Alternatives to MediConCen

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.

Duck Creek Claims offers a robust solution for managing the claims process, aimed at optimizing each stage of the lifecycle for insurance providers. It automates workflows from the first report through to the final settlement, while also simplifying data analysis via integrated analytics and ensuring compatibility with current systems. Notable features encompass advanced first notice of loss (FNOL) capabilities, automated assignments that consider adjuster expertise and current workloads, immediate access to policy and coverage information, and streamlined workflows for adjusters. This innovative platform significantly boosts operational efficiency and minimizes manual tasks, thus facilitating quicker claims resolutions and enhancing customer satisfaction, all while adhering to the latest regulatory standards. With its comprehensive tools and features, Duck Creek Claims positions insurers to effectively respond to the evolving demands of the insurance landscape.

Guidewire ClaimCenter stands out as a premier claims management platform aimed at optimizing the complete claims lifecycle for property and casualty (P&C) insurers. It encompasses a wide array of functionalities, spanning from the initial claim intake phase to final resolution, which empowers insurers to handle claims both swiftly and with precision. Among its notable features are automated workflows, integrated analytics, real-time performance tracking, and fraud detection capabilities, all of which work together to enhance operational effectiveness while boosting customer satisfaction levels. ClaimCenter caters to multiple insurance sectors, such as personal, commercial, and workers' compensation, and can be utilized independently or as a component of the Guidewire InsuranceSuite. By utilizing ClaimCenter, insurers not only expedite the claims process but also gain insights for informed decision-making and remain agile in response to shifting market conditions. Its implementation can lead to significant improvements in both efficiency and overall service delivery for insurers.

Property and casualty insurers require a solution that allows for personalized engagement, unrestricted innovation, and efficient growth. At Guidewire, our dedication to your success is unwavering. We integrate digital solutions, core operations, analytics, and AI to provide our platform as a cloud-based service. With the industry's largest research and development team, service team, and partner ecosystem, we continuously adapt and innovate to serve your evolving needs. This commitment has led over 450 insurers, ranging from startups to the most intricate organizations globally, to rely on Guidewire. We prioritize authentic relationships with customers, potential clients, partners, and investors, fostering communication through well-reasoned arguments and a focus on quality product development, making informed decisions based on solid evidence. Recognized as the most reliable platform in the industry, Guidewire has been the preferred choice for over 450 insurers worldwide, illustrating our strength in the market. With our comprehensive support and innovative solutions, we empower insurers to navigate their challenges effectively.

Insly offers a comprehensive range of software solutions that can be tailored with your own custom modules, allowing you to streamline and fully automate all the processes necessary for operating a thriving insurance enterprise. It includes everything required: forms, workflows, a rating engine, a document template editor, an endorsement library, capacity management, and much more. The platform provides built-in support for broker channels, enabling seamless integration. APIs grant access to all functionalities, facilitating the creation of an ideal Direct-to-Consumer experience. You can automate standard cases for new sales, policy adjustments in the middle of terms, and renewals without hassle. Additionally, all premium accounting tasks are efficiently managed, and you can generate bordereaux and management reports with a single click. The system allows you to design your custom reports and incorporate third-party data to enhance the decision-making process for your underwriters. Furthermore, it easily integrates with your entire technology stack, whether it's legacy or cutting-edge. This flexibility ensures that your insurance operations run smoothly and effectively.

An automated claims platform that operates seamlessly from start to finish, leveraging AI-driven decision models for tasks such as data collection, policy and coverage verification, medical coding, and consistency assessments. Our advanced AI models are designed to minimize losses and enhance your loss ratios by effectively detecting fraud, waste, and abuse in health and life insurance sectors. Qantev empowers insurers globally by improving operational efficiency, curbing losses, and elevating client satisfaction. By integrating artificial intelligence with deep medical knowledge, our dedicated team of data scientists and engineers has created cutting-edge solutions that streamline the claims management process while identifying fraudulent activities. Our specialized AI tools are adept at capturing, cleansing, enhancing, and digitizing data from a variety of claims documents in multiple languages. Additionally, we bolster the performance of your medical provider network with automated insights, identifying pricing gaps, recommending strategies, simulating different scenarios, and much more to optimize outcomes. This holistic approach ensures that insurers not only respond to claims effectively but also proactively prevent potential issues before they arise.

