Alternatives to omni:us

Compare omni:us alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to omni:us in 2024. Compare features, ratings, user reviews, pricing, and more from omni:us competitors and alternatives in order to make an informed decision for your business.

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    Service Center

    Service Center

    Office Ally

    Service Center by Office Ally is a trusted revenue cycle management platform used by over 65,000 healthcare organizations processing more than 350 million claims annually. With it, providers can verify patient eligibility and benefits, upload and submit claims, correct rejected claims, check claim status, and obtain remits. With multiple claim types and submission options, providers can easily submit claims to any payer from any practice management system. Transactions are secure, ensuring the confidentiality of sensitive patient information. With no needed implementation, providers can quickly and effortlessly streamline their billing processes, increase their financial performance, simplify medical billing, and reduce claim rejections for faster reimbursements.
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    Macaw

    Macaw

    Nest Innovative Solutions

    Macaw AMS is for selling Insurance. Brokers, MGAs, MGUs, Program Managers and Lloyds Coverholders can use Macaw AMS to automate their operating model. Macaw AMS is built with a customer-centric model. It supports CRM, Sales, Underwriting, Rating, Policy Servicing, Claims Intimation and Billing. Self-service portals are available for Customers, Producers and Service Providers. Macaw AMS comes with in-built Document Management and Task Management facilities. It has several ready adaptors to provide integrated & in-flow facilities for eSignature, Payment, OFAC check, Mass Emailing and Computer Telephony, using 3rd Party Services. Macaw AMS is hosted in cloud and tested for cyber security. Technology-wise, the screens are responsive and can be used from web / mobile / tablet. The database is relational and the core components are written in Java. At the peak, Macaw AMS can process 500-1000 Policies within one day. Macaw AMS is expected to cut down cost per policy by 30%.
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    Cloud Claims
    Improve claim outcomes with streamlined First Notice of Loss (FNOL), claim processing and flexible reporting. INCIDENT BASED CLAIMS MANAGEMENT Effective claims management is about more than simply managing claims outcomes. It is about having an automated process that ensures efficiency and accuracy across the organization, getting timely notice of losses, and taking swift action are keys to success. The incident-based approach of Cloud Claims covers all accidents and losses, delivering a complete picture of loss to executives and claims managers. REPORTING Are your business executives frustrated by the lack of real-time insight into claim activity? Streamline claims operations with alerts and reminders to engage the right resources at the right time. Cloud Claims is cloud-based and able to connect with your systems via API. Large distributed organizations can enable workers at various locations to report incidents in real-time to management.
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  • 4
    Virtual Examiner

    Virtual Examiner

    PCG Software

    Virtual Examiner®, PCG Software’s flagship product, monitors the internal claims process of an organization to trend provider data for fraudulent and abusive billing patterns, and maximizes financial recoveries. PCG Software’s Virtual Examiner® allows healthcare organizations to enhance their current claims adjudication system with more than 31 million edits per claim. The software solution monitors an organization’s internal claims process to identify unclean claims and reduce payment for improper or erroneous coding to conserve premium dollars. Virtual Examiner® is more than a claims review solution with a focus on code combinations. It is a cost containment solution that evaluates the claim not only for abusive billing patterns but also identifies those claims that may involve third-party liability/coordination of benefits, case management opportunities, physician billing education and many other cost recovery reports.
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    VCA Software

