Hi-Tech Series 3000 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.

Speedy Claims became the top CMS-1500 Software by providing the best customer service imaginable to our thousands of clients all over America. Medical billing isn't the kind of thing most people get excited about - it is just a tedious task you have to do. But while it will never be a fun task, it doesn't have to be as difficult or time consumimg as it is now. With Speedy Claims CMS-1500 software you can get the job done quickly and easily, allowing you to focus on the things you love about your job, like helping patients. With a simple interface, powerful features to eliminate repetitive work, and unrivaled customer support, it's simply the best HCFA 1500 software available on the market. A powerful built-in error checking helps ensure your HCFA 1500 form is complete and correctly filled out, preventing CMS-1500 claims from being denied.

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.

Improve claim outcomes with streamlined First Notice of Loss (FNOL), claim processing and flexible reporting. INCIDENT BASED CLAIMS MANAGEMENT Effective claims management is about more than simply managing claims outcomes. It is about having an automated process that ensures efficiency and accuracy across the organization, getting timely notice of losses, and taking swift action are keys to success. The incident-based approach of Cloud Claims covers all accidents and losses, delivering a complete picture of loss to executives and claims managers. REPORTING Are your business executives frustrated by the lack of real-time insight into claim activity? Streamline claims operations with alerts and reminders to engage the right resources at the right time. Cloud Claims is cloud-based and able to connect with your systems via API. Large distributed organizations can enable workers at various locations to report incidents in real-time to management.

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.

If your staff is wasting precious time and resources by manually statusing claims on web portals and sitting on the phone with payors you need myClaimStatus. Get real-time, actionable claim status information on all of your claims and eliminate the waste. myClaimStatus’s suite of data tools helps you reconcile claims faster. It doesn’t matter how big or small you are. Save more with every claim when you use myClaimStatus. Are you working efficiently? MedX medical claim services use robotic process automation to maximize your workflow efficiency. Easily reconcile reimbursement rates with your contracted amount ensuring you’re receiving what you should. Drill down with real-time data for every healthcare claim from every payor, no matter the dollar amount. This is not your standard healthcare claims processing software. Optimize AR follow-up activities to work by exception and get more done in less time.

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

PLEXIS’ suite of best-in-class apps has a proven record of giving payers the extended functionality necessary for modern core administrative ecosystems. From real-time benefit administration and adjudication to automatic EDI transmission and self-service customer portals, PLEXIS Business Apps have you covered. Passport provides essential connectivity from the core admin and claims management engines to PLEXIS business apps, your own apps, and existing in-house systems. With its flexible API layer, Passport delivers real-time integration with portals, automated workflow toolsets, and business apps. Connectivity is limitless. Streamline workflows with a centralized, modern core administration & claims management platform. Process claims in a timely and accurate manner, and automate the complexities of benefit administration to capture a quick ROI and deliver superior customer service.

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.

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.

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.

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.

The core of PBM Express is the adjudication program. Claims undergo hundreds of edits to achieve accurate processing results, regardless of the difficulty of the plan design. The parameter drive program provides for an extremely flexible architecture that allows for client customization as needed. Laker's advanced software solution provides clients with superior performance and industry-leading uptime. As a technology leader, Laker continually updates and enhances our systems to meet the growing needs of our customers. Laker customers have the marketplace advantage of the fastest, most flexible and most durable system available. What’s more, Laker works closely with our customers to develop, test, and implement new products which allow them to better compete and win new business.​ Laker grows as our customer's claim volume grows. It is in the best interest of both Laker and our customer’s to provide changes to the software in a timely and efficient manner to allow for that growth.

