Best Claims Processing Software in the USA

Service Center by Office Ally is trusted by more than 80,000 healthcare providers and health services organizations to help them take complete control of their revenue cycle. Service Center can verify patient eligibility and benefits, submit, correct, and check claims status online, and receive remittance advice. Accepting standard ANSI formats, data entry, and pipe-delimited formats, Service Center helps streamline administrative tasks and create more efficient workflows for providers.

APP Tech pioneered the incident-based approach to claims and risk management. Since 2003, we’ve delivered integrated technology solutions to hundreds of customers across North America — to improve claims-management efficiency and scalability, increase visibility, shorten response times, lower premiums, and prevent risk events. Cloud Claims by APP Tech is a top-rated risk management and claims software solution. IMS is a purpose-built software solution for self-insureds, TPAs, and companies who want to track their claims and losses. It helps users manage the entire claim lifecycle, from the initial incident report to issuing payments and collections. It offers a variety of features that allow users to have complete control over their claims, as well as risk information. These include incident management and claims management, workgroup tools as well as reporting, insurance tracking, and many other features. We’re proud of our 100 percent implementation-success rate and excellent customer-retention rate, a result of our commitment to understanding our clients’ needs and rolling out solutions that work for them.

Guidewire ClaimCenter, a leading claims-management system, is designed to streamline all aspects of the claims lifecycle. It provides comprehensive functionality, from the initial claim intake through to resolution. This allows insurers to process their claims efficiently and accurately. The key features include automated workflows and embedded analytics, integrated Fraud detection, and real time performance monitoring. These all improve operational efficiency and customer satisfaction. ClaimCenter is compatible with a variety of insurance lines, including personal, workers' compensation, commercial and business. It can be used as a standalone application or as part the Guidewire InsuranceSuite. ClaimCenter allows insurers to accelerate claim processing, make data driven decisions, and adapt their business to changing market demands.

Duck Creek Claims, a comprehensive solution for claims management, is designed to streamline the claims lifecycle. It automates workflows and simplifies data analysis with integrated analytics. It also ensures seamless integration of existing systems. The key features include dynamic first-notice-of-loss (FNOL) capabilities. They also include automated assignment based upon adjuster skills and workload. Instant access to policy and coverage information is also available. Duck Creek Claims improves operational efficiency by reducing manual workloads. This leads to faster claims resolutions, improved customer satisfaction and compliance with latest regulations.

OpenPM offers a fully integrated billing and claims management system that automates accounts receivables management while producing extensive reports to help you better manage your organization. As a browser-based application, OpenPM provides a level of access to your system never before possible. Our real-time claims management features will improve your cash flow and streamline billing and claims follow-up processes. We welcome you to explore OpenPM further and contact us for a customized demonstration for your practice. Medical billing software, revenue cycle management solutions, practice management software, practice management system, medical practice management, EMR integration, EHR integration, practice management scheduling, patient scheduling, online patient billing, patient billing, automatic patient billing and payments, patient payments, electronic patient payments

AZZLY Rize is the premier clinical and business platform for addiction treatment and mental health organizations. As a modern technology platform, AZZLY Rize is a system that can scale with you. Use as little or as many of the features and functions available based on your program and staff needs. Key features for OUTPATIENT Programs include e-check-in, scheduling, appointment reminder, Zoom telehealth, treatment plans, progress notes, assessments and surveys. For RESIDENTIAL Programs: census, medication management, bed board, withdrawal management, DrFirst e-prescribing, EPCS, PDMP and labs. For all Programs: alerts, patient engagement, 5 star implementation and support services, and seamless electronic billing and claims submission. As a true all-in-one platform, we empower treatment centers to take control of their compliance and revenue cycle management and reporting requirements. As a purpose-built tool for mental health and substance use disorder programs, we offer a flexible pricing plan to replace dated technology. Use our compliant Master Library of Forms or we configure your documentation forms to match what you use today. Hosted in Microsoft Azure Private Cloud Network for added security and HIPAA privacy.

AUSIS (Full-stack Behavioral underwriting) AUSIS allows insurance companies to offer in-depth underwriting, scoring and decisions in real time. AUSIS reduces cost, time, risk, fraud, and increases efficiency, decision power, alternative score, and more. AUSIS increases STP from NSTP. It also allows non-invasive methods to aggregate health data from AQI and Location, Mortality and Social, Photo, Video and Health Devices. Weather, Sanitation, and more. AUSIS can reduce the policy issuance cost by up to 40%

Speedy Claims was the top CMS-1500 software by providing the best customer care to our thousands of clients across America. Medical billing is not something people are excited about. It is a tedious task that you must do. Although it won't be an enjoyable task, it doesn’t have to be difficult or time-consuming. Speedy Claims CMS-1500 software makes it easy to complete the job quickly and efficiently, allowing you more time for the things that you love, such as helping patients. It's the best HCFA 1500 software on the market, with a simple interface and powerful features to eliminate repetitive work. It has powerful error checking built in to ensure that your HCFA 1500 form fills out correctly and is complete. This prevents CMS-1500 claims being denied.

