Alternatives to Veritable
Compare Veritable alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to Veritable in 2026. Compare features, ratings, user reviews, pricing, and more from Veritable competitors and alternatives in order to make an informed decision for your business.
-
1
Service Center
Office Ally
Service Center by Office Ally is a trusted Revenue Cycle Management and patient payments platform used by more than 80,000 healthcare providers and health services organizations, which process more than 950 million transactions annually. Service Center is a cost-effective solution enabling providers to control their revenue cycle. With a user-friendly interface, Service Center helps providers check and verify patients’ eligibility and benefits, submit, correct, and check the status of their claims online, and receive remittance advice. Accepting standard ANSI formats, data entry and pipe-delimited formats, Service Center helps streamline administrative tasks and create more efficient workflows for providers. -
2
Inovalon Claims Management Pro
Inovalon
Keep revenue flowing with a powerful tool that speeds up reimbursements with eligibility checks, claims status tracking, audits and appeals, and remittance management for government and commercial claims, all in a single system. Leverage an advanced rules engine that immediately scrubs claims against the most up-to-date CMS and commercial payer rules, allowing you to correct errors before claims go out the door. Verify eligibility across all payers during claim upload and see flagged errors so claims can be edited before submission. Decrease days in A/R with automated workflows for audit responses, appeal submissions, and ADR tracking. Customize staff workflow assignments based on the type of claim and action needed. Automate secondary claims submissions to stop timely filing write-offs. Increase claims revenue with automated workflows for faster, more successful audits and appeals. -
3
eClaimStatus
eClaimStatus
eClaimStatus provides simple, practical, efficient and cost effective real time Medical Insurance Eligibility Verification system and Claim Status solutions that power value added healthcare environments. At a time when healthcare insurance companies are reducing reimbursement rates, medical practitioners must monitor their revenue closely and eliminate all possible leakages and payment risks. Inaccurate insurance eligibility verification causes more than 75% of claim rejections and denials by payers. Furthermore, refiling rejected claims cost an organization $50,000 to $250,000 in annual net revenue for every 1% of claims rejected (HFMA.org). To overcome the revenue leakages, you need a no-fuss, affordable and effective Health Insurance Verification and Claim Status software. eClaimStatus was designed to solve these specific challenges. -
4
Rivet
Rivet Health
Patient cost estimates and upfront collection. Understand patient responsibility instantly with automatic eligibility and benefit verification checks. Hyper-accurate estimates based on your own practice data, creating better care and a healthier business. Send estimates via HIPAA-compliant text or email. It's time to treat 2020 like 2020. Collect more than ever with upfront mobile patient payments. Ditch the write offs and decrease patient AR. Run eligibility checks and provide accurate cost estimates, even for multiple payers, treatments, facilities or providers. Collect payment up front via HIPAA-compliant text or email. Reduce A/R days, collect more revenue and increase patient satisfaction all at once. Identify, analyze and resolve denials, as well as track ROI from reworked claims. Automate denial assignments to team members via Rivet, and leave notes and links along the way to resolve future denials even faster. -
5
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. -
6
Amazing Charts Practice Management
Amazing Charts
Amazing Charts Practice Management is a comprehensive solution designed to streamline administrative tasks and enhance the efficiency of independent medical practices. Developed by a practicing physician, this system automates processes such as capturing patient demographics, scheduling appointments, pre-registering patients with insurance eligibility checks, and generating analytical reports. It also determines patient financial responsibilities at the point of care, maintains insurance payer lists, and ensures prompt and accurate billing to assist in payment collection efforts. Key features include the ability to view unpaid claims to ensure timely resolution, a claims manager who reviews submissions to reduce denials, and an integrated secure connect clearinghouse for high-level support and quick responses to payer changes. The system offers intelligent, interactive role-based dashboards that automatically prioritize work lists across all office areas.Starting Price: $229 per month -