IMPACT is the core to our suite of Healthcare administration software that supports all facets of health care related data transactions. Our customers use Impact to manage enrollment, provider contracts and re-pricing, benefit plans, authorizations/referrals, claims payment and the various complications that surround these functions. IMPACT has tremendous flexibility and provides a wide offering of industry-specific features. Nothing makes us happier than gratitude and accolades from our customers. We enjoy our client interactions and the delivery of software that makes their work lives easier. Technology is meant to serve the customer. MCSI focuses on the development of solutions that fit well within a client's enterprise allowing them to grow and change with their market. We have experience in all aspects of healthcare data management and solutions deployment. We pride ourselves in creating software that focuses on automation, accuracy and reliability.

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

Protect the integrity of your health plan and determine accurate pricing with the Context4 Health Plans Suite, our modular, cloud‑based technology platform. Immediate, actionable, and defensible Fraud, Waste, and Abuse (FWA) detection built by our team of certified clinical, dental, and health benefits experts. Accurate data and cutting-edge cloud technology combine to create a proven and defensible medicare reference-based pricing (RBP) solution. More than 100 healthcare data sets, with professional support to optimize efficiency and compliance. Advanced medical coding software designed to expedite claim submission and minimize denials. Our cloud based Payment Integrity Platform utilizes our proprietary analytics engine to identify coding errors, medical necessity, unbundling, fraud-waste-abuse, audit risks, pricing and other aberrations that can impact your business.

TherapyNotes is an easy-to-use and feature-rich practice management software for behavioral health practitioners. It combines robust scheduling tools, patient notes, electronic billing, and a custom patient portal. The software is also certified HIPAA- and PCI-Compliant, which helps to ensure that all practice and patient records are secure and encrypted. Managing a practice comes with plenty of paperwork that can keep you out of session. With features like simple electronic claim submission and assisted ERA payment posting, you'll have fewer data entry errors and less tedious paperwork. TherapyNotes™ integrates all aspects of your practice to help you improve patient care. Person‑centered documentation, searchable diagnoses, and more time in‑session help you provide your clients with the care they deserve.

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.

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.

This product is an end to end claims system. The primary functions are claims adjudication, claim workflow and payment disbursement. The flexible design allows the addition of adjudication modules on a line of business basis. Each new line of business added reuses the core functionality of the system. This system takes advantage of the user friendly windows screen design and makes use of a relational database to store information within the system. The software platform is Powerbuilder with an SQL database such as Oracle or Sybase. This combination of software supports a client server based environment that is capable of processing large volumes of claims. Installation and training are available and source code is included as part of the licence fee. Expert staff is available for customizations and tailoring of the system to meet any special requirements identified by the client. All modifications are available with detail design and support for acceptance testing.

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.

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.

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.

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.

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.

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.

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).

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.

SpyGlass, our enterprise-class health claims management software, offers a powerful, flexible solution for precise and timely claims processing. SpyGlass makes benefit and plan setup remarkably straightforward. BenefitDriven, fully-integrated with SpyGlass, delivers eligibility, contribution accounting, and pension management to the Taft-Hartley industry with the full range of data and processes for Participants and Employers. HIPAA Director, our all-in-one EDI gateway & scheduler, works as a hub by allowing you to directly connect with vendor partners to help avoid transaction costs, manage batch transfers, and automate transfers. SpyGlass provides a deep, landscape view of your population, with the ability to easily drill down to the higher resolution details. Hundreds of unique reports, fully customizable dashboards, and total control over your system are at your fingertips.

Origami Risk provides integrated SaaS solutions designed to help organizations—insured corporate and public entities, brokers and risk consultants, insurers, third party claims administrators (TPAs), risk pools, and more, transform their approach to managing critical workflows, leveraging analytics, and engaging with stakeholders. Origami Risk is a 5-time Business Insurance Innovation Award Winner, and we've kept that title because we collaborate closely with our clients to develop solutions that address real-world challenges they're facing. Since our founding, Origami Risk has aimed to deliver industry-leading, real-world solutions for risk professionals around the globe. Our acceptance of the 2021 European Risk Management Award for Technology Innovation of the Year underlines this continuous effort. Fully-integrated, comprehensive solutions for reducing incidents & hazards.

