Claims Processing Software
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by Virtual Benefits Administrator
One solution for all benefits administration. Any benefits plan can be built and managed: medical, dental, vision, life and disability, Medicaid, Medicare, Medicare Supplement, care management and long-term care health benefits, flexible spending accounts (FSAs), health savings accounts (HSAs), health reimbursement accounts (HRAs) and COBRA. All transactions are real time, including integrated online payments, cost containment, fraud and abuse edits, provider matching and pricing. Learn more about Virtual Benefits Administrator
We pride ourselves on making simple, affordable claims management software. We've had enough of the insurance industry lagging behind in the technology front, with often expensive, complicated and bloated software. At Claimable, we believe that details matter, and our software has been carefully crafted to provide the tools necessary for timely and efficient claims management. Learn more about Claimable
ZirMed and Navicure empower healthcare organizations to optimize their revenue cycle with end-to-end, cloud-based RCM solutions, including hospital & healthcare systems, physician groups, DMEs, billing services, clinics, labs & more! You'll get the best technology and cloud-based software solutions available, combined with fast, flexible architecture and award-winning client support. And as legislative and industry developments occur, we'll be here helping you stay ahead. Learn more about ZirMed
DataCare provides software solutions for the workers' compensation industry to better manage medical treatment and billing. Our Medical Process Manager and UR platforms help integrate a medical aspect to the claims workflow and expedite the communication process between the URO and requesting physician. While our Care++ mobile application was created for patients to communicate with their nurses, adjusters and claims staff can also send/receive messages to/from the application. Learn more about Ahshay
The ClaimFirst Solution focuses on Life & Health claims management and encompasses a variety of modules designed to meet your specific needs. The ClaimFirst Solution provides full life cycle claims management, supporting both group and individual products. This automated solution is designed to completely or partially replace your manual business processes, allowing for quick and accurate claims processing that reduces reserves and improves customer and employee satisfaction. Learn more about ClaimFirst
by A1 Enterprise
Contract management software web-based with modules for claims, accident tracking, insurance renewals, contract renewal, risk management, cost of risk, and document management. Features in each module include email notifications, contact management, notes, date and time stamps, document version control. Fully hosted or self hosted options available. Private labeling available with integration to web site and company intranets. Scalable to unlimited, world-wide users and multiple languages. Learn more about A1 Tracker
by APP Technologies
IMS is an industry-leading claims/risk management system, covering all commercial lines including P&C, workers' compensation, auto, and general liability. IMS accurately and easily manages the entire claims lifecycle, from first report of incident through issuing payments and collections. IMS's rich features allow for document management, reserves, payments, notes, diary, subrogation, EDI, and bill review. Learn more about Incident Management System
by JW Software
FileHandler Enterprise is an intuitive claims administration system designed to help streamline and automate workflows for the claims and risk management market. Complete with new dashboards, reporting functionality, business intelligence tools, and improved security, FileHandler Enterprise is the new benchmark for Claims Management Software. Learn more about FileHandler
by Priority Data
PDSpectrum is a robust modern policy processing system for P&C Insurance Companies, MGAs, and Program Administrators. PDSpectrum includes: administration, accounting, billing, claims, rating, underwriting, document management, and agent inquiry & quoting. It provides full data connections and integrations to major risk assessment partners. PDSpectrum is hosted, supported and maintained by Priority Data and accessed by company staff, agents and their partners via a secure web-browser connection. Learn more about PDSpectrum
Online mental health practice management software for appointment scheduling, therapy progress notes, electronic billing and EHR. TherapyNotes saves you time by managing the entire workflow of a mental health professional from scheduling appointments to submitting a claim. It's so easy to use you can start using it in your practice today. Extensive security measures are in place to give you peace of mind, so you can focus on what's most important: your clients. Try TherapyNotes Free for 30 Days! Learn more about TherapyNotes.com
by Insurance Technology Solutions
Web based P&C Claims Administration System supporting a wide range of claim processing requirements. TPA, SIR Entities, Risk Managers. Client-centric workflow, Email integration, Messaging and Alerts, Shared Calendar, Litigation Support, Document Management - store any format including MP3 and DVD, Form Letters, Stat Reporting, Robust Transaction Processing - Reserving, Payment/Check Issuance and Recoveries. Learn more about CaseworksPro