7
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. -
8
AltuMED PracticeFit
AltuMED
Conducting thorough checks on the financial eligibility of the patients, running their insurance’s analysis and monitoring discrepancies, the eligibility checker covers all. If however any error does creeps in the data submitted, our scrubber working on deep AI&ML algorithms is capable of scrubbing errors be it coding errors, incomplete or wrong patient financial information. The software, at present, has 3.5 Million edits pre-loaded in its memory. To further streamline the process, automatic updates are issued by the clearing house to inform about the status of in-process claims. Covering the entire billing spectrum from verifying the patient financials to working on denied or lost claims and also has a through follow-up feature for appeals. Our intuitive systems warns if a claim could be denied, taking corrective actions to prevent it but also is capable of tracking and appealing for lost or denied claims. -
9
HEALTHsuite
RAM Technologies
HEALTHsuite is a comprehensive benefit administration system and claims processing software solution designed for health plans administering Medicaid and / or Medicare Advantage benefits. HEALTHsuite is a rules-based auto adjudication software solution designed to automate all aspects of enrollment / eligibility, benefit administration, provider contracting / reimbursement, premium billing, medical management, care management, claims adjudication, customer service, reporting and more. RAM’s Medicare Advantage-in-a-Box offering is unique in the industry; the product of RAM’s extensive experience in Medicare Advantage and an unwavering commitment to changing our industry. HEALTHsuite Advantage™ and eHealthsuite™ are the cornerstones of our pre-configured Medicare Advantage-in-a-Box offering. HEALTHsuite Advantage is a fully integrated suite of modules providing our clients with an unmatched solution to administer their Medicare Advantage and Special Needs Plans (SNP’s). -
10
Vyne Trellis
Vyne Dental
You have better things to do than sit on the phone. That’s why our real-time eligibility tool allows you to quickly verify your patients’ benefits, regardless of their plan. Gone are the days of paying transaction fees for claims, attachments, and checking eligibility! Our plan includes all features for one monthly fee. Subscribe to Vyne Trellis™ and gain the benefit of our team of industry professionals. With us, you can keep a tab on claims, claims that put money back in your firm’s pocket. Regardless of the size of your practice, our platform can handle any volume of claims. Vyne Trellis™ is integrated with the claims administrators and clearinghouses you need. Our dashboard sends you rejection reasons, status updates, and other smart notifications, so you can keep your claims moving. And if you get a little stuck on a claim, our support team is here to help! No more multiple tabs or windows. You can access virtually all of your data and documents, like ERAs and attachments. -
11
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 -
12
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 -
13
Centauri Health Solutions
Centauri Health Solutions
Centauri Health Solutions is a healthcare technology and services company driven by our desire to make the healthcare system work better for our clients and to provide compassionate support for individuals in need. Our analytics-powered software enables hospitals and health plans (Medicare, Medicaid, Exchange and Commercial) to manage their variable revenue through a custom-built workflow platform. While our tailored support of their patients and members provides them with access to life-enhancing benefits. Our solutions include Risk Adjustment (Medical Record Retrieval, Medical Record Coding, Analytics and RAPS/EDPS Submissions), HEDIS® and Stars Quality Program Management, Clinical Data Exchange, Eligibility and Enrollment, Out-of-State Medicaid Account Management, Revenue Cycle Analytics, Referral Management & Analytics, and Social Determinants of Health. -
14
Stedi
Stedi
Stedi is the only clearinghouse built on modern APIs, while supporting both real-time and batch EDI processes. It enables health techs and incumbents to exchange mission-critical transactions - from eligibility to claims and remits. With a security-first cloud infrastructure, built-in payer redundancy via 3,400+ route connections, and market-leading sub-10-minute support response times, Stedi provides reliability and responsiveness to avoid billing outages and reduce denials.Starting Price: $2,000 per month -