Allows users to provide real-time rates and contracts to dealer menus via eRating and eContracting. Users are able to issue policies with electronic signatures and present products to consumers through their own point of sales channels and/or their partners. Having 140+ partners in our network gives dealers the ability to connect to the eMenu or DMS system of their choice. Our policy administration software supports billing, commissions, cancellations, and different statuses of the policy throughout its lifetime, allowing for seamless coverage rating, contracting, and contract remittance. Being fully integrated with your accounting system lets you create, manage, and modify your agents, dealers, coverages, and contracts. This also grants your agents direct access via our Agent Portal. Our F&I software gives the Dealer Principal and Field Representatives access to integrated reports for F&I sales, forecasting, and overall dealership performance in real-time with powerful analytics.

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

Anagram Prosper puts money back in the hands of your patients — at no cost to your practice. Increase your margins, delight your patients, and forget courtesy discounts. We partnered with the best vendors to develop wholesale price lists that better align with the needs of you and your patients. Provide rebates on the same products you already stock. Incentivize your patients, drive more conversions, and collect more revenue. With Anagram Prosper, you can save patients money without offering discounts or lowering your margins. Use our rebate program to drive more sales and make your patients happy. Most patients don’t know about their out-of-network benefits. Anagram Access can pull real-time vision plan eligibility to maximize savings for your patients. With Anagram Access, you can quickly calculate how much your patient owes and how much their vision plan reimburses.

Claims Adjudication for medical, dental, vision, prescription, short and long-term disability claims. Available for on-site license or as a hosted application (ASP). Microsoft technology: SQLServer database with a Windows front end. Acclaimed Customer service staffed by health care claims experts with a minimum of 12 years’ experience in the field. Support calls are logged with status available via the internet. Plan copy and modification feature enable quick setup of plans. Auto-adjudication using benefit codes built using business rules based on over 25 variables from both the claim and the claimant records made available to the adjudication engine. Inbound claims can be scanned images, EDI or paper. HIPPA EDI 5010 transaction sets. Re-pricing fee and UCR Schedules can be loaded on the system in advance of the effective date. The date-driven logic will re-price based on the date of service.

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

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

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.

This application automates the repricing of claims in a Web environment. WebCR verifies provider participation and patient coverage, validates dates of service, and identifies possible duplicate claims. It is supported by a data management team and system, WebDM, that works to ensure accuracy and currency of data. This application automates the repricing of claims in a client/server environment. WebCRX verifies provider participation and patient coverage, validates dates of service, and identifies possible duplicate claims.

Emerged in the year 2000, DataGenix is strongly resolved to provide TPAs, adjusters, and insurance companies with modern claims processing solutions. We understand that claims processing and health benefits management can include several complications. So that your business does not suffer any losses, our experts have created the advanced ClaimScape software that can automate the entire adjudication process. The goal of our business and the Claims software is to resolve the perplexities that hinder the reach of unmatched customer experience for your clientele network. Keeping in mind the modern trends and requirements, we can assure your business's optimum growth with our software products. We have won the trust of top TPAs of the nation and are willing to serve more.

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.

The Acrometis flagship claims processing solution offers unparalleled workflow management, with documents automatically routed by a configurable rules engine. Based around claim assessment scoring, body part to claim compensability matching, jurisdictional directives, relatedness scoring and a host of other claim elements the Acrometis business rules are designed to reduce claim duration and costs. CLAIMExpert automatically processes 65 percent of incoming medical bills and non-medical documents with no user intervention. Documents requiring adjuster intervention are flagged and sorted for easy review and straightforward decision making. Automatically processes incoming documents with NO adjuster intervention. Clients typically see between 11 and 23 points medical loss improvement in the first year. CLAIMExpert contains rules for over 190 different document types, quickly handling whitemail and any other documents that come across your adjuster’s desk.

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

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.

