Best PBM Express Alternatives in 2025
Find the top alternatives to PBM Express currently available. Compare ratings, reviews, pricing, and features of PBM Express alternatives in 2025. Slashdot lists the best PBM Express alternatives on the market that offer competing products that are similar to PBM Express. Sort through PBM Express alternatives below to make the best choice for your needs
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Virtual Examiner
PCG Software
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. -
2
SpeedySoft
$29.95 per user per month 31 RatingsSpeedy 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. -
3
PLEXIS Payer Platforms
PLEXIS Healthcare Systems
PLEXIS' suite best-in-class apps have a proven track record of providing payers with the advanced functionality they need to support modern core administrative ecosystems. PLEXIS Business apps provide a range of services, including real-time benefit administration and adjudication, automatic EDI transmission, and self-service customer portals. Passport provides essential connectivity between the core admin and claims management engines, PLEXIS business applications, your own apps and existing in-house system. Passport's flexible API layer allows for real-time integration to portals, business apps, and automated workflow toolsets. Connectivity is unlimited. Streamline workflows using a central, modern core administration and claims management platform. To provide superior customer service and a quick ROI, process claims quickly and accurately. -
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ClaimAdept
Isoft
This product is an all-in-one claims system. The product's primary functions include claims adjudication, claim workflow, and payment disbursement. Flexible design allows for the addition of adjudication modules to be added on a per-line basis. The core functionality of the system is reused for each new line of business. This system makes use of the user-friendly windows screen design and uses a relational database to store data within the system. Powerbuilder is the software platform. It can be used with an SQL database like Sybase or Oracle. This combination of software allows for a client-server based environment that can process large amounts of claims. Installation and training are provided. Source code is included in the license fee. Expert staff can customize the system and tailor it to the client's requirements. All modifications can be made with detailed design and support for acceptance testing. -
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IMPACT
Managed Care Systems
IMPACT is our core suite of Healthcare administration software. It supports all aspects of healthcare-related data transactions. Our customers use Impact to manage enrollment, provider contracts and re-pricing, benefit plans, authorizations/referrals, claims payment and the various complications that surround these functions. IMPACT is flexible and offers a wide range of industry-specific features. -
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VCA Software
VCA Software
$65 per monthImagine 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. -
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Hi-Tech Series 3000
Hi-Tech Health
$3500 per monthWith 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. -
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PlanXpand
Acero Health Technologies
PlanXpand™, Acero's proprietary transaction processor engine, powers all of our products for administrators of health benefits. Clients can leverage this engine to implement Acero products simultaneously or incrementally. Administrators can choose from one of our standard products or PlanXpand™, which allows them to create a custom solution that extends existing system capabilities. Acero's unique integrated solutions feature Service-Oriented Architecture. This allows health benefits administrators and insurers the ability to add functions and features to existing adjudication platforms. Our sophisticated design and engineering allows real-time adjudication for every type of claim in direct interaction with core claims system. This results in faster processing, happier customers, and less need to adjust claims. -
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CyberSource Medical
ComCom Systems
The most accurate and powerful solution on the market for claims processing. CyberSource Medical Claims Scanning Solution is a turn-key system for HMOs, PPOs, TPAs, or Self-Funded Organizations. It can be installed at your location to automate data entry for CMS-1500, ADA 2006 UB-04, and enrollment forms. CyberSource uses advanced "intelligent", combined with your business rules to recognize, validate, and format the data from medical claims forms. Fuzzy Matching uses intelligent search to identify the exact match between your provider and member database. The matched data can then be used to verify and correct the medical claim data before it is sent through to adjudication. Combining industry-leading OCR efficiency, business rules and "Fuzzy Matching", results in exceptional accuracy for the data from your medical claim forms. -
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BirchNotes
BirchNotes