15
Clearwave
Clearwave
Save 20% of all administrative hours for your practice, check patient insurance eligibility in real-time and streamline patient check-in with our kiosks, tablets, and software. Simplify your patients’ check-in process by allowing your patients to check in before their scheduled appointment—anytime from anywhere. Patient registration is simplified, and patient intake is streamlined. Get patients through the check-in process quickly with our customizable workflow. Average check-in time for new patients is 3 minutes. Check-in for returning patients is less than a minute. Increase successful payments and cash flow to your practice. Medical practices have seen an increase their point-of-sale collections by 25% – 65%. Clearwave is the cure for patients’ impatience. Establish a digital front door that’s always open for scheduling convenience, automated eligibility verification, patient check-in and frictionless financial transparency. -
16
ImagineMedMC
Imagine Software
Manage your members' healthcare and networks with a cloud-based healthcare delivery system. Automate claims processing for managed care organizations. Includes eligibility, referral and authorization processing, provider contracting, benefit administration, auto claims adjudication, capitation (PCP and Specialty), EOB/EFT check processing, and EDI transfers and reporting. Deploy as a cloud solution or an in-house system. Ideal for managed care organizations (MCOs), independent physician organizations (IPAs), third-party administrators (TPAs), preferred provider organizations (PPOs), and self-insured groups. Streamline the complexities of administrating eligibility, referral authorization and claims processing. Features and functions maximize data integrity while reducing data entry. -
17
Eligible
Eligible
Eligible's powerful APIs are the easiest way to add insurance billing experiences into your applications. These accreditations assure patients and providers that Eligible has accomplished the strictest compliance with privacy and security best practices while processing millions of healthcare cases each month. We fully understand the role of a mature and proven information security program in meeting Eligible and customer goals. We are happy to announce the successful completion of our Type II SOC2 review. Achieving this certification helps us assure our customers and the companies with which we interact that we understand our responsibilities in keeping protected health information safe. Instantly deliver exceptional experiences for patient insurance billing to your end users. Run estimations, perform insurance verifications and file patient's claims all with simple APIs.Starting Price: 3% Fee -
18
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. -
19
Axxess Home Health
Axxess
Increase your organization’s cash flow by processing claims from Medicare, Medicaid and all other commercial payers. Automated processing of all payer claims in real time from anywhere at anytime ensures your claims get processed and get paid faster. Automatically submit and track your claims from anywhere at any time with real-time claims status updates. You are assigned a dedicated account manager that is a certified health care claims manager. You even have their mobile phone number. Diversify your revenue sources and improve your cash flow with our automated, anytime, anywhere claims processing with complete visibility to all your electronic funds transfers (EFT) and payment projections. Process, track and fix claims in real-time to capture all your revenue while eliminating costly time-consuming processes. Automate Medicare eligibility verification and claims processing. -
20
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. -
21
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. -
22
Nirvana
Nirvana
We work with private insurance clients to get your therapy sessions covered, every time. Navigating mental health billing and your health insurance plan shouldn’t feel like wandering in the dark. From eligibility to reimbursement, Nirvana makes the insurance process seamless for you and your therapist, so you can save time, headaches, and get paid faster. Instead of spending hours on the phone with insurance trying to figure out what you’re covered for, get a clear understanding of your coverage as soon as you sign up. From eligibility to reimbursement, Nirvana makes the insurance process seamless for you and your client. Seamlessly monitor the lifecycle of your claims with the ability to track submission, processing, and adjudication. Filter between sessions and date ranges to get an in-depth understanding of reimbursement amounts for your sessions.Starting Price: $129 per therapist per month -