Cloud-based healthcare billing and payment solutions help healthcare organizations of all sizes increase revenue, accelerate cash flow, and reduce costs associated with managing insurance claims and patient payments. Navicures technology solutions automate account receivables processes, including claims management; patient eligibility verification; remittance and denial management, appeals, and posting; reporting and analysis; and patient payment collections at and near the time of service. Learn more about Navicure
QuickCap is an advanced healthcare claim processing system built for IPAs, PHOs, MSOs and other management organizations. It is designed to process EDI and manual claims, capitation, eligibility, referrals, authorizations, premium billing, case management and other healthcare related items. The system is considered one of the most efficient and affordable on the market, and can drastically reduce costs for any group. For more information, please call or contact us through our website. Learn more about QuickCap
by Origami Risk
The Origami Risk RMIS and claims management platform was designed by industry veterans committed to helping clients streamline the collection, analysis and reporting of risk information. Our innovative, web based software is designed with the latest technology and is focused on ease-of use, performance and dependability. Each client is managed by a service team member with years of experience who supports the client from implementation to ongoing maintenance. Learn more about Origami Risk
by Online Reporting
The # 1 ranked Claim management system for independent adjusters, TPA's, MGA's, & Mutual Ins. Co.'s. System does not apply to Public Adjusters. Entire system is based on the input from our 1000's of Users. Integrates with Outlook, Quick Books, Xactimate, Xactanalysis, Symbility, NFIP/NFS, LEDES and Google Maps. FileTrac also offers an Adjuster Database module that allows you to track licenses, certificates and so many other criterias. Best suited for companies with 85+ claims per month. Learn more about FileTrac
by Orchestra One
Today's independent providers run on Orchestra One. With Orchestra One, you get one unified platform to run your practice with ease. Grow your business with automated scheduling, billing and communications. We arent old healthcare industry titans, we are a team of doctors just like you looking for something super simple: one place to manage our practice that's ridiculously easy and doesn't cost an arm and a leg. Learn more about Orchestra One
by RAM Technologies
HEALTHsuite is a comprehensive benefit administration system and claims processing software solution designed for health plans administering Medicaid and / or Medicare Advantage benefits. HEALTHsuite is a rules-based auto adjudication software solution designed to automate all aspects of enrollment / eligibility, benefit administration, provider contracting / reimbursement, premium billing, medical management, care management, claims adjudication, customer service, reporting and more. Learn more about HEALTHsuite
by Billing Dynamix
bestPT: A complete, cloud-based revenue cycle management and billing technology solution that provides unlimited support for your entire practice. bestPT streamlines the entire office workflow, integrating scheduling, documentation, billing, and task management into one system. It can also be integrated with most popular EHR systems, including webPT and Cedaron. bestPT users average 95% of all insurance payments received in under 120 days. Full service and in-house billing available Learn more about bestPT
by Beacon Technologies
SpyGlass Health Claims Management System helps claims payers improve accuracy and automation via an easy to use and powerful application. It is entirely web-based and offers reliable, adaptable, flexible, scalable, and open IT architecture, which substantially increases reliability and accuracy through automation, empowering you to maximize the return on your technology investment and includes HIPAA required ICD-10 and 5010 support throughout.
by WLT Software
WLT Software is a leader in advanced benefit administration and claims processing software for Insurance Companies, Government Plans, TPAs & Self Administered Groups. Whether administering multiple plans covering millions of lives or one plan covering a small group, our scalable solutions can be tailored to fit your needs. Our systems have two deployment options available; either on site installation or as a hosted solution, making them the most flexible systems available for your organization.
The Alyce Claims Management System is designed for TPAs, Insurance Carriers and Agencies. It has a very intuitive design, with pages laid out in a logical fashion, which makes it easier for adjusters to get their jobs done faster and more efficiently. Features include multi-tiered infrastructure, duplicate claim alerts, check printing, forms, letters and reports.
Record360 offers industry leading software for digital asset condition documentation, asset condition management, claims management, and analytics for vehicles rentals, fleet management, equipment rentals, truck rentals, property management, towing, movers, dealerships, body shops, auto transportation, car sharing, freight forwarders, and any other industry that benefits from documenting the condition of an asset.
by Intuitive Web Solutions
BriteCore was built from the ground up using the latest modern technology. Deployed using the Amazon Web Services cloud, our enterprise-level software is continually updated to guarantee maximum security, efficiency, and durability at scale. Over 40 insurance carriers, MGAs, and start-ups rely on BriteCore to increase speed to market, improve competitive position, and support growth.