    VCA Software

    VCA Software

    Dreaming of happy, efficient claim handlers; fast, accurate claims resolution; and 5-star policyholder ratings? Our agile, future-ready platform enables your people to perform like rockstars, and equips your company with scalable, intuitive processes to fuel profitable growth. By simplifying and automating the workflow, our clients reduce the cost of the claims journey by as much as 30%. VCA Software is one of the most scalable and integration-friendly platforms in the market. Our robust features, at a mid-range price point, make us a favorite among TPAs and adjusting firms. Yes, VCA is lightning fast, but the system is also whip-smart – equipped with a cutting-edge analytics suite so you can make fact-based decisions. You can count on VCA for industry-leading uptime, privacy, and data security. Our Tier 1 data centers are located in the USA, UK, Canada, and Australia. Our solutions can be easily customized to meet your team’s unique requirements.
    Starting Price: $65 per month
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    ALFRED Claims Automation
    Filing claims are complex and critical processes. More than 60% of people do not file complex due to its complex processes and time taking nature. Artivatic’s dedicated claims platform for each insurance vertical helps insurance businesses to enable digital claims journeys, self-claims processing, automated assessment, risk & fraud intelligence and claims payout. ONE PLATFORM FOR ALL YOUR CLAIMS NEEDS. End to End Claims Automation and Assessment Platform AUTO CLAIMS – HEALTH CLAIMS – TRAVEL CLAIMS – ACCIDENTAL CLAIMS – DEATH CLAIMS – FIRE CLAIMS – SME CLAIMS – BUSINESS CLAIMS – COMMERCIAL CLAIMS
    Starting Price: $10/claims/month
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    Claims Manager
    Claims Manager is a comprehensive, integrated RIMS system built to streamline your process from FNOL to settlement. A unique, configurable business rules engine automates workflow, reduces manual and duplicate work, saves time, and improves outcomes for all stakeholders. Claims Manager’s integrated solutions streamline workflow by helping you administer, adjust, and report your property and casualty claims. Claims Manager is a versatile, and simple to use Risk Management Information System that offers tomorrow’s solutions, today. Its intuitive interface seamlessly integrates with an automated workflow that is accessible anytime, anywhere, from any device. Letting you easily capture, benchmark, administer, and report claims for all lines of property and casualty insurance.
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    AGO Insurance Software

    AGO Insurance Software

    AGO Insurance Software

    AGO Insurance Software, Inc. has been a recognized leader in software and services for property and casualty insurance firms, and we have provided proven, cost effective business solutions to insurers of all sizes. Our products include solutions for policy administration, claims processing, accounting, bureau reporting and expert systems. Our software can streamline your operations, making your business more efficient, productive and profitable. Our System is designed in a modular fashion which can be installed as a completely integrated system or separate modules that can be licensed individually. This provides the flexibility of collaboration with existing legacy or third party systems.
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    Digital Payments
    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.
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    Aclaimant

    Aclaimant

    Aclaimant

    Empower your employees to drive productivity and reduce the total cost of risk with the RMIS built to deliver insight and results. Active risk management is a strategy where you empower your employees to more productively manage risk by leveraging technology that is centralized, connected, scalable, and data-driven to deliver results. Successfully decrease accidents, claim lag time and case duration using Aclaimant’s centralized system that connects your risk management office to incidents in the field. Reduce the cost of claims through better prevention and better mitigation to ultimately improve your insurability. Better utilize superior risk and safety talent with mobile-first, modern technology and automation. Aclaimant keeps your team focused and improves talent appeal, morale, and retention. Get access to case studies and content to better understand how you can put the Aclaimant platform to work for you and your team.
    Starting Price: Free
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    CaseGlide

    CaseGlide

    CaseGlide

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

    Curacel

    Curacel

    Curacel’s AI powered platform enables insurers track fraud and automate claims seamlessly. Collect your claims from your Providers in real-time and easily auto-vet the claims. Curacel Detection helps you detect and curb fraud, waste and abuse in the Claims Process. Collect claims from their providers and prevent fraud, waste and abuse in the claims process. We studied the Health Insurance industry to understand where the most value is lost by Insurers. This was identified to be the Claims Process. The Process is mostly manual and is fraught with a lot of fraud, waste and abuse. Our solution, driven by AI, helps to curb wastage and make the Insurer more efficient, thereby making them unlock hidden value. ravel insurance is peculiar in that it is built on on-demand policies that cover relatively short periods of time. Should a policy holder want to make a Claim, both the insurer and the insured want claim settlement to be as efficient and accurate as possible.
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    A1 Tracker