BirchNotes, the most intuitive practice management and client-centric EHR system for mental health and substance abuse professionals, is designed to help you grow your practice and manage it with ease. An EHR was designed with a mental health therapist in view. Tools and features that are tailored to both mental and substance abuse professionals have been selected. All your EHR, billing and insurance, scheduling, telehealth, and other functions can be integrated into one system. There are no additional log-ins, systems or tools required. BirchNotes is flexible and scalable, regardless of the size or setting of your practice. Our workflows and insights are tailored to your practice. Our smart workflows, automation and customizable settings make it easy to manage your practice. This will allow you to spend more time on what is important to you. A better solution for better outcomes. You can have recurring appointments, group, telehealth, or recurring appointments. Plus, you can customize your calendar. -
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ClaimPilot
Quick Internet
Unrivalled customer support and a web-based solution for claims management. ClaimPilot's web-based claims management software is designed for claims professionals who want to scale their business. It provides all the features, functionality, and ease of use you need to view financial information and claim details with custom reporting. With customizable features, you can address the increasing demand for data inputs. Increase efficiency in claims processing. ClaimPilot is not a heavy, feature-loaded, risk management-focused software package. It also offers the features you need to manage your workers compensation claims, including Lloyd's compliance and workers comp functionality. You also get our legendary customer service. Our experts work with clients to create custom reports and functionality that will support their growing businesses. We believe that success is only possible if you are successful. -
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HEALTHsuite
RAM Technologies
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. -
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Venue Claims Management
KLJ Computer Solutions
$5 per monthVenue™, Claims Management for Independent Adjusters, provides complete management of the entire claims processing process. Venue™, whether you are an adjust firm, third party administrator, insurance carrier or self-insured organisation, is the right tool for you. The user-configurable interface allows clients to customize the claim system in their own way. A built-in web service interface allows for batch or real-time data import, update, and export to virtually all third-party data sharing sources of ALL claim-related data. Integration with billing and policy systems allows for real-time synchronization of all policy-related details. This may include important policy dates and flags like active fraud investigation or assumed policy. Comprehensive capabilities for all aspects of claims processing, including recovery and claim payments, contact management, reserves tracking, reserve tracking, contact management and excess and trust accounts. -
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MediClaims
WLT Software
$1 one-time paymentWLT's MediClaims program offers a cost-effective and straightforward approach to benefits and claims administration. WLT's integrated EDI processes and rules-based architecture allow for claims to be processed quickly and accurately. MediClaims offers a wide range of benefits and claim types, including Prescription Drugs, Vision, Medical, Dental, Vision, Prescription Drugs, Consumer-Driven Healthcare, Disability, Capitation processing, as well as processing capabilities. WLT's MediClaims system allows you to set up your groups for a single or multiple lines of coverage. Without reliable information systems, no plan can function efficiently. WLT is committed to using the most modern technologies available, providing you with the most flexible and sophisticated systems possible. -
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CaseGlide
CaseGlide
CaseGlide is the leader in claims litigation management. Gone are the days when claims management was disconnected and siloed, manual and inefficient workflows, hundreds of emails between defense counsel and claims teams, and unstructured case data, are gone. CaseGlide allows you to focus on strategy, data, efficiency, and improving your litigation management program. Our clients can better predict and manage the outcome of their cases, assign the right attorneys for the right cases, work more strategically and reduce litigation costs. Integrations allow you to send important case data to your data warehouse, data warehouse, document management or accounts payable systems as your defense attorney partners work on your cases in the platform. It's easy to see that the longer a case remains open, the more expensive it will be. -
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DWF 360
DWF Group