by Mitchell International
Mitchell WorkCenter is a truly universal platform of integrated and innovative solutions specifically designed to help settle claims accurately and efficiently through a powerful interconnected workspace that incorporates performance modules to create a simplified workflow for claims settlement staff and trading partners.
by Symbility Solutions
Symbility Mobile Claims, accessible from any personal computer and available as a free Android, iPad and iPhone application, simplifies the complex process of property claim estimating. It enables adjusters and third-party contractors to create estimates complete with detailed diagrams, photos, voice notations, handwritten notes and measurements of the damaged property.
by SpeedySoft USA
Speedy Claims is possibly the easiest to use software available anywhere for billing your patients and insurance companies whether by paper or electronically. An easy to use point and click interface showing the actual CMS 1500 form on the screen makes filling out a claim simple and coupled with our error checking scrubber makes it accurate and powerful. Speedy Ledger makes it easy to track insurance payments and create patient statements. Try us free for 30 days!
by Code Evolution
Virtual Claims Adjuster is a web-based claims management system designed using the latest software development techniques and interface methodologies to ensure a smooth implementation into your business. As you conduct your day to day business, we work in the background, finding ways to make you more efficient and effective. Our business specialists analyze trends, maintain key industry relationships, and employ advanced techniques to evolve your toolset in a way that exceeds your business needs
ClickClaims is ideally suited for small to mid-size property and casualty insurance carriers, independent claims adjusting firms, and third party administrators who need the advanced technologies that drive a competitive market. ClickClaims SaaS model allows for rapid deployment, unlimited scalability, performance, security and versatility that legacy systems cannot match, at a fraction of the cost. Built to evolve as technologies emerge, your investment appreciates over time.
by Hi-Tech Health
Series 3000 is a complete turnkey claims administration solution designed using unlimited system variables which can be programmed to meet your companies specific needs. You won't have to change the way you do business to utilize our software, because we'll partner with your company to ensure that our software is customized to work for you the way you want it to.
CaseBlocks is an award winning, Adaptive Case Management Platform based in the cloud which helps organizations of all sizes manage business processes. It brings operational and technical users together to create custom solutions which can be adapted over time with ease, as the needs of the business change. Its high degree of flexibility allows CaseBlocks to be configured to support a vast range of business processes using case templates.
by Quick Internet
ClaimPilot is a streamline web-based claims management system that allows you to manage all of your claim files as well as your organization. ClaimPilot offers solutions for Independent Adjusting Agencies, Third Party Administrators, Self-insured Companies, Public Entities, and more! Managing a claim through ClaimPilot is easy & intuitive. ClaimPilot offers custom built step-by-step workflow that is geared for speed and simplicity. Our automated process allows you to manage your claims better.
by Simultaneous Solutions
Simsol Software provides insurance carriers, adjusters, and restoration contractors with a complete end-to-end solution for the electronic assignment, estimating, claim documentation and data management for property claims.
FBCS is a powerful software solution that simplifies the administration and tracking of claims. Recent upgrades to the application centralizes data and further automates the adjudication process.
by Aquarium Software
AquariumClaims is an on-demand web-based, claims management solution. Unlike traditional offerings, it offers lower cost of ownership coupled with high configurability and flexibility: numerous customers have been able to grow their business to new levels of profitability through increased claims processing efficiency, improved customer service levels & higher claim volumes. More business without more people - new levels of performance without higher costs. For further details visit our website.
by Sapiens International
Sapiens offers innovative, rules-based insurance solutions for Policy Administration, Billing, Claims, Reinsurance and Commissions that modernize business processes enabling organizations to be adaptive and flexible while leveraging out-of-the-box functionality.
by PLEXIS Healthcare Systems
PLEXIS Healthcare Systems is a leading payer technology company that delivers trusted enterprise core administration and claims management solutions to healthcare payers and delivery systems around the globe. PLEXIS ignites growth, innovation, and efficiencies across diverse business lines for payer organizations such as health plans, dental plans, vision plans, TPAs, cost containment companies, specialty groups, government healthcare, and international insurers.
by iTech Workshop
This is a secure Cloud-based medical claims & authorizations management solution which is ideal for claims processing TPAs/ASOs, IPAs. BPOs etc. Features include automated claims processing, claims validation & scrubbing, direct online authorizations & claims submission by providers, direct payers connectivity, denials & rejections management, claims adjudication, generate ERAs & EOBs, aggregated data access, analytic & more. The solution ICD-10 ready & available in monthly subscription.
by United Systems and Software
United Systems and Software, Inc. ("USSI") offers a full line of integrated professional insurance administration systems tailored to meet your specific industries requirements and niche demands. Our software offerings cover a wide variety of industries and lines of business. Since 1979, USSI has been a pioneer in leading edge Insurance Administration Software Systems and Professional Services.
