally, Optum Advisory Technology Services provides expert support for digital transformation initiatives, offering system selection, procurement, implementation, and AI tools. It also features partnerships with trusted resellers, such as ServiceNow, to offer cutting-edge healthcare solutions.