    A1 Tracker

    A1 Enterprise

    A1 Tracker is presented by the vendor as a robust & configurable risk management software offering either stand-alone or fully-integrated risk management software covering many business segments across an organization. Claims & Incident Management Claims & incident reporting for claims of any type: injuries, medical, commercial, customer, insurance, work comp, asset, auto, liability. Risk Management & Threat Assessment: Risk register for tracking risks at any level in an organization, including by entity, project, asset, contract, vendor, division, business, unit, region, and more. Real-time risk reports & heat maps, dashboard metrics, alerts, & notifications. Contract Management: Contract module for tracking contracts of any type with vendors, employees, customers, and any other parties. Insurance Policies & Certificates: Policies & certificates of insurance tracking with reminders & renewals. For agencies & carriers policy management includes tracking clients.
    Starting Price: $800/month
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    ClaimsControl

    ClaimsControl

    Claims Control

    Our goal is to digitize the data exchange between all claims handling participants: insurers, brokers, their customers, loss adjusters, and all others. Use our platform to account and share your claims or connect your claims system to our API hub to get integrated with your partners. Connect your claims system to our API hub to start exchanging the data with your partners. Direct integration of all claims systems is impossible, therefore information is exchanged manually. This slows down the process, increases costs and complicates claims process automation. The purpose of ClaimsControl is to enable digital data exchange for all insurance claims handling process participants. If you develop any solutions related to claims management, let's talk and find the ways how we could help you to exchange the data with other systems or how we can provide your solution to our users.
    Starting Price: $400 per year
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    EvolutionIQ

    EvolutionIQ

    EvolutionIQ

    Our solutions drive lower loss costs, lower expenses, and higher customer satisfaction, and are proven at tier 1 carriers. EvolutionIQ enables the future of claim handling for complex lines of coverage, a deep partnership between skilled professional adjusters, and a highly specialized predictive guidance system. Equipped with clear prioritization, pro-active claim alerts, and rich context, empowered adjusters reduce losses and expenses while delivering an enhanced claimant experience. Reduce unwanted variability in the claims pipeline with a consistent, scalable claim guidance system. With the more efficient allocation of adjuster resources & fewer wasted claim reviews. With targeted claim investigations, litigation avoidance, and timely claim settlement. Our claims AI acquires and harnesses data to deliver the tactical guidance your team needs. EvolutionIQ combines structured and unstructured carrier data with our proprietary third-party data.
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    FBCS Enterprise
    FBCS Enterprise is a centralized system for guiding decisions about non-VA Purchased care to improve fee basis claims management and adjudication through efficient claims processing. A web-based solution, CTM Plus streamlines workflows and provides oversight to resolve consult and Return to Clinic (RTC) tracking pain points, and ensure patients are called and scheduled on time. Purchasing analytics help to reduce cost and waste, for greater overall accountability. Expired and recalled items are also monitored automatically to keep patients safer. Delayed or misplaced orders can have significant consequences for your bottom line and quality of care. Time spent sorting through paper records and scrolling through screens is time you won’t have for patients. Checking every patient for opioid prescriptions can be an exhausting, multi-step process. DSS PDMP streamlines everything into one simple step.
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    Polygonal

    Polygonal

    City Computers

    Polygonal builds upon the strength and rich functionality of earlier versions and combines it with the latest Microsoft VB.Net and Business Intelligence technology to provide a comprehensive solution able to respond efficiently and quickly in the dynamic market of today. Polygonal, a modular, multi-currency, underwriting, policy/claims administration software solution integrated with transactions, reinsurance, accounting, messaging, data warehouse reporting, document management, and workflow modules to provide a full end-to-end business process with tangible results. Polygonal, designed from a business prospective using City Computers specialist team. We have many years' experience working in the insurance market as practitioners as well as solution providers.
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    Mitchell WorkCenter

    Mitchell WorkCenter

    Mitchell International

    Auto insurers need tools to simplify physical damage claims processing from the first notice of loss (FNOL) to settlement. Mitchell WorkCenter is an open, end-to-end modular solution that allows you to configure the modules and integrations specific to your unique business needs. Achieve better outcomes through improved accuracy and efficiency, while lowering the total cost of ownership. Our platform provides you with the ability to send and receive all information straight into your claims management system. With a proven track record of projects implemented in 90 days or less, your IT department will find integration with Mitchell WorkCenter simple. No two businesses work the same way. With WorkCenter, you can configure and manage your software based on your business needs. Access our entire suite or select certain features that best fit into your claims management workflow.
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    SSG Digital