FACTS Services is an integrated technology and services provider focused on providing cost effective healthcare payor solutions across the entire claim continuum. The result is a dramatic reduction in cost and improved turnaround time for all facets of the healthcare delivery cycle. FACTS delivers technology within the ASP and turnkey settings and a full administrative services solution that lowers the overall cost of doing business while increasing the value and quality of customer service.
by Garvin-Allen Solutions
Quoting, rating, policy administration, billing, claims management and reinsurance software solutions for property and casualty companies of all sizes. This modular system can interface across platforms or operate as a complete end-to-end solution. Advanced Insurance System is a perfect solution for personal, commercial and specialty lines and is available with rates, rules and forms pre-loaded. Integrating AIS into your business is an easy, efficient, and a hassle-free process.
by Patriot Managed Care Solutions
Flexible and cost effective, Patriot's software application streamlines workflow by automating the administrative process, giving clients turnkey functionality, scalability and peace of mind to focus on their core business: ASP model ideal for HMOs PPOs and TPAs. Features include claims adjudication, eligibility management, premium billing, custom report generation and analysis. Patriot drives workplace efficiencies and simplifies the administrative process for managed care organizations.
by KLJ Computer Solutions
Venue is a secure web-based claims processing software that can handle multiple lines of insurance claims (except health and dental). Track time and expenses accurately, invoice your clients from within Venue, eliminate duplication using Venue's comprehensive document management, store audio, video and other file formats. Form templates allow you to complete forms with a click of a button. Venue also allows your clients to view the status of their claims and uses 128-bit encryption.
by AdvanTec Information Systems
Integrated solution for independent claims adjustment agencies. Handles claims, data collection, notes, history, expenses, fraud analysis of claimants and witnesses. Interface to accounting back office to handle third party billing , payroll, (AR/AP/GL/PR). Multi user system, any number of insurance carriers, remote access available.
by KMR Systems
KMR Claims Manager is a fully integrated, customizable state-of-the-art medical claims processing software solution for TPAs, self insured and claims administrators. Features include: comprehensive claims processing-ability to scan, receive via EDI or manual entry; coordination of benefits, co-pays & deductibles; full claims history display; adjuster analysis reporting; actuarial reporting; custom & ad-hoc reports, online portals for members/participants & providers, document imaging integration
Aldera empowers our customers to facilitate the business of healthcare through an advanced core administrative system and collaborative, open solutions that allow you to thrive in the post-healthcare reform era.
by Startech Software
Stop wasting money! Our Clients are saving over 50% of their claims processing costs! Let Startech Software show you a better way. Our Eclipse software will save you time and money. Claims like Workers Comp,Tort, GL, P&C, Auto, Long and Short Term Disability can be done with ease. Full featured. Check printing. Fee schedules. Extensive reporting. Top rated customer support. Call or visit website for free demonstration.
by J&J Technology Consulting
Automates truck insurance form processing by transferring data to any carrier application, broker agreement, permits or any other form.
by Anodas Software
Improving customer service and satisfaction, streamlining business processes, and reducing costs are key drivers for any business within the insurance sector.
Enkata's solution for Healthcare Payers provides visibility into how manual claims processors work & drives improvement through automatic identification & delivery of coaching opportunities. Enkata's unique approach uses powerful data visualizations to help understand exactly how work is being performed from high level overviews to individual process steps. Enkata uses this insight to find patterns of behavior that limit productivity/lower quality in manual claims processing organizations.
Coupling BPM and Case Management tools and expertise, BizFlow has created frameworks supporting rapid application development of insurance core processes requiring structured and dynamic work interactions. Applications combine business rules, forms, data models, content handling, data repositories, system integration, and user interfaces to enable process automation for Sales, New Business, Underwriting, Policy Maintenance, Billing, Collections, Commissions, Customer Service, and Claims.
Deep-function workers' comp claims management software from a software provider with years of experience. Extensive data capture for quick reporting and intelligence. Diary and alerts that mobilize and focus the workforce on claims that need their expertise. Routine claims can be effectively and efficiently managed with rule-based, auto-adjudication facilities. Case management capabilities. Accurate, efficient payment and bill processing. Advanced business intelligence and executive dashboards.