Five Sigma embarked on a quest to empower claims organizations to embrace innovation. Their collection of claims management tools and distinctive platform equips insurers with what is necessary to adapt their claims operations to an ever-evolving environment. By offering a suite of Claims-First Cloud-Native and User-Centric products, Five Sigma enhances the capabilities of adjusters, enabling them to manage claims more effectively and swiftly. Through the automation of routine administrative tasks, adjusters can concentrate on making informed decisions while the system efficiently manages the rest. Introducing Clive™ by Five Sigma, the first AI-driven claims adjuster in the industry, is revolutionizing the claims processing landscape for insurers, MGAs, and TPAs. By harnessing cutting-edge AI and automation, Clive optimizes the entire claims lifecycle, from the First Notice of Loss (FNOL) to the final settlement. This AI agent not only boosts the efficiency of claims handling but also improves accuracy and reduces costs by automating various tasks, ultimately leading to a more streamlined and effective process for all stakeholders involved. In this way, Five Sigma is setting a new standard for the future of claims management.

Our advanced technology, driven by artificial intelligence, accelerates and enhances the precision of claims decisions, allowing you to improve your customer service experience significantly. By customizing specific features and integrating various data sources, we have created a versatile solution that caters to all insurance sectors, including health, life, motor, and property insurance. Sprout.ai ensures speedy and precise claims decisions across different industries. Our system can process a wide range of claim documents, extracting pertinent information from sources such as handwritten notes from doctors, call transcripts, and prescription records. Each claim is further validated using external data points, which include treatment codes, provider network guidelines, and medication details, ensuring comprehensive accuracy by cross-referencing with policy documents. Utilizing deep learning AI algorithms, we not only predict the optimal next steps for each claim but also provide a transparent rationale behind those recommendations, enhancing trust in the claims process even further.

The process of filing claims is intricate and essential. Over 60% of individuals refrain from submitting complex claims due to the involved procedures and the time they require. Artivatic offers a specialized claims platform tailored to various insurance sectors, empowering companies to facilitate digital claims experiences, enable self-processing, automate evaluations, and implement risk and fraud intelligence alongside claims payouts. A SINGLE PLATFORM TO ADDRESS ALL YOUR CLAIMS REQUIREMENTS. Comprehensive Automation and Assessment for Claims. AUTO CLAIMS – HEALTH CLAIMS – TRAVEL CLAIMS – ACCIDENTAL CLAIMS – DEATH CLAIMS – FIRE CLAIMS – SME CLAIMS – BUSINESS CLAIMS – COMMERCIAL CLAIMS – EVERY CLAIM MATTERS.

eOxegen is an innovative claims management system powered by artificial intelligence, aimed at improving the efficiency of health insurance operations. By automating the claims process through a Straight Through Process (STP), it minimizes the need for manual intervention, resulting in quicker claim settlements and higher accuracy. The system features sophisticated fraud detection capabilities, leveraging AI algorithms to detect and flag potentially fraudulent activities at an early stage. Furthermore, eOxegen includes functionalities such as provider contracting and empanelment, management of pre-authorizations and adjudication, as well as comprehensive reporting through business intelligence analytics dashboards. Its AI-driven workflow automation guarantees consistent task execution, reduces repetitive activities, and boosts overall productivity. In integrating these diverse functionalities, eOxegen enables insurance providers and third-party administrators to refine their claims management processes while also lowering operational costs. Ultimately, the platform serves as a transformative tool for the health insurance industry, fostering a more efficient and reliable claims handling environment.

ARNIE serves as an efficient motor claims management platform that simplifies the claims process by seamlessly connecting the individuals and systems involved in the background, making the entire handling procedure more straightforward. Claims handlers leverage ARNIE to access crucial information precisely when they need it, while assessors benefit from ARNIE's mobile capabilities to perform and finalize vehicle evaluations effortlessly on the go. Additionally, repairers utilize ARNIE to collaborate effectively with insurers, ensuring that tasks are completed efficiently. We are thrilled to be developing straightforward AI and machine learning solutions, along with providing the necessary support for their integration into your business and technological frameworks. Our conviction lies in the idea that minor enhancements made consistently over time can revolutionize the motor claims industry, and we are equally inspired by the notion that ambitious visions can be realized sooner than anticipated. In this evolving landscape, we are committed to being at the forefront of these transformative changes.

