Alternatives to PowerClaim

Service Center by Office Ally is a trusted revenue cycle management platform used by over 65,000 healthcare organizations processing more than 350 million claims annually. With Service Center, providers can verify patient eligibility and benefits, upload and submit claims, correct rejected claims, check claim status, and obtain remits. With no implementation needed, providers can easily submit secure and confidential claims to any payer from any practice management system to streamline their billing processes and financial performance with faster reimbursements.

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

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.

Virtual diagramming, voice annotation and photo documentation are all available in your palm. It is quick and easy to capture claim information onsite, eliminating the need for followup visits. This also gives policyholders a great opportunity to be involved in the settlement process. In just a few steps, adjusters can estimate, document, and close a claim. This allows for a quicker, more efficient, and more accurate claim settlement. Mobile Claims makes it possible to settle claims onsite with onsite estimates. Our algorithms, which are logic-based questionnaires that generate loss-specific estimates in fraction of the time it takes to build standard estimates, can be applied to create custom estimates in a fraction the time. It is easy to integrate, train and use. The cost of changing is virtually eliminated, which has huge benefits for carriers, adjusters and contractors as well as policyholders. Fully equipped with aerial imagery/measurement and 3D virtual diagramming, geospatial visualizations, video collaboration, contents, and so on.

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.

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.

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.

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.

FBCS Enterprise is a centralized platform for guiding decisions regarding non-VA Purchased Care to improve Fee Basis Claims Management and adjudication through efficient claim processing.

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.

Anagram Prosper gives money back to your patients -- at no cost for your practice. You can increase your margins and delight your patients. We partnered with top vendors to create wholesale price lists that better fit your needs and those of your patients. Rebate on products you already own. Incentivize your patients, increase conversions, and earn more revenue. Anagram Prosper allows you to save money for your patients without having to offer discounts or lower your margins. Our rebate program will help you increase sales and make your patients happy. Patients don't know what their out-of network benefits are. Anagram Access allows you to determine your patient's eligibility for vision plans in real time. This will maximize your savings. Anagram Access allows you to quickly calculate the amount your patient owes, and how much their vision plans reimburses.

Connect everyone to your property claim. ClaimLogik connects everyone involved in a property claim, from the first notice of loss to completion. Property assessment & repair ecosystem. We connect everyone involved in your property claim, from start to finish. Stakeholder Management. ClaimLogik connects all stakeholders in a claim with real-time access. This allows them to complete tasks and manage activities in the right order, at the right time and with complete transparency. All stakeholders have access workflow modules that are customized to allow them to track, manage, and complete tasks throughout the claim. Stay connected. All stakeholders connected to one claim. All stakeholders have complete transparency about the claim status. All activities throughout the claim are within your sight. Digital contracts between the Insurer and the supply chain. Service level agreements with all suppliers. Trades KPI management to compare and measure supplier performance. Automated exception management for tasks that fall outside of SLAs

Insurance is seeing significant changes due to digital technologies. Those who keep up with this evolution will be able to retain a competitive edge. Cloud-native enterprise claims management platforms are replacing traditional claim management tools that required multiple systems, paper files, and manual processes. The Majesco ClaimVantage Claims Management Software L&H platform streamlines claims processing from intake to payment calculation. It also integrates multiple systems to improve information flow across your business. With timely and accurate claim decisions, you can improve customer experience and operational effectiveness. Built on the Salesforce Lightning Platform Majesco ClaimVantage Claims Manager Software for L&H allows insurance companies and TPAs modernize and optimize their claims operations.

Find out why insurance adjusters and contractors choose our easy-to-use Estimating Software to Process Claims and Property Repair. Create estimates, sketches, digital pictures, reports, and other insurance forms, with minimal training. Never pay again for technical support calls. Our knowledgeable and friendly support representatives are available to help you. Simsol offers the most competitive rates, especially if you sign up for an entire year. ClaimsWire, a web-based software solution designed for insurance companies, allows for electronic assignment, tracking and exchange of data related to property claims. It integrates seamlessly into Simsol and supports all platforms for property estimation. It has powerful management and review features, built-in accounts, and more.

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.

Quadient®, Correspondence allows you to manage your claims correspondence in the cloud. Quadient®, Correspondence is a subscription-based SaaS service that allows insurers to create and approve claims correspondence for customers. This can be done in both print and digital formats. There is no dependence on IT. Quadient Correspondence was created and priced for insurers that want to transform to digital but don't have the funds to invest in a full-service customer communications management (CCM). Business analysts update and create templates. Templates are approved by compliance experts and claims managers. Users of business correspondence can use a controlled editing process. Authorized personnel approve and review correspondence before it is sent. Instant delivery via email or SMS, PDF or email. Start by choosing the right claims correspondence template for your business and customizing it within the pre-defined editable fields.