ClaimsVision is PCIS' flagship multi-line claims management solution. This SaaS deployed solution leverages the latest technology to optimize the claims process for clients while giving them the most thorough reporting and tracking metrics available. Rapid Implementations (under 60 days) Architected for seamless interfacing Dashboard and Workflow designed to close claims faster "No Touch" FROI/SROI EDI reporting cuts down on time, costs, errors
by SmartSimple Software
SmartSimple CMS360 is a platform for designing and deploying solutions that help insurers, health care providers and independent medical examiners gather the right content, make more accurate decisions, and take action to advance business outcomes. Some of the world's largest accident benefit claims and referral management firms look to CMS360 to automate their structured, repeatable processes and centralize case content - giving a complete picture of file history.
Intellect Claims is an industry proven solution that spans life, disability health, critical illness, long term care and annuity. Intellect Claims takes all of the elements that make claims processing so complex managing a large amount of information, multiple work streams and intricate calculations and brings them together in a single intuitive environment. Role based user interfaces provide users with the tools, information and functions to easily handle a claim in one place.
NAVRISK VISION is a comprehensive administration tool for General Liability, Medical Practice Liability, and Workers Compensation Claims with additional solutions for Analytics, RMIS, Policy Issuance, Safety and Property Appraisal. We serve clients in the alternative risk market including Self-Insureds, Public Risk Pools, Insurance Brokers, and TPAs.
Our software is tailored for all areas of electronic healthcare transactions and developed with the user in mind. Work smarter, not harder to gain efficiency. Claim Master - is an advanced application that manages all aspects of healthcare claims and processes your 837 transactions. Enrollment Master - seamlessly transmits 834 files to plan sponsors, insurance companies, or TPAs. EDI Exchange - securely transports EDI files, manages trading partners, and performs HIPAA compliance checks.
by JDi Data
Claims Manager. A comprehensive insurance software product developed for small to mid tier Claims Departments, Risk Managers and TPAs administering P&C, GL, Commercial Auto, Public Entity, Med Mal, Excess Coverage, WC. Capture relevant claim information, record all file activity. Comprehensive diary and alarm system with full document depository.
Healthaxis is the premiere healthcare payer solutions company that offers customized solutions for commercial and governmental health benefit administrators. Our mission is to enable our customers to pay claims better, faster, & less expensively, reduce administrative costs, & provide better plan value. Our approach is cost-effective and client-focused, making sure that we are listening to their needs of our customers and developing customized solutions for them.
by ERIC Systems
Risk Manager is an integrated suite of program modules designed for the administration of worker compensation and multi-line liability claims ONLY (not employee benefits). It is suitable for use by any size organization that is self-insured and self-administered, third-party administrators (TPA), governmental agencies, insurance carriers, association of self-insureds, and/or retrospective rating groups.
by Vitech Systems Group
The V3 System is a complete investment administration solution that helps organizations achieve administrative excellence, harness significant processing efficiencies and realize the potential of true business intelligence. The V3 System is specifically designed to meet the unique needs of investment administration: Opportunity Management Fund Administration Investor Management Portfolio Management Fund Accounting Performance Analytics
ppoONE is a leading information services company providing enterprise business solutions for the health care industry. As an ASP or SaaS company, ppoONE is a leader for automated claims repricing, provider and fee schedule management, credentialing, customer service, EDI and reporting for PPOs, TPAs and insurance carriers. Using the power of the Internet, we deliver a flexible, highly accurate and productive easy-to-use system that streamlines operations and reduces costs.
Plan Management Policy Generation Renewals Discounts Management User Management Document Management Payment history and management Various Business Report Broker and Agent Management
Progressclaim.com is a simple yet powerful mobile collaboration tool suitable for all contractors that saves needless time and money wasted on payment submission and approval. Built specificially for the construction industry it is designed to eliminate errors associated with manual processing. Its cloud based, can be accessed anywhere on any device, and is super simple to use. Progressclaim.com reduces risk, saves time & money, improves cash flow and is Security Of Payments Act compliant.
Act-isure is a flexible, modular medical and protection insurance system supporting product design/ management, policy sales/servicing (including channel and agency management), claims processing, provider management and financial management and reporting. Act-isure can be deployed either as an integrated whole or as a components in a complex enterprise landscape computing landscape in domestic and international insurance markets around the globe in multiple currencies and languages.