Waystar offers market-leading technology that streamlines and unifies revenue cycle. Their cloud-based platform streamlines workflows, improves financials for all healthcare providers and provides more transparency to the patient's financial experience. Waystar has been ranked best in KLAS for Claims & Clearinghouse every year since 2010. It has also received #1 rankings in Black Book™, surveys since 2012, and the Frost & Sullivan North America Customer Valu Leadership Award for ambulatory RCM service in 2019. Waystar is used by over 450,000 providers, 750 hospitals and 5,000 plans. It integrates with all major HIS/PM systems. Waystar.com and @waystar on Twitter provide more information.

Easy to use Practice Management Software for Chiropractors. It allows patients to book appointments online, bill their bills and access electronic health records (EHR). zHealth provides fully customizable SOAP notes that can be clicked, typed or dictated.

HoudiniEsq, a browser-based web-based law practice management system for modern law firms, is advanced and flexible. HoudiniEsq is available in the cloud and on-premise. It offers a rich feature set that allows law firms to streamline workflows and capture and classify all documents. It also automates billing, task scheduling, group calendaring, and automates billing. The platform integrates with solutions like LawPay, Microsoft Office and Outlook. It also integrates with Evernote, QuickBooks.

The vendor presents A1 Tracker as a robust and configurable risk management system that can be used standalone or in conjunction with other business segments within an organization. Risk Management & Threat Assessment: Register of risks to track risks at all levels within an organization. This includes entity, project, asset and contract, vendor, divisions, business units, regions, and more. Real-time risk reports and heat maps, dashboard metrics alerts & notifications. Contract Management Contract module to track all types of contracts with customers, vendors, employees, and customers. Claims & Incident Management Reporting on claims and incidents for any type of claim: injury, medical, customer, insurance or asset, liability, work comp, liability, etc. Certificates & Policies in Insurance: Policies & certificates for insurance tracking with reminders and renewals. For agencies & carriers policy management includes tracking clients.

Imagine happy, efficient claim handlers, fast, accurate claims resolution, and 5-star rating from policyholders. Our platform is flexible and future-ready, enabling your employees to perform like rockstars and equipping your company with scalable, intuitive processes that will fuel profitable growth. Our clients can reduce the cost of claims by up to 30% by automating and simplifying the process. VCA Software is a highly scalable and integrated platform. VCA Software is a favorite among TPAs as well as adjusting firms due to its robust features at a moderate price point.

With over 30 years’ experience, Hi-Tech Health has the expertise to service payers of all types and sizes, including TPAs, Carriers, Insurtech, Provider Sponsored Plans, and Medicare Advantage plans. Series 3000 is a cloud-based claims administration solution for businesses within the healthcare industry. No matter what your adjudication, reporting, or plan needs are, this platform reduces time processing claims and increases productivity as it assists with: •Client management •Benefits input •Electronic claim submissions •Claims processing With an implementation timeframe of 3-4 months, you can quickly get started with Series 3000. Our professional services and back office support teams are here to guide you through customization and training. With experts available at your fingertips, we’ll be able to support you so outside consultants won’t be needed. As your business grows, we’ll work with you to scale your software system to continue to meet your needs.

Daisee develops technology to give you deep insight into the behavioural, emotional, and commercial dynamics of your customers. Daisee automatically scores all customer interactions using a digital quality scorecard that is the first of its kind. This automatically identifies quality assurance issues that need human intervention in areas such as compliance, communication, and conduct. Daisee allows you to see beyond words and uncover the emotion deep within your interactions. It reveals what your customers really think, feel, and are saying. Daisee is software that can be easily deployed across any telephony system and can help organisations immediately create business value. Globally Daisee is available in Australia, New Zealand, and the USA.

Kanverse AP Invoice Automation platform intelligently automates document processing workflows for enterprises. Kanverse brings together multiple AI technologies - Computer Vision, Natural Language Processing, Machine Learning, and Fuzzy Logic, along with Business rules and workflows to accomplish end to end automation. Automate invoice and other accounting documents ingestion, extraction, processing, validation, and publish processed data to downstream business applications (e.g., Oracle EBS, Oracle Fusion, NetSuite, Microsoft Dynamics, Majesco, etc.) Kanverse AI engine combines multiple cutting-edge technologies which deliver up to 99.5% data extraction accuracy: out-of-the-box Leverage AI and automation to process a multitude of document types; convert unstructured and skewed data into actionable insights and reduce operational costs across business processes. Intelligent automation eliminates manual, repetitive, and time-consuming activities; staffs, can focus on other business-critical activities. Also, helps to Protect PII Data and Prevent Fraud.

