Alternatives to mDOC
Compare mDOC alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to mDOC in 2026. Compare features, ratings, user reviews, pricing, and more from mDOC competitors and alternatives in order to make an informed decision for your business.
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expEDIum Medical Billing
iTech Workshop
A secure, SaaS-based Medical Billing, RCM software that helps doctors to increase the collection, and receive faster payment with improved automation. Features like Seamless Insurance Eligibility Verification (IEV), Appointment scheduling, Claims scrubbing, Claim Status Inquiry (CSI),Auto Posting, and Public health clinic make the software efficient and easy to use. expEDIum SDK is available with several APIs to integrate EMR software seamlessly with expEDIum Medical Billing / RCM software. -
2
NovoHealth Dental
NovoDynamics
Our platform automatically flags and prioritizes anomalous claims for review. NovoHealth Dental ensures exceptional claim quality and offers real-time analysis. Our platform provides accurate and consistent dental disease assessment. The future of dental claims processing is here. Our proven AI platform is in use within some of the country's largest dental payer organizations. We offer pilots to demonstrate the value of our solution. NovoHealth Dental saves time and money by making dental insurance claim review faster, easier and more efficient. It helps your analysts uncover anomalies that may indicate errors, omissions or potential fraud. We use AI to quickly verify and assess the quality of submitted claims and their attachments. The platform quickly, accurately, and consistently assesses dental diseases. Our AI fingerprints and analyzes every claim and attachment to detect high-confidence anomalies. -
3
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 -
4
Thrizer
Thrizer
Thrizer is a payment platform designed to simplify out-of-network therapy billing for both therapists and clients. For therapists, Thrizer functions similarly to platforms like Stripe or Square, allowing them to charge clients while automatically submitting out-of-network claims, eliminating the need for superbills and reducing administrative burdens. Clients benefit by paying only their co-insurance after meeting deductibles, with Thrizer covering the remaining fees upfront and awaiting insurance reimbursement on their behalf, thereby reducing upfront costs and expediting access to therapy. It also offers a free real-time benefits calculator, providing transparency on out-of-network benefits and estimated out-of-pocket costs before sessions. Additionally, Thrizer provides a superbill upload feature for clients whose therapists do not use the platform, enabling them to manage their claims efficiently.Starting Price: $2 per session -
5
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. -
6
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. -
7
ImagineBilling
ImagineSoftware
The industry’s first intelligent, multi-specialty medical billing software. Streamlining billing and patient collections for over 75,000 physicians across the country. Globalized data eliminates the need for duplicate entry. Visit-driven to allow for large volume and complex information. Flexible data structure accommodates requirements across multiple practices and specialties. Helping you get paid faster. Post payment manually or through electronic remittance. Automatically scrub claims for errors and missing information. Automatically refile insurance claims based on selected criteria. Fast review to evaluate and approve charges. Audit charges by modality, procedure, insurance, user, doctor or date of service. Intuitive reports for tracking the financial health of your front-end and back-end billing. Never lose another charge again. Integrates with your preferred clearinghouse or statement vendor. -
8
ProviderSoft
ProviderSoft
Specialty Software for your Early Childhood Program. We Focus on Function so you Focus on Families. Manage data for clients, providers, referral sources, and staff. Generate custom, dynamic reports and flags. Easily access schedules, prescriptions, and insurance authorizations. Create and submit electronic, paper, or custom claim files. Generate invoices and statements for families. Upload and track electronic or manual responses from Payers. -
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Paradigm
Paradigm
Paradigm Senior Services offers a full-service, AI-powered revenue cycle management platform specifically tailored to home-care agencies that bill third-party payers such as the U.S. Department of Veterans Affairs (VA), Medicaid, and other managed-care payers. It automates and streamlines every step of the billing and claims process: from eligibility/authorization verification, state- or payer-specific enrollment and credentialing, to submission of clean claims, denial handling, and payment reconciliation. It integrates with common agency management software and electronic visit verification tools to scrub shifts, verify authorizations weekly, and reconcile payments, reducing denials and minimizing administrative burden. Paradigm also supports “back-office as a service” for providers; even if they already have internal billing staff or scheduling software, Paradigm can take over claims processing as a specialized, expert billing department. -
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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. -
11
MedLedger
Health Data Services
MedLedger includes many features that can improve your addiction clinic performance. Submit professional and institutional electronic claims for all services, both in-patient and out-patient. Easy patient billing and the ability to take pre-payments via credit card or online payment portal will make MedLedger the only software you will need to efficiently run your clinic. We have worked with traditional practices for over 25 years. We offer physicians the very best and most affordable practice management and EHR solutions available with our MedLedger software. Fast claims submission, patient statement print and mail services, electronic prescribing, and more all at a low monthly cost. Our software is being used by some of the best-known players in the addiction recovery industry. MedLedger offers a user-friendly and price-effective choice for practices that need to submit both Professional and Institutional claims. -
12
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. -
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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 -
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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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ediLive!