23
E-COMB
KBTS Technologies
EDI Compatible Medical Billing (E-COMB) is a web based solution for generating medical claims complying with the HIPAA transaction and code set standards, regulated by the US Government following the recommendations of American National Standards Institute (ANSI). The application is designed to generate, submit and reconcile the claims to the insurance carriers, guarantors and/or patients. This is one of the most important tools for doctors in realizing their revenue by reducing the turnaround time in the claims reimbursement. All the information related to environment of the Doctor’s Office/Hospital is grouped together as Master Data. This information is frequently used for claims processing and is less likely to change quite often. Master Data contains details of the Procedures, Diagnoses, Doctors, Payers, and Billing Providers etc. This data is created as part of the initial set up and can be updated easily at any time. -
24
Inovalon Provider Cloud
Inovalon
Optimize revenue cycle management, care quality management, and workforce management all in one single-sign-on, easy-to-use portal. More than 47,000 provider sites rely on our innovative tools to simplify complicated operations across the patient care journey. Improve the patient financial experience and simplify administrative and clinical complexities with the Inovalon Provider Cloud – all while saying goodbye to siloed workflows. Our SaaS solutions help you strengthen financial and clinical outcomes across the patient journey, from creating front- and back-end revenue cycle processes for better reimbursement to ensuring appropriate staffing levels for optimal care. This is all managed in one comprehensive portal to take your organization to new heights improving revenue, staff equity, and care quality. Enhance your organization’s efficiency, productivity, and overall effectiveness. Discover what the Provider Cloud can do. -
25
Paradigm
Paradigm
Paradigm Senior Services offers a full-service, AI-powered revenue cycle management platform specifically tailored to home-care agencies that bill third-party payers such as the U.S. Department of Veterans Affairs (VA), Medicaid, and other managed-care payers. It automates and streamlines every step of the billing and claims process: from eligibility/authorization verification, state- or payer-specific enrollment and credentialing, to submission of clean claims, denial handling, and payment reconciliation. It integrates with common agency management software and electronic visit verification tools to scrub shifts, verify authorizations weekly, and reconcile payments, reducing denials and minimizing administrative burden. Paradigm also supports “back-office as a service” for providers; even if they already have internal billing staff or scheduling software, Paradigm can take over claims processing as a specialized, expert billing department. -
26
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. -
27
I-Med Claims
I-Med Claims
I-Med Claims provides top-tier medical billing and revenue cycle management (RCM) solutions, trusted by healthcare practices across the U.S. We handle all aspects of RCM, from eligibility verification to denial management, helping practices streamline operations and maximize reimbursements. With billing plans starting at just 2.95% of monthly collections, we offer affordable solutions that enhance financial workflows, maintain compliance, and improve cash flow. By outsourcing billing to us, practices can focus on patient care while benefiting from reduced claim denials and faster payments. -
28
Oracle's Digital Insurance Platform empowers insurance providers to deliver innovative solutions and exceptional digital customer experiences. This comprehensive insurance management system streamlines operations from sales channels to back-office processes, enabling rapid deployment of new offerings and seamless implementation of necessary changes. With real-time analytics, insurers gain valuable insights into their business, facilitating informed decision-making. The platform supports both individual and group life and annuity insurance, consolidating underwriting, policy processing, billing, and claims into a single, efficient system. Health insurers benefit from simplified enrollments, premium billing, and claims adjudication, enhancing member satisfaction through transparent and personalized services. Additionally, the platform accelerates the bancassurance lifecycle by providing real-time connectivity between banks and insurers, ensuring speed, consistency, and reliability.