    SSG Digital

    iPipeline

    Innovator, connector and leader for the insurance industry. We have the most extensive straight-through processing platform within the UK. Explore how our digital platform addresses your business needs. Business transformation powered by increased agility and a digital end-to-end experience. Improved productivity fueled by adviser and consumer self-service capabilities. Higher customer lifetime value through proactive ongoing engagement with customers. Customer and Adviser Portals – users access policy documentation and update personal and policy details and features digitally, in real time. Components cover every facet of the user experience including full reinsurance reporting, external portal integration, and automated and clerical underwriting. Flexible deployment – from full end-to-end SSG Digital platform deployment, to discrete integrated individual components (e.g. underwriting only, New Business only).
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    Advanced Insurance System

    Advanced Insurance System

    Garvin-Allen Solutions

    Advanced Insurance System (AIS) is used by organizations of all sizes and is designed to work as an out-of-the-box solution. At the same time, customers can modify and deploy products quickly while taking advantage of the broad configuration capabilities of the software. This modular integrated system can interface across platforms or operate as a complete policy administration solution for Personal, Commercial or Specialty lines of business. Configuring new lines is easy with AIS. AIS provides agents and insurers with the functionality they require to increase growth. In an increasingly competitive market, AIS delivers automation and self-service functionality to save time and operational costs while boosting sales. With the ability to create new products or enter new states at your fingertips, AIS provides the competitive advantage you have been looking for.
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    AUSIS

    AUSIS

    Artivatic.ai

    AUSIS – Full-stack Behavioral Underwriting AUSIS enables insurance businesses to provide in-depth underwriting, scoring & decisions in real-time. AUSIS provides reduction in cost, time, risk & fraud with enhancing efficiency, decision power, alternative scoring and more. AUSIS helps increasing STP from NSTP and also enables non-invasive methods of health data aggregation from AQI, Location, Mortality, Social, Photo, Video, Health Devices, Weather, Sanitation and more. AUSIS reduces up to 40% reduction in per policy issuance.
    Starting Price: $10/month/user
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    Oracle Insurance Policy Administration
    Meet changing market demands with a modern, rules-based life insurance policy administration solution that supports new business underwriting, policy issuance, billing, collections, policy processing, and claims for Individual Life and Annuity and Group Insurance all on a single platform. Rethink your business by consolidating policy processes for optimal, long-term efficiency. Scale up or down with a rule-based, life insurance policy management system that creates a digital ecosystem for an improved customer experience. Rapidly configure, manage, and bring group insurance products to market through a highly flexible, rules-driven policy administration solution. A life insurance policy management system on a single platform for individual & group that creates hybrid products and collaborates across businesses. Increase business agility with a componentized solution that shares business rules to increase speed to market and drives process automation reducing operational costs.
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    Mutual Expert
    Expert simplifies things for your agents while keeping you connected to your insureds. This makes Expert a key asset for your company, helping you retain and grow your business. Go Grellow for your company by switching to [dot] Expert, a flexible yet easy-to-use system that enables you to manage all aspects of a policy’s lifecycle. Gain complete control and flexibility over your policy rating, underwriting and management. Streamlines your routine process while reducing your operational costs through automation and batch processing. Take advantage of a comprehensive report library that displays the data you need from all aspects of your business. Improve your customer satisfaction with faster claims processing and easier access for both agents and insureds.
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    Total Loss Pro
    The frequency of total loss claims continues to rise, now accounting for some 20 percent of collision and liability losses across the auto insurance industry. Yet, far too often, carriers’ total loss operations lack cohesive integrated digital workflows, leading to excessive costs, customer dissatisfaction, and poor visibility and oversight. Enter Total Loss ProTM from Vemark. It’s the one solution you need to transform total loss claims processing from a frustrating black hole to a well-oiled machine while allowing you to keep up with the rapid pace of change. Faster settlement for Improved policyholder experience and satisfaction. Higher employee morale from reduced frustration, and fewer tedious processes. Increased visibility and transparency for data-driven decision-making. Auto claims that result in a total loss are more complex than vehicle repair claims. Total Loss Pro is a cloud-based solution that improves all stages of this complex salvage vehicle workflow.
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    Majesco ClaimVantage
    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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    Kanverse