Virtual diagramming, voice annotation, photo documentation and full pricing capabilities in the palm of your hand. Quickly and accurately capturing claim information onsite eliminates the need for followup visits and provides a great chance to engage policyholders in the settlement process. Adjusters can document, estimate, and close a claim in a few easy steps leading to a faster, efficient and more accurate claim settlement. Mobile Claims ensures that onsite estimates become onsite settlements. Utilizing logic-based questionnaires, our algorithms can be applied to generate custom loss specific estimates in a fraction of the time than the standard estimate construction today. Easy to integrate, train, and use. Virtually eliminating the cost of change, creating enormous benefits for carriers, adjusters, contractors, and policyholders alike. Fully equipped with aerial imagery/measurement, 3D virtual diagramming, geospatial visualization, video collaboration, contents, etc.

OneTouch is a tool that allows a user to conveniently transmit claims or statements to Apex, login to the Apex website, or search for claims that have been sent in the past all from of your computer desktop. In order for OneTouch to work, the user must be a registered client with Apex EDI and have a username and password setup. Once a user has a username and password OneTouch can be configured so the user can utilize the tools described. With OneTouch Search you can search your claim and statement files that have been sent to Apex from the convenience of your desktop. The OneTouch search feature allows you to search your statement and claim files for patient names, subscriber IDs, or several other options. After you click the search button you will be logged into your Apex webpage and shown the results of your search. To perform a search first choose what you want to search for by clicking on the magnifying glass dropdown menu.

bestPT is a complete, cloud-based physical therapy billing service and practice management software solution. Created for private practices of all sizes, bestPT helps solo practitioners and franchise owners of physical therapy clinics to manage payment and revenue generation as well as keep track of claims processes. Integrated with the most popular EHR systems, including webPT and Cedaron, bestPT helps streamline billing processes to make the entire office's workflow more efficient.

W5 Claims Management Software - Managing your claims, understanding and growing your business. How many things do you and your staff do every day over and over? Get this, do that, repeat. It’s not just about saving time on repetitive tasks. It’s about making sure they don’t get missed when you have a long list of to do’s that need doing now. - Automation Documents, thousands and thousands of documents and photos. Getting them, organizing them, securing them, distributing them. It’s a big job and critical to your success. - Document Management Time constraints and customer SLA’s. It’s not enough that you need to meet those challenges but you have to measure and report your successes and failures. So how well do your adjusters perform? Where and what are the potholes that trip up your staff? Can you show your customers that their trust is well placed? - Workflow + Business Intelligence Analytics

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.

Do not be worried about trying something new. This software was designed to be easy to use and flexible. All information is stored on secure servers in the cloud. There are no installations, just go to the website from any device and log in. Updates are no longer something you have to worry about. We will publish updates to the website at regular intervals. Everyone in your company now shares a custom database. If you need to change the price of a common item to match pricing in your area, everyone in your company will be able to use that same item. PowerClaim XML is a complete stand alone property adjusting software package. It allows you to quickly complete estimates as well as create photo sheets, diagrams, captioned reports and more. PowerITV Replacement Cost Calculator is a web-based solution that allows you to find the replacement cost of practically any structure quickly and accurately using timely data provided by the Craftsman Book Company.

Streamline Your Complete Healthcare Data Workflow. Smart Data Solutions has the tools and experience needed to streamline both your paper and electronic workflows. Our integrated validation, matching, and normalization tools ensure the highest quality data possible, increasing auto-adjudication and reducing manual processing. Whether you’re new to Smart Data Solutions or a long time partner, our development process helps guide you through projects to ensure the best possible position for overall success. Whether your needs are basic or complex, our staff will work with you to understand your needs and the impacts of your workflows. We believe in focusing on your goals, what you want to accomplish, and from that, identifying the best way to get there. Smart Data Solutions provides complete front-end pre-adjudication solutions for hundreds of Payers nationwide. Whether you need basic services or a completely custom workflow, Smart Data Solutions offers a variety of solutions.