Our software is built with industry knowledge and expert consulting. This knowledge is used to inform the business processes that are to be integrated into our platform. 360 provides end-to-end claims management transparency and integrity, which allows our clients to lower the total cost of their claims. Our clients get better results by using cost-effective technology that transforms the way they do business. Our software is customizable to meet the needs of our clients. It can also be integrated into existing systems to facilitate integration. This allows for in-house resources to support value-added activities that help businesses differentiate and grow. -
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W5 Claims
Burkitt Computer
$7900 one-time paymentW5 Claims Management Software: Manage your claims, understand and grow your business. What are you and your staff doing every day? Do this, do that, and repeat. It's more than just saving time on repetitive tasks. It's about making sure they don’t get overlooked when you have a long list to do. - Automation Documents, thousands to thousands of photos and documents. They include organizing, organizing, securing, and distributing them. It's a huge job that will determine your success. - Document Management Time constraints, customer SLA's and document management. Not only do you need to meet these challenges, but you also need to measure and report your successes. How do adjusters do? What are the biggest stumbling blocks that can affect your staff? Can you demonstrate to your customers that they have trust in you? - Workflow + Business Intelligence Analytics -
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OneTouch Claims Processing Software
Apex EDI
OneTouch allows users to send claims or statements to Apex easily, log in to the Apex website, and search for claims that were sent in the past from the comfort of their computer desktop. OneTouch can only be used by registered clients of Apex EDI. Users must have a username/password setup. OneTouch can then be set up once a user has created a username/password so that they can access the described tools. OneTouch Search allows you to search all of the Apex claim and statement files from your desktop. OneTouch Search allows you to search your claim and statement files for subscriber IDs, patient names, and many other options. After clicking the search button, you will be logged in to Apex and shown the results of the search. First, click on the magnifying glasses dropdown menu to select what you want to search. -
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PowerClaim
Hawkins Research
$99 per monthDon'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. -
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Conexia
Conexia
Authorize, claim processing and payment are available at the point-of-care. Improve care coordination and improve outcomes for lower medical costs while streamlining administrative processes. Engage providers at point of care to share and capture data in real time, resulting in an unprecedented exchange of health information. We work with our clients to develop risk management strategies that produce better outcomes at lower costs. We aim to improve the user experience of everyone in the ecosystem. To optimize clients' resources, we deliver a minimum of a 3:1 ROI. Conexia has created a core technology platform (ONE), which can be customized to meet the different regulatory requirements and operational processes of each client in each geographic region. Our initial implementation is usually an overlay on the existing technology ecosystem of the payer to create real-time processes. -
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Coronis Health
Coronis Health
Coronis Health has more than 30 years experience in revenue cycle management and medical billing. We understand the impact that new legislation can have on medical facilities. We're breaking down the No Surprises Act and how it could impact your bottom line as the No Surprises Act goes into effect. Coronis Health, a global healthcare revenue cycle management and medical bill company, offers specialized solutions and global capabilities. Coronis Health combines industry-leading technology with high-touch relationships building to allow healthcare professionals & facilities focus on patient care, financial independence, and financial success. -
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Mercury Policy & Claims Administration
Quick Silver Systems
Quick Silver Systems' Mercury allows Automobile, Property, and Casualty insurers to rate, quote, bind, make payment, and report claims online. Online document access, bill payments and the first notice of loss will reduce customer service calls. Modular API-based system allows seamless integration to existing or new data providers. Digital document production is possible and the system can be used on any device. Our visual work-flow creator allows you to create custom, event-driven work-flows. Get the most current information about Written, Earned and Unearned premiums. You can automatically save every page, card and report to share with associates. You can collect currency in any digital format, including ACH, EFT and Electronic Checks, Credit or Bank Card. -
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Daisee
daisee
$89/month 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. -
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Risk Manager