Texas Medical Systems
ediLive! claims processing software works with any NSF, ANSI, or print file claim image, allowing the HIPAA complaint transmittal of any practice management software's claim file. Additionally, ediLive! customers benefit from real-time connectivity and claim collections workflow management. ediLive! attaches all claim status messaging from payers directly back to the claim for easy follow-up and correction, taking all incomplete claims and compiling them into a single on-screen worksheet for fast corrections and resubmittal. If you use ediLive!, we have a wonderful product call claims scrubber that can help you to get your claims paid – not only faster, but better! Call our office to schedule a free on-line demonstration. We can scrub the first 100 claims for you as a free trial. Every coding error you make costs your practice money. -
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DentalXChange
DentalXChange
Submit claims online using your practice management software or direct online entry. Check patient eligibility, plan benefits details, and claim status. Easily attach documentation to a claim without having to use any other service. Create a fully functional, professional website for your practice featuring web portal capabilities. Allow patients to view and pay their statements and give office staff access to your DentalXChange dashboard directly through your practice's website. Offer patient education videos to your patients on your website to help them visually understand their treatment options. Send statements to your patient's email with a secure web link to give them the option to pay online. Market your practice and increase your visibility with free inclusion in our nationwide online dental provider community. Manage your staff hours online and calculate your payroll with ease. -
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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. -
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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. -
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ClinicPro Medical Software
ClinicPro Software
ClinicPro medical practice management includes comprehensive patient data, insurance coverage, appointment scheduler, management reports, electronic or hard copy insurance claims, plain paper insurance statements or emailed patient statement. ClinicPro medical practice management includes comprehensive patient data, insurance coverage, appointment scheduler, management reports, electronic or hard copy insurance claims, plain paper insurance statements or emailed patient statement. All the features of our unlimited package software plus the trusted proven Billing Technology for independent clinics to simplify your medical billing and maintain control of your practice. Clinic Pro EMR is not Medicare certified. It is, however, an excellent tool for creating daily encounters for commercial insurances, Blue Cross Blue Shield, and personal injury practices using touchscreen or tablets, modality. -
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ClinicPro Chiropractic
ClinicPro Software
The Pro’s Choice for Medical or Chiropractic Practice Management Software – ClinicPro practice management software is used for pain management clinics, OB/GYN, chiropractic, ophthalmology, general practice, imaging centers and pediatric specialties. Because ClinicPro is so adaptable to the practice management needs of any specialty, ClinicPro software can interface with the clearinghouse of your choice. ClinicPro chiropractic practice management includes comprehensive patient data, insurance coverage, appointment scheduler, management reports, electronic or hard copy insurance claims, plain paper insurance statements or emailed patient statement. ClinicPro chiropractic practice management includes comprehensive patient data, insurance coverage, appointment scheduler, management reports, electronic or hard copy insurance claims, plain paper insurance statements or emailed patient statement. -
21
eClaims
TELUS Health
Streamline the claims process for your patients with an easy-to-use online service. With eClaims you can Delight your patients by submitting claims on their behalf. You’ll reduce their out-of-pocket expenses and help give your practice an edge on the competition. Reduce clients' out-of-pocket expenses, minimizing the credit card fees associated to your practice. Help attract new clients and retain existing ones with a proven increase in return appointments. When registered, you also benefit from free marketing. Once registered, view patients’ insurance coverage and submit claims electronically. Get instant responses from insurers. Start using it without any specialized hardware or software. Save on credit card fees by charging your clients only the portion not covered by their insurer. View your past transactions to ease payment reconciliation. Select whether payment should be assigned to either the healthcare professional or the patient. -
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Pro Health Billing
Pro Health Billing