An integrated solution that offers a comprehensive perspective on the property and casualty insurance lifecycle. Enhance efficiency and save valuable time with an advanced, rules-driven, multi-state underwriting module that automates the gathering of necessary information as well as the generation of quotes, endorsements, cancellations, audits, and renewals. Improve combined ratios by adopting a contemporary and efficient approach to the claims adjudication process, fostering both ease of use and collaboration. Boost new business opportunities by facilitating seamless information exchange with brokers, ensuring that data intake is streamlined and standardized while granting brokers round-the-clock access to essential information. Maintain control over what submissions your underwriters prioritize. Elevate customer satisfaction and retention rates by offering policyholders self-service capabilities for accessing policy details, submitting and reviewing claims, making online payments, and more. Ultimately, you have the flexibility to determine which portal features will deliver the optimal user experience for your clients, ensuring they receive the support they need.

Enhance your operational effectiveness and automate processes confidently by integrating timely and dependable insights into your claims management system. Utilize Claims Compass, a versatile platform that connects multiple solutions seamlessly, to incorporate these crucial insights directly into your system. By leveraging this platform, you can accelerate cycle times and refine the claims handling workflow, all while minimizing costs through access to comprehensive data and analytics. Streamlining your workflows allows for the application of advanced analytics, providing valuable intelligence that fosters improved decision-making throughout the claims process. Additionally, bolster your fraud prevention efforts by utilizing predictive analytics, sophisticated investigation techniques, and effective medical provider management tools. Ultimately, ensure a quicker restoration of your customers’ satisfaction by harnessing a claims management system that offers unmatched processing capabilities. This comprehensive approach not only benefits your organization but also enhances the overall experience for your clients.

Oracle's Digital Insurance Platform equips insurance companies with the tools needed to create cutting-edge solutions and outstanding digital experiences for customers. This all-encompassing system simplifies everything from sales channels to back-office functions, allowing for quick introduction of new products and easy adaptation to changes. By leveraging real-time analytics, insurers can acquire critical insights that support better decision-making processes. The platform accommodates both individual and group life insurance, as well as annuities, by integrating underwriting, policy management, billing, and claims handling into one streamlined system. Health insurance providers experience enhancements in enrollment procedures, premium billing, and claims processing, which leads to greater member satisfaction thanks to clear and tailored services. Furthermore, the platform improves the bancassurance process by facilitating immediate connectivity between banks and insurance firms, which guarantees efficiency, uniformity, and trust. This interconnected approach fosters a more dynamic insurance environment, ultimately benefitting both providers and their clients.

Claims Workspace serves as an all-encompassing solution aimed at optimizing the management of property claims through the integration of data, automation, and collaborative tools. This platform enhances workflows, leading to improved results for both insurers and restoration experts. With the ability to seamlessly connect to various data sources, Claims Workspace ensures that users have real-time access to critical property information, assessments of damages, and repair cost estimates. The automation capabilities significantly minimize manual work, thus speeding up the claims process and increasing precision. Furthermore, the collaboration features promote effective communication among all parties involved, fostering transparency and efficiency throughout the entire claims process. By utilizing sophisticated analytics and user-friendly interfaces, Claims Workspace not only empowers users to make well-informed decisions but also boosts customer satisfaction and optimizes overall operational performance. Additionally, this comprehensive approach to claims management positions businesses to respond more effectively to client needs and market changes.

Klear.ai stands out as a cutting-edge software solution tailored for claims and risk management, leveraging the power of native artificial intelligence. This all-encompassing platform integrates various aspects such as risk management, claims administration, analytics, auditing, and policy management, with the goal of optimizing operations and bolstering decision-making capabilities. Through its AI-driven predictive analytics, Klear.ai empowers organizations to foresee potential challenges, uncover hidden risks, and receive actionable recommendations, leading to more informed decisions and favorable results. The user-friendly interface and adaptable features of Klear.ai ensure that it can be customized to meet the specific needs of different businesses, creating a seamless user experience. By employing sophisticated machine learning algorithms, the software automates various workflows, minimizes manual tasks, and continuously enhances its processes by learning from new information. Furthermore, Klear.ai includes powerful fraud detection tools that significantly aid organizations in reducing unnecessary financial losses, strengthening their overall risk management strategies. Ultimately, Klear.ai positions itself as an indispensable tool for businesses seeking to enhance their operational efficiency and risk management prowess.