ERIC Systems
$19995.00/one-time Risk Manager uses Microsoft SQL Server, which allows the creation of custom views or queries for reporting purposes. ODBC-compliant applications can also be used without dependence on ERIC Systems. Risk Manager is constantly under development. Updates are published regularly. Our policy regarding updating is simple. We provide newer versions without additional charges to the standard technical support agreement. User logins are given dollar limits for individual check or reserve transactions. You can not exceed the total paid to date or total incurred thresholds at the enterprise level without acknowledgment. Client suggestions are the basis of our policy for developing new program features and standard reporting. -
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Complete Claims
Complete Health Systems
Claims adjudication for short- and long-term disability claims. Available as an on-site license (ASP) or as a hosted app (ASP). Microsoft technology: SQLServer database with Windows front end. Highly acclaimed Customer service, staffed by experts in health care claims with at least 12 years of experience in the field. Support calls are recorded and status is available online. Plans can be copied and modified quickly using the plan modification feature. Auto-adjudication with benefit codes built using business principles based on more than 25 variables from the claimant and claim records that were made available to the adjudication engines. Inbound claims can either be scanned images or EDI. HIPPA EDI-5010 transaction sets. The system can be loaded with UCR Schedules and re-pricing fees in advance of the effective date. The date-driven logic will reprice based on the date service was rendered. -
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Newgen Claims Processing
Newgen Software
Automate the entire claims process, from the initial notice of loss and fraud detection through claims adjudication and settlement. You can address different types of claims differently, such as maturity and death claims, while improving regulatory compliance, and eliminating non-compliant penalty. Data capture, payment tracking and tracking, legal matter processing, monitoring and monitoring all allow for faster, more accurate and effective processing. -
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omni:us
omni:us
Integration into existing claims systems is seamless. Automate processes and reduce costs It is no longer a choice between improving customer experience and saving money. Data driven insights enable you to make better decisions. Automate manual processes Empower your claims personnel. Invest in the happiness of your customers. Integrate incoming claims seamlessly with your insurance core system. Automate claim processing to reduce inefficiencies and increase customer satisfaction. -
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ClaimScape
DataGenix
DataGenix was founded in 2000 and is committed to providing TPAs, adjusters, insurance companies and other entities with modern claims processing solutions. We know that claims processing and managing health benefits can be complicated. Our ClaimScape software automates the entire adjudication process so that your business doesn't suffer any losses. Our Claims software and business are designed to solve the problems that prevent you from providing a superior customer experience for your clientele. Our software products can help your business grow in the most modern ways, keeping in mind current trends and requirements. We have earned the trust of top TPAs across the country and are ready to serve you more. -
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SSI Claims Director
SSI Group
You can improve your claims management process and reduce denials with unmatched edits. Access to technology that allows for accurate claim submission and quick reimbursement is essential for health systems. Claims Director, SSI’s claims management software, streamlines billing processes and provides visibility by guiding users throughout the electronic claim submission process and reconciliation process. The system monitors changes in reimbursement criteria and incorporates them as they occur. The solution allows organizations to make the most of their reimbursement efforts by allowing them to edit at all levels: payer, industry, and provider. -
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CLAIMSplus
Addiox Technologies
Expedited claims. Multiple interfaces work in conjunction with your corporate brand. Access to digital data from any location, at any time. You can speed up your life and health processing by using faster systems that meet your needs. You can speed up your claims processing to meet the increasing number of claims. At the same time, you can reconcile and resolve more complex claims with record speed. It's here. It's out. There are no interruptions or delays in claims processing. CLAIMSplus expedites claims by working with employers, TPAs, and insurers using robust in-the cloud processing platforms. CLAIMSplusis focused on optimizing processes and expediting medical cases through secure, reliable, and efficient electronic claims management. Our technology, which is the core of our business, manages claims efficiently and quickly. We asked our clients and found that the claim's timeframe is the most important aspect of claims processing. -