Pro Health Billing's Medical Billing Software has simple tools that help with data entry, automated task that take only minutes to setup and very easy to use. You can print your first claim in 20 minutes! With tools like Auto-Codes, Repeat Last Claim and Auto Co-Pays. Pro Health Billing is a wrist saver! Small Medical Practice Companies love Pro Health Billing's Claim and Patient Scheduling Modules. Together they become a powerful tool that cuts your workload almost in half! With tools like Non Payment and Non Billed Alerts your revenue will increase as your workload shrinks! 'Pro Health Billing' is the best medical billing software to help you bring in more income and quickly! With our Claim Catcher Dashboard and our industry leading 'Revenue Cycle Manager' to fix those alerts, claims never go unnoticed! Know the status of all your claims with just a glance. -
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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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OneTouch Claims Processing Software
Apex EDI
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. -
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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. -
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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. -
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MediConCen
MediConCen
The ultimate insurance claim automation solution powered by patented blockchain technology. Claims are the moment of truth for all insurance, and with our solutions, everything has been craftily designed to automate insurance claims for insured and insurers with unbeatable accuracy and speed, from claim estimation before a claim occurs, to making the right claim decision and settling the payments. MediConCen is a leading insurance technology that automates insurance claims and makes insurance usable for insurance companies, medical networks, and clinics using Hyperledger Fabric blockchain. We empower claim assessors with powerful AI models and expert knowledge decision rule engines so that fraud and abuse can be spotted instantly and clean cases can be approved right away for consistently perfect claim cost management and unbeatable efficiency. Be in the know with powerful claim analytics that simply work for underwriting and product development. -
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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. -
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Majesco ClaimVantage
Majesco
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. -
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Venue Claims Management
KLJ Computer Solutions
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.Starting Price: $5 per month -
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ClaimBook
Attune Technologies
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. -
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AcuVine
AcuVine
Verify your patient's insurance coverage within seconds and submit a claim all in one place. Correct any denied claims on the spot so you can get paid faster and resubmit instantly. Track your claims from submission all the way to their payout and know exactly when you will be paid. AcuVine has partnered with industry leaders working extensively to design and build forms to help prevent audits. We've focused all of our efforts on compliance so you don't have to. Our forms are fully customizable and built with your specific industry in mind. Schedule your patients to manage your day-to-day hours and availability and have them fill out forms prior to their appointment. Seperate by appointment type to easily see your day at a glance. Manage multiple patients with multiple employees and block out time as needed. Collect payment, manage invoices, and track sales and inventory of all your products.Starting Price: $79.97 per month -
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TheraBill
TheraBill
Therabill is a cloud-based practice management software for nutritional, mental and behavioral health specialists. Therabill combines therapy billing, scheduling, and documentation in one simple solution, allowing users to submit claims, manage schedules, enter treatment notes, and maintain patient information with ease. Therabill also offers a chock-full of helpful features including exportable client statements and invoices, automated appointments and reminders, and provider portals. -
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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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PatientStudio
PatientStudio
Maximize your appointment calendar with improved visibility into your clinic's schedule and provider availability. View and schedule appointments across many providers, rooms or locations to ensure a steady patient flow. Automatically invite patients to complete patient intake online. Custom digital paperwork can be completed and submitted using a smartphone or personal device. The patient's data will sync directly to their patient chart. Reduce no-shows with perfectly timed patient reminders via email and text message. Patients and staff can communicate, confirm or reschedule with two-way text messaging. Easily generate claims from patient notes and suggested ICD-10 codes. Automatically scrub and submit claims electronically. Services to manage your entire billing process, from submission to payment collection. Quickly create defensible, legible, and comprehensive clinical notes with documentation templates, assessment reports and pre-populated patient data. -
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TrackAbility
Recordables