-
29
Kovo RCM
Kovo RCM
Kovo RCM is a revenue cycle management and medical billing service platform that helps healthcare providers streamline billing processes, optimize reimbursements, and reduce administrative burden so clinicians can focus more on patient care. It delivers end-to-end RCM services that include insurance eligibility verification, claims submission and tracking, denial management and appeals, coding support, credentialing, patient billing and collections, and custom reporting and analytics to provide clear financial insights and improve cash flow. Kovo RCM supports a wide range of medical specialties, including cardiology, anesthesiology, radiology, mental and behavioral health, internal medicine, surgery, EMS and ambulance services, wound care, and more, offering tailored billing expertise for the unique coding and reimbursement challenges each field faces. -
30
EzyMed Online 4
Top Tech Computing Systems
EzyMed Online 4 is a fully integrated Medical Practice Management software for General Practices, Radiology and Specialists Centres. Developed for the Australian medical practice environment, EzyMed Online 4 encompasses all functions required for the Medicare Australia's Online Claiming Online process, Department of Veterans Affairs (DVA) Claims and Australian Childhood Immunisation Register (ACIR) claims. EzyMed Online is a comprehensive system designed to manage your practice efficiently with just a few clicks of the mouse. A secure database management ensures your system consistently maintains its performance even with a million or more records. From the time a patient is registered at the reception, the consultation is tracked by EzyMed Online 4 and stored in the patient’s database as paperless recording. The patient’s medical history can be retrieved at anytime even to all appointments ever recorded. -
31
Assurance Reimbursement Management
Change Healthcare
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. -
32
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. -
33
FINEOS
FINEOS
The FINEOS Platform provides clients the only complete end-to-end SaaS core product suite that includes FINEOS AdminSuite enabling quote to claim administration as well as add-on products, FINEOS Engage to support digital engagement and FINEOS Insight for analytics and reporting. The foundation of your digital insurance strategy. The FINEOS Platform seamlessly blends FINEOS AdminSuite + FINEOS Engage + FINEOS Insight + Platform Capabilities to create the most modern single core insurance platform for Life, Accident and Health. Legacy core systems utilized a ‘one size fits all’ business technology approach that no longer fits the needs of an agile business. Today, consumers, employers and brokers have access to powerful SaaS computing platforms and software tools that set a much higher bar for an insurer’s digital strategy. Monolithic insurance software models of the past focused solely on details of the insurance contract. -
34
MedicsPremier
Advanced Data Systems
Keep your practice on track with MedicsPremier (MedicsPM), a reliable practice management software from Advanced Data Systems. MedicsPremier comes with a wealth of tools that enables practices to streamline operations and get paid more, faster. This includes specialty-specific scheduling, automated patient workflow, patient information management, tax rates, products and inventory, specialty-specific EDI, patient statements, and integrated document scanning. With our system, get out-of-network alerts while scheduling patients. Access the patient responsibility estimator for an approximation of what they’ll owe after insurance. Remind patients about their copayments. Perform pre-appointment batch eligibility verifications. Get proactive alerts on claims likely to be denied. Yes…protect your revenue in advance! -
35
Claim Agent
EMCsoft
EMCsoft’s Claims Management Ecosystem assures that healthcare providers and billing companies deliver clean claims to insurance payers for proper claim adjudication. It is the integration of our versatile claims processing software Claim Agent and comprehensive fitting process called the Four Step Methodology into your claim adjudication process. This approach enables, supports, and automates your work process to maximize claim reimbursement. Request our free online demo for a great introduction into the functionality/features of Claim Agent and how it fits into your claim adjudication process. Claim Agent scrubs and processes your claims from the provider system to the insurance payers in a efficient, cost effective, and timely manner. The software is compatible with any system making implementation process quick and simple. We provide custom edits, bridge routines, payer lists, and work flow settings that are unique to each user. -
36
PrognoCIS Practice Management
Bizmatics
Seamlessly integrating with, our cloud-based Practice Management solution allows for quick and easy billing management, which enables your practice to quickly identify and confirm patient insurance benefit eligibility level and copay. Work with many different clearinghouses. Efficiently manage your accounting books. Easily reconcile patient accounting and insurance billing. Quick and easy online patient payments and EOB/ERA processing. Our healthcare practice management system has a very robust tasking system. You can quickly find and assign claims to work on using a filter-based search function. You can filter and search outstanding claims by around 100 different parameters, including patient vs. insurance responsibility, primary/secondary/tertiary payer or payer grouping, provider, date of service, aging bucket, and denial reason. Filters can be saved and reused later.Starting Price: $250 per month -