Sapiens ClaimsPro is an all-encompassing claims management system tailored for Property & Casualty (P&C) insurers, featuring auditable, customizable, and AI-enhanced automation applicable across various business lines. The software's intelligent, rules-based workflows expedite claims processing, thereby reducing both costs and the time to settle claims. Its user-friendly interface allows adjusters to access essential features with just a single click, significantly improving their overall experience. Additionally, a centralized repository provides a comprehensive view of claims, policies, and accounts, which enhances customer service and streamlines vendor management. ClaimsPro also empowers insurers to swiftly adapt to evolving business needs, manage intricate claims with advanced case management tools, detect and mitigate fraud, and proactively address exposure in response to catastrophic incidents, ensuring timely service delivery. Thus, this software not only optimizes operational efficiency but also strengthens the insurer's capacity to respond effectively to unprecedented challenges.

FileHandler Enterprise helps TPAs, insurance carriers, public entities and self-insured organizations automate processes and improve efficiency. Our software keeps you on track with automation and customization, creating a standard claims management process for your business. From implementation to continuous, dedicated support through our Quality Assurance and Implementation Team Members, our goal is to deliver our client partners an effective business management tool, empowering them to automate workflows and increase productivity throughout their business cycle. FileHandler Enterprise allows businesses to facilitate integration with several third-party applications. We ensure that our software works well with preexisting systems in an essential part of our goal at JW Software; helping create customized third-party integrations for your preexisting ISOs, state systems, insurance systems, and much more. FileHandler Enterprise™ software will help you manage and close claims quickly, process payments to parties or vendors, and provide advanced reporting necessary to manage your business.

AUSIS – Comprehensive Behavioral Underwriting AUSIS empowers insurance companies to conduct thorough underwriting, scoring, and decision-making instantly. By utilizing AUSIS, businesses can experience significant decreases in costs, time, risk, and fraud while simultaneously boosting efficiency and decision-making capabilities through alternative scoring methods and additional features. Furthermore, AUSIS enhances the straight-through processing (STP) rate from non-straight-through processing (NSTP) and allows for non-invasive health data collection from various sources, including air quality index (AQI), geographical location, mortality statistics, social factors, images, videos, health monitoring devices, weather conditions, sanitation levels, and more. With AUSIS, insurance firms can achieve as much as a 40% reduction in the costs associated with issuing each policy. This innovative solution not only streamlines the underwriting process but also provides valuable insights that can lead to better risk assessment and management.

AI Insurance is a cutting-edge, cloud-based platform that leverages artificial intelligence to enhance and automate insurance management workflows for program managers, captives, third-party administrators, and risk retention groups. By integrating multiple functionalities into a unified interface, the platform facilitates claims management, financial tracking, digital portals, application processes, premium billing, policy issuance and signatures, rating engines, and data management. Among its standout features is AI-driven automation for tasks like invoice auditing, where defense counsel invoices are meticulously analyzed against established guidelines to thwart unauthorized legal fees, as well as application parsing that efficiently gathers data from received applications to fill out forms automatically. Furthermore, the platform boasts indemnity prediction capabilities, asserting a 25% increase in accuracy compared to traditional adjusters after one year of use, which aids in generating cost predictions and actionable recommendations for claims. This innovative solution not only enhances operational efficiency but also empowers users with valuable insights to improve decision-making in the insurance field.

The FINEOS Platform stands out as the sole comprehensive end-to-end SaaS core product suite for clients, featuring FINEOS AdminSuite for managing everything from quote to claim, alongside add-on products such as FINEOS Engage to enhance digital interaction, and FINEOS Insight for advanced analytics and reporting capabilities. It serves as a cornerstone for your digital insurance approach. By integrating FINEOS AdminSuite, FINEOS Engage, FINEOS Insight, and robust platform capabilities, the FINEOS Platform establishes itself as the most contemporary single core insurance solution tailored for Life, Accident, and Health sectors. In contrast to outdated legacy core systems that relied on a 'one size fits all' technology model, which is no longer suitable for dynamic businesses, modern consumers, employers, and brokers now benefit from sophisticated SaaS solutions and software that elevate expectations for an insurer's digital initiatives. The previous monolithic insurance software systems primarily concentrated on the intricacies of insurance contracts, overlooking the need for flexibility and adaptability in today's fast-paced market. Embracing the FINEOS Platform means adopting a future-ready approach that aligns with current consumer demands and technological advancements.