TherapyNotes is an intuitive and feature-rich practice management system for behavioral health professionals. It includes robust scheduling tools, patient notes and electronic billing. It is also PCI-Compliant and HIPAA-certified, which ensures that all patient and practice records are protected and encrypted.

Ahshay Platform by DataCare offers a variety of software solutions for medical management. It includes a medical process manager, nurse management software, utilization review, auto case management software, and many other software solutions. The platform can be used to meet the needs of insurance providers, self-insured group, managed care, and individual nurses case managers.

DrChrono's all-in-one medical practice management, electronic medical records and medical billing platform will help you increase efficiency in your medical practice. DrChrono empowers doctors to better serve patients with its simple interface and dozens more advanced features. Users can easily schedule patient appointments, edit and check patient charts, and manage billing.

Claimable claims management software is designed for businesses to manage insurance claims. Reduce admin time and increase your claims handling capabilities. Stop searching shared folders or inboxes. All you need to access your claims data is a few clicks away Your data is safe and secure stored in the cloud. It is accessible from anywhere. No more paper! Prepare for an audit with a detailed history of each claim at hand. Keep track of all your documents so you can access them whenever you need. Filter and report on claims data to increase productivity and keep you informed. To organize and categorize your claims, label them. Keep detailed notes about each claim and share them with your team. You can quickly see which tasks are due and completed by assigning tasks to your team. You can quickly build and manage your contacts for claims and find contacts instantly.

Don't be afraid to try something new. This software was created to be simple to use and flexible. All data is stored on secure servers in cloud. You don't need to install anything. All you have to do is go to the website using any device and log into. You no longer have to worry about updates. We will update the website at regular intervals. Every employee in your company now has access to a customized database. Everyone in your company can now use the same item if you need to adjust the price of a common item in order to match local pricing. PowerClaim XML can be used as a standalone property adjusting software package. It allows you to quickly create estimates, as well as photo sheets, diagrams and captioned reports. PowerITV Replacement Cost Calculator allows you to quickly and accurately calculate the replacement cost for virtually any structure using the Craftsman Book Company's timely data.

Enter gets Providers (doctors and practices & hospitals) paid faster that anyone in history. Enter processes insurance claims and pays within 24 hours. It also automatically communicates and collects patient responsibility using a white label collection engine that includes payment plans. Enter is 30x more efficient at getting claims paid, and 45x quicker at getting patients billed at the exact same cost as existing medical billers. In just one year, we processed over $150 million in claims. Providers have access to a $100mm credit facility. United Healthcare Nevada - Revenue Cycle Management Partner Enter supports a wide range of specialties, including ASC, Orthopedics and Neurology, Dermatology. Emergency Rooms, Behavioral Healthcare, Pain Management, and many more. - Enter works with all government and commercial health insurance carriers. - Enter integrates all EMR/practice management systems. No monthly fees No integration fees. Venture backed by Enter

Parascript software automates mortgage and loan document processing faster and more accurately. It also automates insurance document-based tasks that allow for the intake and review of healthcare insurance data. Document processing automation automates the process of processing documents to improve efficiency, data accuracy, and reduce costs. Parascript software is driven by data science and powered by machine learning. It configures and optimizes itself for automating simple and complex document-oriented tasks like document classification, document separation, and data entry for payments and lending. Parascript software processes over 100 billion documents each year in the areas of banking, government, insurance, and other related fields.

Our goal is digitization of data exchange between all claim handling participants: insurers and brokers, their customers and loss adjusters. Our platform allows you to account and share your cases or connect your claims system with our API hub to integrate with your partners. To exchange data with your partners, connect your claims system to the API hub. Direct integration of all claims systems cannot be achieved, so information must be exchanged manually. This slows down the process and increases costs. It also complicates claims process automation. ClaimsControl's purpose is to allow digital data exchange between all participants in the insurance claims handling process. Let's discuss any claims management solutions you may have. We can help you exchange data with other systems, or provide our users with your solution.

Filing claims is a complex and crucial process. Because of its complexity and time-consuming nature, more than 60% of people don't file complex claims. Artivatic's dedicated claims platform allows insurance companies to facilitate digital claims journeys, self claims processing, automated risk assessment, fraud intelligence, claims payout, and self-claims processing. ALL YOUR CLAIMS NEEDS CAN BE MET IN ONE PLATFORM. End to End Claims Automation and Assessment Platform AUTO CLAIMS – HEALTH CLAIMS – TRAVEL CLAIMS – ACCIDENTAL ClAIMS ­ DEATH CLAIMS – FIRE CLAIMS SME CLAIMS — BUSINESS CLAIMS ­ COMMERCIALCLAIMS