37
Wisedocs
Wisedocs
Wisedocs' document processing platform features enable insurance companies, independent medical evaluation firms, and legal entities to process claims with more speed, accuracy, and efficiency. Automatic organized medical records by date, service provider, title, and category. Automatic page duplication saving up to 30% of your time and money processing extra pages. The administrative hurdles with medical record reviews and sorting can be a challenge. Wisedocs has made automating medical record reviews a breeze for insurance, legal, and medical firms. Wisedocs will create an organized medical record index with insights based on your custom needs. Get important insights and easily searchable and indexible records pulled from the medical record review and intelligent summary. -
38
Anagram
Anagram
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. -
39
Inovalon Insurance Discovery
Inovalon
Insurance Discovery reduces uncompensated care and underpayments by identifying active billable coverage previously unknown to the provider. Using sophisticated search capabilities, this solution identifies if patients have multiple active payers to help boost reimbursement opportunities. Prevent reimbursement delays and increase the speed of revenue capture by sending claims to the right payers on the first submission, enabled by more accurate coverage information. Run Insurance Discovery with verified patient demographic data to get accurate coverage and eligibility information. Replace manual insurance discovery methods with one quick, comprehensive search that inquires numerous databases in seconds to deliver detailed, accurate coverage information. Improve the patient/resident experience and estimate accurate out-of-pocket costs to improve their financial experience. -
40
Experian Health
Experian Health
Patient access is the starting point for your entire revenue cycle process. Ensuring correct patient information on the front end reduces the errors that cause rework in the back office. 10 to 20 percent of a health system's revenue is forced to remediate denied medical claims and 30 to 50 percent of those occur during patient access. By adopting an automated, data-driven workflow—not only are you reducing the errors that lead to claim denials, you’re also improving access to care for your patients through capabilities like online scheduling options that are available 24/7. Access is further improved by reducing the friction around patient billing by leveraging real-time eligibility verification to deliver accurate patient estimates at registration. Increase staff efficiencies by improving registration accuracy. Correct discrepancies and errors in real time to avoid costly denials and rework. -
41
RevCycle Engine
Aptarro
RevCycle Engine applies built‑in, customizable rules and AI‑powered automation to correct coding and charge errors at the source, ensuring billing data is accurate before claims are submitted. By integrating seamlessly with EMRs and practice management systems, it ingests claims data in real time, applies industry‑proven rules tailored to each organization’s needs, and fixes errors automatically, reducing preventable denials and costly rework. Streamlined workflows prioritize and route only complex or exception claims for human review, boosting team efficiency and reducing burnout. With AI‑driven charge accuracy, the platform increases clean claim rates, lowers cost‑to‑collect, and stabilizes cash flow, all visible through clear dashboards and real‑time insights. Scalable automation handles high claim volumes without overtime or late‑night efforts, while features such as charge accuracy validation, denial prevention, coding review optimization, payment collection support, and more. -
42
OptiPayRCM
OptiPayRCM
OptiPayRCM’s platform delivers seamless, “last-mile” revenue cycle management automation by integrating with EHRs, clearing houses, payer portals, and other systems via flexible adapters so your billing workflows can be processed end-to-end. Its unified core engine handles eligibility checks, claim submissions, payment postings, denial management, and full accounts receivable workflows using AI and robotic process automation to reduce manual effort and accelerate cash flow. Real-time dashboards and reports provide visibility into key metrics and enable predictive insights, while customizable automation supports exceptions and unique workflows. It reduces first-pass denials by up to 63%, speeds claim status checks up to 50 times faster than human processing, and reduces payment cycle time by up to 35%. It is compatible with more than 200 healthcare systems and supports direct integrations via EHRs, FHIR, EDI, and HL7. -
43
Quadax
Quadax
How well you manage the challenges of your revenue cycle has a direct effect on your bottom line and the success of your entire organization. It doesn’t matter how many patients seek your care if it’s taking months to receive the expected payments for the services you provide. And, you shouldn’t have to spend hours each day tracking down the payments you’ve worked hard to earn. There’s a better way to maximize healthcare reimbursement. Let Quadax be your guide to creating a comprehensive, sustainable and orderly strategic plan, and select the right technology solutions and services that best fit your business model. With us as your partner, you can achieve operational efficiency, optimize financial performance and enhance the patient experience. The goal for every claim going out the door is to avoid a denial and get paid as quickly as possible. -
