HEALTHsuite Description
HEALTHsuite provides a comprehensive benefit management system and claims processing software solution for health plans that administer Medicare Advantage and Medicaid benefits. HEALTHsuite, a rules-based auto adjudication solution, automates all aspects of enrollment / eligibility and benefit administration, provider contracting / reimburse, premium billing, care management, claim adjudication, customer support, reporting, and more.
HEALTHsuite Alternatives
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.
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Planview ProjectAdvantage brings clarity, control, and scalability to enterprise project management by unifying project data, resources, and performance insights in one platform. Built for growing PMOs and complex organizations, it eliminates silos and inefficiencies by connecting teams through a single source of truth. Users can monitor resource allocation, track workloads, and forecast capacity with precision using dynamic dashboards. ProjectAdvantage’s portfolio scoring tools and sandbox environments make it easy to prioritize initiatives and align them with company strategy. Its flexibility supports any methodology—Agile, hybrid, or Waterfall—making it ideal for diverse industries and workflows. Seamless integrations with leading enterprise systems like Jira, ServiceNow, and Microsoft Teams enable cross-functional collaboration and real-time visibility. Backed by AI-driven analytics, Planview Projectadvantage helps accelerate project delivery, improve performance tracking, and ensure continuous strategic alignment. Designed for agility, it’s a transformative solution that turns project chaos into structured, measurable success.
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Virtual Examiner
Virtual Examiner®, PCG Software’s flagship product, monitors an organization's internal claims process to track provider data for fraudulent or abusive billing patterns and maximizes financial recovery. The Virtual Examiner®, a PCG Software product, allows healthcare organizations to improve their claims adjudication system by allowing for more than 31,000,000 edits per claim. The software monitors an organization's internal claim process to identify and reduce payments for incorrect or erroneous code to save premium dollars. Virtual Examiner®, is more than a claims management solution that focuses 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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Commissionly Tracker
Our insurance commissions calculation software saves you time and recovers profit from missed Medicare and other insurance lines.
Our insurance commission management software automates tracking missing payments and calculates all commissions, overrides and splits, overrides and bonuses.
Multiple carrier reports will automatically be converted into standard formats to allow you to extract useful reports from them.
Easily check discrepancies and errors and export these in report format.
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Integrations
No Integrations at this time
Company Details
Company:
RAM Technologies
Year Founded:
1981
Headquarters:
United States
Website:
ramtechnologiesinc.com/solutions-services/healthsuite-advantage/
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Product Details
Platforms
Web-Based
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Customer Support
Online Support
Live Rep (24/7)
HEALTHsuite Features and Options
Claims Processing Software
Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration
HEALTHsuite User Reviews
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