IBSuite supports the entire insurance cycle, from initial quotes to binding, while also managing comprehensive policy administration, effective claims processing, and billing, empowering clients to operate a robust insurance enterprise and swiftly launch innovative customer experiences and digital business models in a cost-effective manner. Engage in a tailored consultation with our specialists in insurance technology, where we will investigate your specific challenges, identify potential opportunities, and formulate a plan for how IBSuite can drive your insurance business toward growth and prosperity. By optimizing the sales process and enhancing decision-making through real-time analytics and external integration, IBSuite equips insurers to swiftly respond to evolving market dynamics while ensuring compliance with industry regulations. Additionally, IBSuite offers genuine multi-channel capabilities and a customer-focused approach to designing new products and sales avenues, catering to direct sales, sub-agencies, and white-label solutions. As a result, insurance providers can elevate their service offerings and drive greater customer satisfaction. This comprehensive platform not only boosts operational efficiency but also fosters innovation in an ever-changing marketplace.

NSURE breaks new ground as the first AI-powered insurance management system tackling all aspects of core operations. From handling policy administration and claims to automating tasks, it empowers both Life and Non-Life insurers. This web-based system seamlessly integrates everything, allowing customers and agents to create policies online. By harnessing the power of digital solutions and automation, NSURE boosts business performance, efficiency, and overall productivity

ClpHub stands out as a worldwide provider of cloud-based insurance solutions tailored to meet the needs of insurance firms, regardless of their size. The innovative platform features a versatile configuration tool, empowering users to create a wide range of products without undergoing a traditional development process, thereby allowing businesses to launch new offerings without any coding, development team, or technical expertise required. By streamlining business operations in policy and claims administration, ClpHub significantly cuts down on manual labor and associated costs. Additionally, the platform facilitates remote onboarding, enabling clients to complete the onboarding process without needing to visit a physical branch. It boasts an intuitive interface that enhances user experience for employees, alongside robust APIs that allow seamless integration with third-party services or customer portals linked to the insurance core. Furthermore, ClpHub's device-agnostic design ensures accessibility across various devices, including PCs, laptops, tablets, and smartphones, making it a versatile solution for modern insurance needs. With its comprehensive features, ClpHub represents a significant step forward in enhancing operational efficiency for insurance providers.

Seamlessly incorporate insurance into your digital platforms within days via a straightforward API and commercial agreement. Our adaptable technology layer enhances both new and established insurance initiatives. We offer versatile solutions that accommodate any insurer, allowing you to select from our reliable network of risk carriers or continue with your existing partners. You can effortlessly introduce insurance across various business lines, no matter your operational scope. Qover holds licenses to distribute digital insurance products in 32 European countries, enabling us to integrate smoothly with your current insurance offerings or collaboratively develop a tailored product that meets the needs of you and your customers. We prioritize your clients as if they were our own, ensuring that while the user experience is yours, our efficient digital claims processing, prompt payouts, and comprehensive multilingual support result in a reported 90% customer satisfaction rate. Additionally, we provide a transparent performance dashboard that equips you with the insights necessary for making informed, data-driven choices regarding your program. Our team of experts is dedicated to working alongside you, offering guidance to enhance revenue and deliver greater value to your business while fostering long-term partnerships.

A robust management system is essential for your agency as it serves as its foundation, necessitating a platform that can efficiently oversee your entire operations while adapting to your growth. Applied Epic® stands out as the most widely utilized management software globally, providing comprehensive oversight of your agency across various roles, locations, and lines of business, which includes both property and casualty as well as benefits. With our browser-native Applied Epic software, your team can effortlessly access vital data, reduce software maintenance demands, and swiftly harness the advantages of new features. Construct your agency on a platform that streamlines back-office functions, keeps your front office sales team in sync, and seamlessly integrates with customer service and insurer connectivity solutions. Ensure that your staff enjoys a user-friendly experience, allowing them to efficiently access account and policy information, generate quotes, submit claims, and handle renewals with just a few clicks. This efficiency not only enhances productivity but also boosts employee satisfaction as they navigate their tasks with ease.

Crunchwork is designed for insurers that want to gain an edge in the market with a customer-centric, fast claims process. Crunchwork, a cloud-based software for insurance claim management, has everything your supply chain needs to triage, complete, and process claims. In one platform. This is the easiest way to transform all aspects of your claim lifecycle. Crunchwork, unlike other platforms for managing claims, is flexible and powerful enough to run your entire business the way you prefer.