44
TruBridge
TruBridge
In the ever-changing world of healthcare, business and financial health is critical to the success of your healthcare organization. Get the people, products and processes you need for success that goes beyond simply getting paid. Revenue cycle management suite that helps businesses manage claims scrubbing, and review patients' eligibility through verifications. TruBridge is in the business of helping hospitals of all sizes get paid faster and get paid more through a combination of people, products and process optimization. Our arsenal of RCM offerings ranges from revenue cycle consulting, to an HFMA Peer Reviewed® product to complete business office outsourcing. TruBridge has been helping hospitals, physician clinics, and skilled nursing organizations become more efficient at serving their communities for years. Today, our trained experts stand ready to do the same for your organization, enabling you to overcome the unique revenue cycle challenges you face every day. -
45
ClaimScore
ClaimScore
ClaimScore is the only independent software solution dedicated to resolving the ever-expanding claim fraud problem in class action settlements. Each claim is reviewed individually using our proprietary AI, ML, & Cloud Architecture in real-time and each result is reported instantaneously in an interactive dashboard. Each claim begins with a ClaimScore of 1,000 and is reduced each time it fails a criterion. Each criterion has either a fixed weight or sliding weight depending on both the correlation to fraudulent claims and the correlation to valid claims. To maximize transparency, each claim is tagged with deduction codes associated with the criteria it fails, thus ensuring that the parties, the administrator and the court definitively know all specific reasons why each claim was rejected. -
46
MedClarity
Medusind
MedClarity is Medusind's turnkey RCM technology. MedClarity is a robust, web-based medical billing and practice-management software. The solution comes with a range of tools to enable medical practices of all sizes to take full control of their front-office and revenue operations. In addition to offering intuitive navigation and workflows, MedClarity boasts an advanced rules engine for clean claim submission, smart scheduler, comprehensive reporting and business analytics, real-time insurance eligibility verification, denial management and claim status lookup, and integration more than 30 EMR platforms. -
47
SpyGlass
Beacon Technologies
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. -
48
Cortex EDI
Cortex EDI
Cortex EDI provides medical, institutional, and dental practices with all the services they need to increase efficiency in the workplace. Our free medical billing software and claims clearinghouse software can help you streamline your workplace processes. We have the user-friendly tools you need to help you manage client billing and save you time. Our tools also provide you with such necessities as patient eligibility verification for private health insurance, Medicare, and Medicaid. We provide our free medical billing software to medical, institutional, and dental practices with no signup fees and no contracts. Sign up today to receive free training on how to properly use our practice management and medical claims clearinghouse software. Consolidate your various EDI service needs with Cortex EDI today to start streamlining your workplace processes. Cortex EDI is a leading clearinghouse and practice management software vendor for electronic medical transactions. -
49
Artsyl ClaimAction
Artsyl Technologies
Processing high volumes of medical claims through intelligent automation helps businesses deliver higher levels of efficiency that does more than reduce costs. For organizations that rely on manual processes, managing medical claims documents and data is labor-intensive and error-prone, injecting unnecessary risk into the process. With ClaimAction medical claims processing software from Artsyl, your organization can improve margins, minimize touch points and eliminate processing bottlenecks. Capture medical claims data without the need for custom software coding. Route claims data and documents automatically to the right claim examiner, based on your business rules. Configure complex benefits and reimbursement rules to streamline processing and reduce payment delays. Respond quickly to changing government regulations and support data, document and process compliance. -
50
DocVilla
PS3G
DocVilla is a comprehensive, multi-specialty, mobile-friendly, HIPAA-compliant cloud-based health technology platform that integrates EHR/EMR, telehealth, e-prescribing, patient engagement, medical billing, analytics and reporting, direct primary care, inventory management, remote patient monitoring, and more into a unified, configurable suite. Providers simply sign in to access a customizable electronic medical records system with secure messaging, video visits, controlled-substance e-Rx, and a free patient portal for scheduling, payment, and secure communications. The platform streamlines workflows by automating eligibility checks, claim submissions, charge posting, insurance eligibility and claim filing, ERAs/EOBs, medical dictation and speech-to-text, patient consent forms, lab integrations, electronic fax, and automatic appointment reminders.Starting Price: $100 per month