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ClaimsXPress
Insurity
A claim is the most significant interaction in insurance. It's the moment of truth both for policyholders and insurers. ClaimsXPress gives insurers the opportunity to provide unique experiences that lead to positive results. Insurers can differentiate themselves from others in any market by offering a claims service. ClaimsXPress helps insurers improve the claims experience, build customer loyalty, and attract more business from distributor channel partners. Companies that are agile know they can grow faster by using efficient processes and systems that can scale. ClaimsXPress was designed to support insurers' growth. In claims response and data access, speed is important. ClaimsXPress excels in both areas, allowing users to achieve their goals faster. -
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CoreLogic Claims Connect
CoreLogic
CoreLogic modernizes global property and casualty insurance with flexible, collaborative, and secure claims estimation technologies. We create world-class experiences that simplify life and improve business. Claims Connect™, a CoreLogic®, streamlines the claims process by creating an integrated digital ecosystem. Transform your workflow to ensure that your customer's claims can be resolved quickly and accurately. All information is stored securely on one platform, and can be accessed by all claimants. There is no need to switch between different software programs to edit or review claim information. Claims Connect automatically syncs with Claims Connect to allow everyone to instantly see any changes or create estimates. Your claims resolution will be easier, quicker, and more efficient if everyone involved is up-to-date with the information they require, when they need it. -
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Five Sigma
Five Sigma
Five Sigma was founded with the mission of enabling claims organizations to innovate. Five Sigma's suite of tools and platform for claims management is what Insurers require to adapt to the rapidly changing world. Our suite of Claims First Cloud-Native products and User-Centric products allows adjusters to better manage claims and do so much faster. Automating administrative tasks allows adjusters to focus on making the right decision, while the system takes care everything else. The complete suite of claims management tools, including an in-system omnichannel communication platform, automated documentation and workflows, reporting, and open APIs. The state-of-the-art claims management platform allows you to go live in just weeks. Five Sigma's unique SaaS offerings, agile methodology, and weekly upgrades make it possible for carriers to improve their claims operations. -
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Claim Leader
ClaimLeader
Claim Leader is a technology company that develops and delivers technology solutions to automate communication and workflow processes within the business enterprise of insurance claim organizations. Our software solutions simplify your operations while enhancing productivity with an integrated web platform. Claim Leader systems' feature-rich modules simplify the workflow for both field staff and internal administrators. Management tools enable internal users to assign tasks to field staff, organize workload, identify files for review, and streamline workflow. -
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Smart Data Solutions
Smart Data Solutions
Streamline Your Complete Healthcare Data Workflow. Smart Data Solutions has both the experience and tools to streamline your electronic and paper workflows. Our integrated validation, matching and normalization tools ensure high quality data, increasing auto-adjudication, and decreasing manual processing. Our development process guides you through projects, no matter if you are new to Smart Data Solutions or an existing partner. No matter what your needs are, we will work with your staff to understand them and the impact of your workflows. We believe in focusing your efforts on your goals and what you want to achieve. Then, we will identify the best route to get there. -
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Reduce time and complexity in document processing, while supporting straight-through efforts. Shift Document Decisions, an AI-powered solution, analyzes documents to find relevant details and creates contextual views of action items needed to move the claim along. Our models have been specifically trained to process insurance documents, allowing them the accuracy of a human claims adjuster. Automated evaluation of documents against data is a great way to speed up processing and create a complete picture for each claim. AI that is industry-specific continuously learns how to combine claim data with document detail to deliver decisions on claims documents that have impact. Reduce manual reviews, identify claims complexity, and direct claim handlers to details that require action. We are 100% focused in insurance and hire industry's top talent to provide unmatched support.