Liability claims management software solutions from Recordables. Software solutions to improve claims management including General Liability, Auto, Property, Incidents, and more. Recordables Liability insurance tracking software organizes incidents and claims that include auto, property, and general liability policies. Tracking all liability and risk incidents and claims, TrackAbility provides comprehensive liability claims tracking software solutions Benefits of TrackAbility liability claims management include start to finish injury liability claims management from incident through completion. Create customizable liability claim types with user-selectable criteria. Safety professionals and field users can collaborate on claims and reports, continuing to add pictures and videos for incidents or claims. Receive a holistic view of financial data necessary for claims management, such as payments and losses based upon individuals, locations, policy specifications, and other data. -
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Pivot Point
Catex
Pivot Point is an end-to-end reinsurance transaction system developed by CATEX, designed to revolutionize the management of reinsurance-related data for brokers and general agents. This comprehensive platform integrates placement, contracts, accounting, claims, and reporting processes into a single application, ensuring consistent access and reporting across all lines of business. Key features include company management, which stores vital contact information and affiliations; contract management, allowing oversight of various contract types with complex terms; claims management, ensuring accurate linkage of claims data to contracts; accounting and settlement, automating statements and payment schedules; and management reporting and analytics, utilizing built-in dashboards powered by Power BI for enhanced reporting. By unifying these functions, Pivot Point streamlines operations reduces manual tasks, and enhances data accuracy. -
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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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Snapsheet
Snapsheet
Snapsheet makes claims simple. We do this through a suite of innovative insurance software solutions which transform insurance companies' ability to seamlessly manage claims, reduce cycle time, increase appraisal accuracy, and deliver payments effortlessly. We started it all with virtual appraisals, and followed that up with our leading claims management system. Today we are driving an industry-wide movement in claims by delivering solutions that enhance customer experiences while our customers create innovative, data-driven claims organizations. -
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Gentem
Gentem Health
Gentem Health is a platform that transforms the reimbursement experience by not only handling the end-to-end billing and revenue cycle processes, but also advancing payments to private medical practices. Nothing falls through the cracks. Our platform serves as a single source of truth to understand your billing operations and monitor your core metrics so you’re always on top of your revenue. We support the imperative need for cash flow and capital to fuel sustainable growth. Get access to working capital while Gentem submits, scrubs, and pursues your claims. Our specialty-focused experts — empowered by cutting edge technology — are dedicated to maximizing your collections. Technology built to drive results. State-of-the-art analytical tools and A.I. powered automations give you more control over your practice’s revenue than ever before. Gain complete transparency into your claim process with real-time performance analytics and timely alerts to ensure that no claim is left behind. -
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Overjet
Overjet
Enables efficient and accurate claim review and real-time payment integrity to ensure the right claim is paid at the right time for the right amount. Helps providers manage and deliver high-quality care, automate administrative tasks, and identify key areas of practice growth. We have great opportunities for dentists, computer vision scientists, and software developers. Join us in impacting millions of lives. Move from manual and inconsistent review to automated and efficient review of every claim. Move from post-payment recovery to pre-payment & prevention model to make accurate payments. Increase dentists productivity by auto charting, identifying coding and billing errors and establishing diagnostic & treatment protocols for every appointment. -
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Veritable
314e Corporation
Veritable accelerates patient insurance eligibility verification and claims-status checks by providing instantaneous results in a clean, intuitive interface. It supports real-time, batch uploading of patient lists to verify eligibility across more than 1,000 payers (including national Medicare and all state Medicaid) and multiple service types. It also enables tracking of claims status, from submission through reimbursement, so practices and billing companies can proactively identify issues to reduce payment delays and denials. Key benefits include automating eligibility and claims workflows to reduce manual entry and phone calls, improving front-desk patient experience by validating coverage and copayments at check-in, and offering seamless integration for both technical and non-technical users with strong data-security controls. It includes a “Code Explorer” for instant lookup of ICD-10-CM, ICD-10-PCS, HCPCS Level II, and CPT codes.Starting Price: $50 per month -