    Kanverse

    Kanverse.ai

    Automation is one of the primary growth drivers towards increased profitability, and the demand to automate workflows across accounts payables (AP) has witnessed significant growth - across small to large Enterprises. Usher in zero-touch invoice processing with Kanverse. Ingest, extract, validate, and publish without manual interventions. Reduce cycle time, increase efficiency, reduce invoice processing errors, meet global compliance standards, and save costs. Traditional OCR solutions required process owners to create multiple templates to capture data from different invoices. Kanverse APIA uses AI-powered OCR to read invoices, eliminating the need to develop templates for extraction and the painful template creation process. Kanverse's AI-powered Accounts Payable Invoice Automation reduces invoice documents processing cycle time, increases organizational productivity, reduces document processing errors, and meets all end-to-end compliance and security requirements.
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    Newgen Claims Processing
    Automate the end-to-end claims journey, from intimation of the first notice of loss and fraud detection to claims adjudication, and finally claims settlement. Experience the flexibility of addressing various claim types differently, like death and maturity claims, while improving regulatory compliance and eliminating non-compliant penalties. Enable faster, accurate, and effective processing through data capture, payment tracking, salvage and recovery tracking, legal matter processing, monitoring, and more. Effective registration, adjudication, tracking, and management of claim submissions. Built-in, comprehensive business rules for automatically categorizing claims as “fast track” or “non-fast track”. Flexibility to add or modify stakeholders— garages, assessors, loss adjusters, surveyors, investigators, claim officers, etc.
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    Claims Software

    Claims Software

    Claim Ruler

    A new and smarter way to process and settle claims. Modern, end-to-end solutions to settle claims for all lines of property, liability, and workers’ compensation insurance. ClaimRuler™ is a cloud-based claims management system designed specifically for I/A firms and Third-Party Administrators, CAT Adjusters, Insurance Carriers, Self-Insureds, and Municipalities. The platform supports end-to-end claims processing with built-in guided workflows, robust reporting capabilities, and a fully automated diary system to streamline the settlement of claims. ClaimRuler™ was purposefully built to service the needs of real people in the industry. Its functional and intuitive approach to design makes working with forms, lists, documents, and photos a simpler and more natural experience. From I/A firms, TPAs, and insurance carriers to municipalities and self-insured corporations, ClaimRuler™ adapts and scales along with your organization.
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    Sumex

    Sumex

    Sumex

    Efficient checks, integrated expertise and a high degree of automation reduce the transaction costs of vouchers to a minimum. Sumex Core is the basis for automated electronic invoice verification. It contains the business components and workflows, which can be assembled and parameterized in a modular way. Current and correct tariff and reference data are central to efficient invoice verification. Sumex reference data is compiled from publicly available sources, processed in a timely manner and made available on the Sumex tariff server. The data is additionally presented in an information system and can be consulted directly by the experts in the context of the current billing. DRG Expert supports the controlling of billing for services in acute care, created according to SwissDRG regulations. DRG Expert presents case data in the context of regulations, contains statistical key figures and offers what-if analyses.
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    MyClaimStatus

    MyClaimStatus

    Medical Payment Exchange

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

    Beagle Labs

    Beagle Labs

    Streamlining the claims process from end to end. Technology-driven, people-centric, and built on integrity. A robust claims service interaction platform for insurance carriers, MGAs, captives, and self-insured entities. Deployments, claims organization, and advanced file management at your fingertips. At Beagle, we understand the unique challenges faced by insurance service providers and independent adjusters when it comes to claims handling. Our core software functionality is designed to streamline the process, reduce costs, and provide rapid responses to your claims. Our technology brings efficiency and expertise to every step of the adjustment process. Express claims and inspection responses that reduce liability and drive efficiency. New policy inspections, policy renewals, and daily losses. Beagle was developed to handle the processes required on a daily basis. Streamlined claims handling by leveraging the latest technologies that enable a more efficient resolution.
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    MediClaims