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EMSmart
EMS Management & Consultants
EMSmart™, claims processing technology, raises the bar and improves your bottom line. EMS IMC's priorities are to use a compliant, accurate, efficient system to manage a complex billing process and maximize your revenue. EMS IMC's new solution, EMSmart™, allows clients to focus on patient care while ensuring that revenue is collected in a compliant way. EMSmart™, our new proprietary claims processing platform, delivers the industry's best rules-based process automation while retaining human judgement at the appropriate points of the revenue cycle process. EMSmart™, our internal processing engine, is now available to you. We are excited to share this information so that you can be confident that your claims are in the best hands possible, both human and machine. -
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I-CAPS
W.O. Comstock & Associates
I-CAPS, an Intelligent Claims Administration System, addresses all functional areas in the health claims payment environment. It uses a single architecture that covers the needs of payers, including billing, enrollment, claims, claims management, contracting and pricing. Our Intelligent Claims Administration System, I-CAPS, and our Coding Compliance Software (Advanced Value Scale -AVS), support knowledge-based decision making to help our clients reduce costs. With (Advanced Network Administrator -ANA), it is easier to ensure the integrity of Provider data. Our (RB-UCR), which is the first industry-first Resource-Based Usual Customary and Responsible fee schedule based upon RBRVS/NCCI, is also easier. Cost Containment Audit and Recovery Services, (CCARS), can be used to perform a non-invasive audit of claims effectiveness. -
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HealthRules Payer
HealthEdge Software
HealthRules®, Payer is the next-generation core administrative system that offers transformational capabilities for health plans of any size and type. Health plans that have implemented HealthRules Payer for more than 10 years have been able quickly respond to market opportunities and stay ahead of their competitors. HealthRules Payer differs from other core administrative solutions because it uses the patented HealthRules language™, a vernacular similar to English, which delivers a new approach to configurations, claims processing and information transparency. HealthRules Payer transforms health plans that want to grow, innovate, and compete beyond other core systems. -
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ResolvMD
ResolvMD
ResolvMD is a full-service, experienced medical billing company that processes all types of health service claims (AHCIP, etc.). ResolvMD is a full-service medical billing company that processes all health service claims (AHCIP etc.) on behalf of doctors. Our goal is to make doctors as competent and confident in their billing as they are in the practice. We do this by surfacing data-derived insights, democratized knowledge, and other data-derived insights. We offer the most secure, cost-effective and modern platform for processing claims. Our target audience is physicians (mainly specialists such emergency physicians, urgent care plastic surgeons, anesthesiologists and paediatricians, as well as general surgeons). To process their claims for health services, they need a billing agent. They value efficiency, time, trust and cost. Today, we are targeting Alberta physicians (primarily in Calgary, Edmonton and Medicine Hat, Lethbridge. Okotoks, and any other centre with more than 25,000 people). -
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Enterprise Health Solution
HM Health Solutions
HM Health Solutions offers a complete solution for health plans. The Enterprise Health Solution is a comprehensive platform that manages health plans. It provides the support you need and the business outcomes you desire. Platform applications and tools manage functions such as enrollment, billing, claims, provider management, customer service, and billing. The Enterprise Health Solution (EHS), which can seamlessly move your member from enrollment to claims payment, is the only end-to-end proven solution. Others claim to offer a fully integrated solution. They don't mention that you might need to order all modules in order to achieve this integration. The Enterprise Health Solution has always been focused on health plan administration. Our expertise in the area of health plan payers is unmatched by any other company. -
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A1 Tracker
A1 Enterprise
$800/month 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. -
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Total Loss Pro
Vemark
Total loss claims account for around 20% of all collision and liability losses in the auto insurance industry. Too often, total loss operations of carriers lack cohesive digital workflows. This can lead to high costs, customer dissatisfaction, poor visibility, and poor oversight. Vemark's Total Loss ProTM is your solution. It's the only solution that will transform total loss claims processing into a smooth, efficient machine. You can also keep up with the rapid pace and changes in the world. Improved satisfaction and experience for policyholders through faster settlement. Employee morale is higher due to less frustration and fewer tedious processes. Transparency and visibility for data-driven decision making. Total loss claims for autos are more complicated than those for vehicle repairs. Total Loss Pro, a cloud-based software that helps to improve all stages of this complex salvage vehicle workflow, is available. -