Damco's InsureEdge Insurance Software is an all-in one software designed to help insurance companies gain maximum value from its extensive modules. This highly configurable and customizable software features the best insurance processing functions in the industry. InsureEdge is suitable for multiple insurance lines and can efficiently and effectively manage and streamline workflows to increase profitability, performance, and accuracy. It supports a variety daily operations via back office automation and other modules such as customer relationship management, policy administration and claims processing. InsureEdge, an insurance software that is flexible and scalable, is the key to future-proofing your business.

Safeguard the reliability of your health plan while pinpointing precise pricing with the Context4 Health Plans Suite, our versatile and cloud-centric technological framework. Experience immediate and actionable insights for detecting Fraud, Waste, and Abuse (FWA), developed by our skilled team of certified experts in clinical, dental, and health benefits. By leveraging accurate data and state-of-the-art cloud technology, we deliver a robust and defensible Medicare reference-based pricing (RBP) solution. Our platform comprises over 100 healthcare data sets, complemented by professional guidance to enhance operational efficiency and ensure regulatory compliance. Additionally, our sophisticated medical coding software is tailored to streamline claim submissions and reduce the likelihood of denials. Furthermore, the cloud-based Payment Integrity Platform harnesses our unique analytics engine to uncover coding mistakes, assess medical necessity, address unbundling, detect fraud, waste, and abuse, evaluate audit risks, and identify pricing discrepancies, all of which can significantly influence your organization's performance. This comprehensive approach not only safeguards your financial health but also positions you for sustainable success in the ever-evolving healthcare landscape.

ClickClaims is ideal for small to medium-sized property and casualty insurers, independent claims adjusters firms, and third-party administrators who require advanced technologies to drive a competitive market. ClickClaims SaaS model is fast and cost-effective. It offers a scalable, flexible, secure, and performance that legacy systems simply cannot match. Your investment will appreciate over time because it is built to adapt to new technologies.

Claims Signal™ represents a revolutionary open claims quality solution developed by Aon and Athenium Analytics, designed to help insurers detect high-risk claims at an earlier stage. By improving the experience for policyholders, this platform can lead to a significant enhancement in claims indemnity and expenses, estimated between 4% to 6%. In today's fast-paced insurance environment, claims teams face mounting pressure to elevate customer satisfaction, streamline operations, and minimize financial leakage. While routine quality audits can effectively highlight root causes and deviations from optimal practices, the feedback from these audits may not be accessible for weeks or even months post-claim closure. Imagine having the ability to continuously monitor open claims and resolve quality concerns before they negatively impact results. The Claims Signal platform leverages advanced artificial intelligence to scrutinize open claims, identify potential problems, and send immediate alerts, empowering front-line managers to take action before a claim reaches conclusion. With the integration of predictive analytics and timely alerts, insurers can achieve a reduction in claims leakage of up to 4%, ultimately transforming the claims management process. This proactive approach not only enhances operational efficiency but also fosters a culture of continuous improvement within claims teams.

Ensure a steady stream of revenue by utilizing a robust platform that accelerates reimbursements through eligibility verification, tracking claims status, conducting audits and appeals, and managing remittances for both government and commercial claims, all integrated into one cohesive system. Take advantage of a sophisticated rules engine that promptly cleanses claims in accordance with the latest CMS and commercial payer regulations, enabling you to rectify any inaccuracies prior to submission. During the claim upload process, confirm eligibility across all payers and identify any flagged issues, allowing for necessary edits before the claims are sent. Reduce the days in accounts receivable by implementing automated workflows for handling audit responses, submitting appeals, and tracking administrative dispute resolutions. Tailor staff workflow assignments based on the specific claim type and required actions. Additionally, automate the submission of secondary claims to prevent timely filing write-offs. Ultimately, enhance your claims revenue through automated workflows that facilitate quicker and more successful audits and appeals, ensuring your organization remains financially healthy. Furthermore, this comprehensive system can adapt to your evolving needs, providing long-term benefits as your operations grow.

360Globalnet's acclaimed no-code digital claims platform, 360SiteView, empowers insurers to seamlessly manage and automate the complete claims journey from the First Notice of Loss (FNOL) to the final settlement. This comprehensive digital solution enables customers to submit and track their claims through an intuitive, incident-specific template available on a website, app, or via a contact center. By leveraging video, images, and documents, the platform optimizes the claims process, which leads to reduced lifecycle times and improved customer satisfaction. A fully automated customer portal ensures that clients receive updates on their claim status without needing to remember extra logins or passwords. With nearly complete configurability, 360SiteView allows operational teams to create and implement digital workflows without requiring technical skills. It accommodates a diverse range of claim types, including but not limited to motor, property, casualty, travel, pet, warranty, commercial, engineering, aviation, and marine, making it a versatile solution for insurers. Furthermore, its user-friendly design and adaptability mean that it can evolve with the changing needs of the insurance industry.