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iNymbus
iNymbus
iNymbus DeductionsXchange resolves and disputes deductions and chargebacks automatically while increasing speed and efficiency by 30X. DeductionsXchange introduces cloud robotic automation for uploading denied claim packets to retail vendor portals and submitting disputes on the customer’s behalf. Not only are processing costs reduced dramatically via the elimination of manual labor, but companies can also take back revenue from previously invalid and undisputed chargebacks and deductions. -
44
Caseware Corporation Tax
CaseWare UK
Produce, tag, analyse, calculate and submit CT600s online all in one location. Incorporate all the latest taxonomies and revised CT600 forms, our software gives you the ability to complete and submit an unlimited quantity of tax returns directly to HMRC online. Quickly populate your capital allowances additions worksheet by copying data straight from your excel fixed asset spreadsheet. Claim or surrender current year or brought forward losses using our dedicated group relief and loss allocation worksheets. Make your claims for R&D tax relief, whether under the SME scheme with enhanced deductions or surrendered losses, the large company RDEC, or both. Split your profit and loss account into multiple trade and investment activities and break out adjustments, allowances and claims for each separately on your computation. -
45
Payapps
Payapps
Reduce administration of progress claims by up to 50%. Quickly and easily access and review standardized claims created within Payapps by your supply chain. Configurable approval workflows and automated alerts remind you to respond to and issue payment schedules, enabling compliance with security of payment legislation and helping you maintain your reputation as a good payer. Whether used as a stand-alone solution or integrated with leading construction ERPs or accounting software, Payapps provides standardization of your processes and documentation. You'll have full oversight of where received claims are at within the approval process. Integrating with your construction finance software automates the transfer of critical financial data to drive efficiency, eliminate duplicate data entry, and reduce the risk of errors. Payapps automatically brings forward and reconciles previously approved claims so you don't have to waste time working in spreadsheets or duplicating last months claims. -
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ESO Billing
ESO
Automate your workflow and integrations, and put an end to the repetitive manual work associated with revenue cycle management. ESO Billing frees your team to focus on what they do best. In today’s reimbursement world, efficiency counts. ESO Billing was built to save you time at every possible point in the billing process. Even its interface has been freshly redesigned for the ultimate in speed and ease of use. Customize your workflow based on your business process, task-based workflow moves each claim through its stages with minimal touches. It even alerts you automatically when payments aren’t on time, for the ultimate peace of mind. Our payer-specific proprietary audit process ensures that each claim contains all critical billing information prior to claim submission. The result? The lowest clearinghouse and payer rejection rate in the industry. Pair billing with ESO Health Data Exchange (HDE) and ESO Payer Insights to tap into hospital-generated billing information with one click. -
47
ALFRED Claims Automation
Artivatic.ai
Filing claims are complex and critical processes. More than 60% of people do not file complex due to its complex processes and time taking nature. Artivatic’s dedicated claims platform for each insurance vertical helps insurance businesses to enable digital claims journeys, self-claims processing, automated assessment, risk & fraud intelligence and claims payout. ONE PLATFORM FOR ALL YOUR CLAIMS NEEDS. End to End Claims Automation and Assessment Platform AUTO CLAIMS – HEALTH CLAIMS – TRAVEL CLAIMS – ACCIDENTAL CLAIMS – DEATH CLAIMS – FIRE CLAIMS – SME CLAIMS – BUSINESS CLAIMS – COMMERCIAL CLAIMSStarting Price: $10/claims/month -
48
One Inc
One Inc
One Inc offers a single platform built for insurance to process premiums and claims payments. It’s the one solution you need to deliver a frictionless payment experience. Close claims faster and save money on processing checks by paying claims digitally through ClaimsPay®. Increase customer retention, lower operating costs, and reduce security and compliance risk by delivering digital claims payments through payees’ preferred payment channels and methods. Give policyholders the digital payment options they want without getting rid of your existing core systems and processes. Securely capture payment information without storing it on your network. Make reporting and reconciliation fast, easy, and painless. Put money back into your pocket by processing inbound and outbound payments digitally. Gone are the long days of processing paper checks, and manual reporting and reconciliation processes. -
49
CLAIMSplus
Addiox Technologies
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. -
50
omni:us
omni:us
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.