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Gallagher Bassett
Gallagher Bassett
Will your claims service provider rise to the occasion when the unthinkable happens? Claims Management is a way for GB to fulfill all the promises and potentials of the entire insurance industry. It is the moment when we are called to do more than just making good. We are called to do more and make it better. This call has been answered every day for more than 50 years. It is in our DNA to do more than what is expected. People are at the center of everything we do. We serve people and have a very special person who makes it happen. Our RMs are among the most engaged and empowered in the business. Each one is committed to delivering a superior result. They have proven it time and again. They do it with a spirit that we call Own the End result. To make better decisions earlier in every claim's life. To identify and deliver the correct resources at the right time and place. -
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SpyGlass
Beacon Technologies
SpyGlass, our enterprise-class software for managing health claims, is a powerful and flexible solution that allows for fast and accurate claims processing. SpyGlass makes it easy to set up benefits and plans. BenefitDriven is fully integrated with SpyGlass and provides eligibility, contribution accounting, pension management, and payroll management to the Taft-Hartley sector with all the data and processes for Participants as well as Employers. HIPAA Director, our all in one EDI gateway & scheduler acts as a hub, allowing you to connect with vendor partners to help reduce transaction costs, manage batch transfer, and automate transfers. SpyGlass gives you a detailed, panoramic view of your population. You can drill down to more detail. You have access to hundreds of reports, fully customizable dashboards and total control over the system. -
46
Adjustify
Adjustify
$12 per claimAdjustify, a web-based video-calling application that allows professionals and customers to connect to each other remotely to conduct in-home inspections or remote meetings. To connect digitally with your customer, schedule a call. Users can use the video call to take digital measurements, access customer phone features like zoom and flash, and capture unlimited photos. Users can view the video recording of the meeting and make notes. Innovative video conferencing technology provides continuity during social distancing by assisting claims management in any industry. Adjustify is a safer and more efficient way to handle claims during times of social distancing. Advanced Video Calling allows users to connect with customers and conduct efficient inspections on-site from any location. -
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Origami Risk
Origami Risk
Origami Risk provides integrated SaaS solutions designed to help organizations--insured corporate and public entities, brokers and risk consultants, insurers, third party claims administrators (TPAs), risk pools, and more, transform their approach to managing critical workflows, leveraging analytics, and engaging with stakeholders. Origami Risk has won five consecutive Business Insurance Innovation Awards. This is because we work closely with our clients to create solutions that address real-world problems. Origami Risk was founded in order to provide real-world solutions that are industry-leading for risk professionals all over the world. This continuous effort is reflected in Origami Risk's acceptance of the 2021 European Risk Management Award as Technology Innovation of the Year. Comprehensive, integrated solutions to reduce incidents and hazards. -
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InsuraSphere
IDP
InsuraSphere is a complete suite of products and solutions that grow with your business. InsuraSphere is the complete product suite designed by insurance professionals for insurance professionals. All the essential information you need to manage your business, including quotes, claims, agents and policies, can be found in one place. InsuraSphere's integrated policy management system will streamline your processes. With agent and insured portals, you can give your stakeholders access the information and workflows that they require. Agents can rate, quote, or issue their own policies using your company's role-based permissions and business rules. Add third-party integrations to customize your company's workflows. InsuraSphere was designed to meet the changing needs of agents and carriers. InsuraSphere can grow with your business, whether you're just starting or moving from a legacy system. -
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TherapyNotes
TherapyNotes
$49 per user per monthTherapyNotes 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. -
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Aquarium Platform
Aquarium Software
$200 per monthAquarium's platform is the best solution for insurance companies looking for an easy, efficient and cost-effective route to market. Our platform has a track record of delivering a fast return on investment. It can be deployed in existing IT environments with minimal impact and is fully scalable to meet the business's needs. The platform is made up of several service components that are both functional and technical. They provide a complete, end-to-end solution. This component gives customers a single view of all channels, including web, SMS, email and phone. It facilitates automated engagement through inquiry and follow-up, sales process as well as mid-term adjustment, renewals, claims management, and mid-term adjustment. Net promoter scores can be calculated via SMS or email, including keyword and sentiment analysis.