Claims representatives now have the opportunity to work hand in hand with policyholders like never before. Engaging policyholders more thoroughly in the claims process not only enhances customer satisfaction but also helps in lowering the expenses associated with claims handling. Today’s policyholders anticipate a high standard of service that aligns with their schedules rather than the representatives'. When policyholders are actively involved throughout the entire claims process, their satisfaction with the experience tends to increase significantly. By utilizing ClaimXperience video collaboration, you can gain the advantage of "eyes-on-site" directly from your desk, allowing for effective triage and evaluation of damage severity. This increased precision enables more claims to be settled directly, eliminating the costs tied to on-site visits. Moreover, when an on-site assessment is truly required, you can ensure that the right expert is dispatched from the very beginning, thereby streamlining the process even further. Ultimately, this approach fosters a more efficient and customer-centric claims experience.

A risk management solution for property and casualty. All-in-one benchmarking and claims management system that simplifies claims-related processes and makes adjusters' lives more simple. TerraClaim provides two tools to simplify claims-related operations. These tools are powerful enough on their own, but even more so when combined. An innovative cross-industry data analytics and claims benchmarking solution that compares your claims performance to industry peers. This helps you set better goals, manage risk reserves, and improve claim outcomes. The world's best property and casualty claims management software that streamlines your internal processes, improves productivity, drives desired results, and prevents fraud.

RiskVille empowers businesses to streamline essential tasks in policy, claims, and risk management, allowing for efficient handling of daily operations such as customer interactions, claims processing, and risk assessments all within a single platform. This cloud-based solution caters to various types of insurance companies, recognizing the significance of having a comprehensive view of business performance while executing daily tasks with precision. By automating repetitive tasks, RiskVille frees up your staff from mundane duties, enabling them to focus on more valuable activities. With a commitment to compliance, we ensure that your audit processes are smooth and straightforward, allowing you to approach audits with confidence and assurance. Our platform is fully compliant with GDPR regulations and is hosted on the trusted Microsoft Azure infrastructure, guaranteeing the safety and security of your sensitive data. Additionally, RiskVille enhances client satisfaction by offering straightforward online access to policies and claims, along with friendly reminders for renewals, ensuring that you not only meet but exceed client expectations in service delivery. Ultimately, RiskVille is designed to make insurance operations more efficient and effective, creating a seamless experience for both businesses and their clients.

Dragonfile – The Smarter Way to Manage Claims Dragonfile is an intuitive, powerful claims management tool designed specifically for adjusters. Dragonfile, built by industry experts, streamlines workflows, automates update, and organizes documents, helping adjusters save time and reduce stress. Centralized File Management: All claim documents are stored in one place. Automated Reminders and Notifications: Never miss another deadline. Seamless Accessibility: Work from your desktop, tablet or mobile device, wherever you are. Zero to minimal training required - Simple and user-friendly interface designed for adjusters. Customizable Workflows: Adapt your workflow to your needs and work smarter. Dragonfile is a powerful tool that can help you manage P&C and Flood claims. It eliminates manual work and increases productivity.

ScoutWorks stands as an innovative service platform designed to allow users to effortlessly access, manage, and monitor a diverse range of solutions, from field inspections to AI-enhanced claims processing. This versatile platform boasts more than 30 distinct service types, including field inspections and appraisals for various sectors such as automotive, heavy machinery, specialty services, and real estate. In addition, it offers features like photo inspections through applications like Scout and Scout Snap, as well as virtual inspections and appraisals, underwriter assessments, and on-demand desk adjusters for various tasks, including desk evaluations, subrogation assessments, and claim analysis. By combining cutting-edge technology with a nationwide network of professionals, ScoutWorks delivers its comprehensive services throughout all 50 states and Canada. With a rich history of over two decades in operations, the platform prioritizes transparency, accountability, and consistency in both claim management and its outsourcing solutions, ensuring a reliable experience for all users. Ultimately, ScoutWorks stands out as a multifaceted tool for organizations seeking to streamline their operational processes in a rapidly changing environment.