    MediClaims

    WLT Software

    WLT’s MediClaims system offers a cost-effective, straightforward, and efficient approach to benefit and claims administration. WLT’s rules-based architecture and integrated EDI processes allow claims to be processed quickly, easily, and accurately. MediClaims’ administration and processing capabilities encompass a range of benefit and claim types, from Medical, Dental, Vision, and Prescription Drugs, to Consumer-Driven Healthcare, Disability, and Capitation processing. With WLT’s MediClaims system, you have the flexibility to configure your groups for a single line of coverage or for complex benefit packages with multiple lines of coverage. No plan can work efficiently without support from reliable information systems. WLT makes a point of always working with the most advanced technologies, providing you with the most sophisticated and flexible systems available today.
    Starting Price: $1 one-time payment
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    Insurium

    Insurium

    Insurium

    A unified solution providing a 360º view of the P&C insurance process lifecycle. Generate premium and save time with a powerful rules-based, multi-state underwriting module that automates the collection of information and the creation of quotes, endorsements, cancellations, audits, and renewals. Reduce combined ratios with a modern and streamlined approach to the claims adjudication process that is both intuitive and collaborative. Increase new business by making it easy to exchange information with brokers. From streamlining and standardizing the intake of information to providing brokers access to the information they need anytime. Control what submissions your underwriters are focusing on. Drive customer satisfaction and retention by providing your policy holders self-service access to policy information, claims intake and review, online bill pay and more. You decide what portal features to provide your customers for the best user experience.
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    EvoClaim

    EvoClaim

    DWF Group

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

    mobile claims

    Symbility Solutions

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

    CLAIMExpert

    Acrometis

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

    PayorLink

    PayorLink

    PayorLink solutions offer more than just medical claims management on behalf of employers to take on a comprehensive platform approach in providing better employee benefits to reduce healthcare costs, promote healthy lifestyle, lifetime health and improve workforce productivity in the process. Rising employee health costs is a worldwide phenomenon and a growing concern for both payor companies and provider entities alike. PayorLink™ is designed to reduce payor health cost, motivate staff productivity and optimize provider claims quality resulting from in part, information exchange efficiencies directly between payor companies and affiliate provider clinic, medical centre or hospital. Enhanced with Employee Health Profile and Assessment tools for staff wellness and productivity realization.
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    SpyGlass

    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.
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    PCRS

    PCRS

    PCMI

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

    INSIS

    Fadata

    Winning and satisfying today's empowered consumers means having the right process foundations for your digital business. Fadata’s connected software solutions keep you ahead of the game. Insurers today are looking for the right digital business foundations, including the flexibility to respond quickly to new business opportunities, easy connectivity and other capabilities to help them stay ahead of the competition. Fadata’s insurance process platform, INSIS, is the most advanced and comprehensive solution available across all major lines of business. INSIS helps you release products more rapidly, drive engagement with your customers and partners, make processes faster and more efficient, and strengthen operational control and compliance. Capabilities are integrated on a single, highly flexible platform.
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    TIA

    TIA

    Sapiens

    The only response is agility. The Tia Solution is built to meet the ever-changing needs of major league, mid-sized and niche insurers who want to bundle and market services for more efficient customer engagement. Standardization and automation. Think: machine learning and AI. And think: Software-as-a-Service, IoT, open source and REST APIs. Our digital ecosystem empowers you to cover every link of every insurance value chain – and lets you cherry-pick the modules you need to connect efficiently with users. More than 20 years of developing insurance software has taught us that the only constant is change. Consequently, we create software that makes it easier for insurers all over the world to rapidly target user needs, not just system requirements. True to our Scandinavian heritage, we listen before we launch and turn our meticulous attention to detail into new design standards. Creating the future of insurance in close collaboration with peers, partners and customers.
    Starting Price: $500000.00/one-time
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    Fermion Merimen
    We are a market leader in providing a collaborative and information exchange platform for the insurance industry. As the pioneer in offering Software as a Service (SaaS) for the motor insurance industry, we have successfully deployed this model throughout the insurance ecosystem communities. We have enabled our clients to grow without disproportionate overheads and provided rapid transformation capabilities with lower risks and predictable cost using our infrastructure.
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    SSI Claims Director
    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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    Conexia