Wisedocs offers a document processing platform that empowers insurance companies, independent medical evaluation firms, and legal entities to handle claims more quickly, accurately, and efficiently. The platform automatically organizes medical records by various criteria such as date, service provider, title, and category. Additionally, it features automated page duplication, which can save up to 30% in both time and costs associated with processing redundant pages. Navigating the administrative challenges of reviewing and sorting medical records can often be daunting, but Wisedocs simplifies this process for insurance, legal, and medical organizations. By creating a tailored medical record index, Wisedocs provides valuable insights that cater to specific requirements. Users can easily access critical information through records that are searchable and indexed, resulting from the medical record review and intelligent summary features. This streamlined approach not only enhances productivity but also helps firms make more informed decisions based on comprehensive data.

Curacel's AI-powered platform allows insurers to track fraud and automatically process claims. You can easily collect your claims from your Providers and auto-vet them. Curacel Detection can help you identify and curb fraud, waste, and abuse in the Claims Process. Collect claims from providers to prevent fraud, waste, and abuse in the claims process. To understand where Insurers are losing the most value, we studied the Health Insurance industry. This was the Claims Process. The Claims Process is mostly manual and is prone to fraud, waste, and abuse. Our AI-driven solution helps reduce wastage and makes the Insurer more efficient, unlocking hidden value. Ravel insurance is unique in that it is built upon on-demand policies that only cover a short time. Both the policy holder and the insured want a fast and accurate claim settlement.

AdvantageGo delivers innovative commercial insurance and reinsurance management solutions that offer insurers the IT agility they need to create an intelligent digital strategy in partnership with a leading IT provider. With over 25 years’ experience, we harness the power of proven, functionally-rich core solutions and augments it with the energy and culture of being an InsurTech leader. AdvantageGo enables insurers and reinsurers worldwide to fuse the traditional with digital, helping them rapidly adapt, drive change, and succeed with agile software and Microservices. Enhance your digital landscape and open up the possibility of true risk mitigation with our pioneering technologies.

WaterStreet’s platform for property and casualty insurance, along with its policy administration services, empowers your organization to achieve greater efficiency. This comprehensive suite not only provides business process outsourcing for insurance but also enhances the customer experience through advanced technology and streamlined procedures. By improving visibility and interactions with policyholders, your agents can more effectively pinpoint cross-selling opportunities and offer proactive support when customers are in need. The integration of process automation, along with real-time access to documents and data, guarantees prompt delivery of accurate information that fosters accountability and transparency. The WaterStreet P&C Insurance Suite consolidates all your data and operational processes, thus removing the necessity of juggling multiple software systems for your business. This seamless integration exemplifies outstanding customer service, providing a robust link between clients and agents, as well as between agents and insurance companies. Ultimately, this holistic approach not only increases efficiency but also enhances overall satisfaction for all parties involved.

BrokerEdge, developed by Damco, is a comprehensive insurance broker software that provides an all-in-one solution for brokers across various insurance sectors. It empowers brokers to harness the advantages of automation and enhanced connectivity, improving their operational efficiency and accuracy. By utilizing BrokerEdge, customers, insurance agencies, and brokers can thrive simultaneously. The centralized platform enables brokers to streamline their daily tasks, such as maintaining customer databases, tracking leads, and updating policies. In addition to features like automated marketing, lead management, commission tracking, and policy administration, this top-tier software includes an advanced customer service portal and a mobile application, enhancing its scalability and adaptability. BrokerEdge not only contributes to increased revenue but also eliminates inefficiencies, ensuring workflows are smooth and uninterrupted, ultimately leading to enhanced service delivery. The breadth of functionality within BrokerEdge positions it as an invaluable tool for modern insurance practices.

The most popular insurance software platform. SchemeServe rates and underwrites complex schemes with speed and accuracy. We deliver a responsive service to your customers. Your business will grow faster. SchemeServe is flexible and responsive and can adapt to market changes immediately, rather than waiting weeks. Rapid delivery of products to the market. Technology that is customer-focused. Our features allow you to offer seamless digital journeys to customers to purchase insurance. There's less hassle. We will help you take control of your company's growth. You can build your own products. SchemeServe is intuitive and easy to use, with technical support. SchemeServe understands that every second of downtime can mean lost revenue. We make it a priority for you to continue trading. Uptime is a priority at SchemeServe. Subscribe online to our uptime metrics. Let us show you how SchemeServe can help you grow your insurance business.

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.