    Conexia

    Conexia

    Provide authorizations, claims processing and payment in real-time at the point of care. Enhance care coordination and improved outcomes to lower medical cost while streamlining administrative processes. Engage providers at the point of care to capture and share data in real-time resulting in an unparalleled exchange of health information. We partner with our clients to implement risk management strategies that result in better outcomes with lower costs. We strive to improve the user experience for everyone involved in the ecosystem. We deliver a minimum 3:1 ROI for our clients to allow them to optimize their resources. Conexia has developed a core technology platform (ONE) that is customizable to meet the diverse regulatory requirements and operational processes for each client in each geography. In most cases, our initial implementation is an overlay on the payer’s existing technology ecosystem to create real-time processes.
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    ppoONE Connect
    This application automates the repricing of claims in a Web environment. WebCR verifies provider participation and patient coverage, validates dates of service, and identifies possible duplicate claims. It is supported by a data management team and system, WebDM, that works to ensure accuracy and currency of data. This application automates the repricing of claims in a client/server environment. WebCRX verifies provider participation and patient coverage, validates dates of service, and identifies possible duplicate claims.
    Starting Price: $1000.00/month
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    ClaimBook

    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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    WrapPortal
    WrapPortal® is the complete, automated wrap-up solution that significantly increases your productivity while reducing costs. Plus WrapPortal is entirely customizable, secure, and scalable, with easy-to-use interfaces for administrators, contractors, carriers and executives. Perhaps most importantly, WrapPortal removes potential-limiting software obstacles so you can focus on maximizing your core business rather than trying to make one-size-fits-all-software work for your unique business. With WrapPortal wrap-up insurance software, you’ll be light-years ahead. Once a project is initiated, WrapPortal wrap-up insurance software automates enrollment, payroll, certificates, renewals, reports, and communication, increasing efficiency, project capacity, and your wrap capabilities. Plus, WrapPortal’s ICR (intelligent character recognition) scans documents and automatically populates data fields, virtually eliminating manual paperwork and data entry. It’s so easy, you won’t even break a sweat.
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    Shift Claims Document Decisions
    Remove time and complexity from document processing while supporting straight-through processing efforts. Shift Claims Document Decisions is an AI-powered solution that analyzes documents for relevant details and creates a contextual view of action items required to move the claim forward. Our models are specifically trained with insurance documents in mind, allowing them to process forms with accuracy matching or surpassing that of an experienced human claims adjuster. Automatically evaluate documents against available data to create a complete picture of each claim and accelerate processing. Industry-specific AI continually learns to combine claims data with document details to deliver claims document decisions that drive impact. Minimize manual reviews, identify complexity, and direct handlers to claims details requiring action. We are 100% focused on insurance and hire the industry’s best talent to provide our customers with unmatched support.
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    Open GI

    Open GI

    Open GI

    Whether you’re looking to build and launch new insurance products, improve your operational efficiency or get a clearer view of your clients to improve the customer experience, we’ve got you covered. You can rely on more than 40 years of expertise in the general insurance market, connecting brokers and MGAs with insurers to deliver the most competitive personal and commercial lines available today. You’ll benefit from reliable software that powers your business to bring multiple lines of business to market and scales with you as you grow to meet new demand. You’ll also be supported by a team of experts equipped to tackle your specific challenges, helping you to improve efficiency, increase revenue or reduce operating costs. Throughout dedicated design, build, delivery process and beyond, you’ll be given guidance on how to connect with the market and take advantage of access to an established Partner Network of market-leading insurance service and solution providers.