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.

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.

WLT'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.

Claims management software is perfect for customer service, complaints, and claims. Reduce claims processing time, reduce costs per claim, and manage claim loads with intelligent reporting, trend analysis, fraud detection, and intelligent reporting.

Acrometis' flagship claims processing solution provides unparalleled workflow management. Documents are automatically routed using a configurable rules engine. Acrometis business rules, which are based on claim assessment scoring, claim compensability matching, body part to claim compensationability matching, jurisdictional directives and relatedness scoring, are designed to reduce claim costs and length. CLAIMExpert automatically processes 65 per cent of all incoming medical bills. Documents that require adjuster intervention are flagged for easy review and quick decision making. All incoming documents are processed automatically with no adjuster intervention. In the first year, clients typically see an average of 11 to 23 points improvement in their medical loss. CLAIMExpert has rules for more than 190 document types. This allows you to quickly handle whitemail and other documents that may come across your adjuster's desk.

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).

Us4U is a pioneer in the creation of unemployment claims software solutions that help companies reduce their UI expenses. The company provides simple, cost-effective and efficient software to help businesses manage their employment costs. UCA 360, UCA-LITE and The Extractor 360 are core solutions of Us4U. They also offer SIDES 4 U, the Unemployment Tax Auditor, SIDES 4 U and the Unemployment Team development.

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.

PayorLink solutions go beyond managing medical claims for employers. They offer a complete platform approach to providing better employee benefits that reduce healthcare costs, promote healthy lifestyles, lifetime health, and increase workforce productivity. Rising employee health costs are a global problem and a growing concern for both providers and payor companies. PayorLink™, which is a system that allows payors to exchange information directly with affiliate providers clinics, medical centres, hospitals, and other healthcare providers, is designed to lower payor health costs, increase staff productivity, and optimize provider claims quality. Enhanced with Employee Health Profiles and Assessment tools to improve staff productivity and wellness.

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

Accelerate your scoping, estimation, and cycle time. Create 360deg 360deg photo tours with detailed 3D in less than 20 seconds per room. Floor plans can be generated in as little as 5 hours. With just a few taps on your smartphone, you can get scope of work reports. Estimates that are compliant with insurance can improve your bottom line. You will find everything you need to accurately document, sketch and scope your estimate. Low upfront costs with maximum time savings, and most bottom line improvements. No complex onboarding or training required. Pick it up and get started. A team of professionals is available to help you, including a 24-hour hotline. Our camera is more accurate and has a smaller margin of error than a phone. Years of industry insight fuel our products, and propel your business to the next level. DocuSketch transforms the restoration industry with cutting-edge software, reducing cycle time, increasing profitability, and expediting claim processing to drive growth and assist.

Startech Software's TotalEclipse™ product offers a fully-featured single-database Claims Management & Medical Bill Review Software Application. TotalEclipse™, the culmination over three years worth of development and testing, was created by real claims adjusters and bill reviewers as well as administration managers who use this critical software every day to do their job. Software is often designed with the user in view. TotalEclipse was developed with our users in mind. The application was built around real-world workflows and focuses on making it easy to access the most important information for the job. Eclipse provides the processing power, functionality, and reporting capabilities that you need to maximize productivity and reduce costs. The single-database backend can be scalable to work with either the Microsoft SQL Server™, or Oracle™.

FINEOS Platform offers clients the only comprehensive SaaS core product suite. It includes FINEOS AdminSuite, which allows for quote to claim administration, as well as FINEOS Engage which supports digital engagement, and FINEOS Intelsight for analytics. Your digital insurance strategy's foundation. FINEOS Platform seamlessly combines FINEOS AdminSuite, FINEOS Engage, FINEOS Insight, and Platform Capabilities to create a modern, single-core insurance platform for Life, Accident, and Health. Legacy core systems used a single-size-fits-all approach to business technology that does not fit the needs of agile businesses. Consumers, brokers, and employers have access to powerful SaaS computing platforms, software tools, and a higher standard for digital strategy for insurers. The monolithic models of insurance software that were used in the past focused only on the details of the insurance contract.

AGO Insurance Software, Inc. is a leader in software and services for property- and casualty insurance companies. We have provided cost-effective business solutions to insurers of all sizes. Our products include solutions to policy administration, claims processing and accounting. Our software will streamline your business operations, making it more productive, efficient, and profitable. Our system is modular and can be installed as either a complete system or as separate modules that can be licensed separately. This allows for collaboration with legacy systems or third-party systems.

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.

DXC Assure is an integrated software solution that helps insurance companies worldwide support digitally-savvy consumers and manage the dual agendas of building the new and tackling legacy. A digital platform for insurance can help accelerate the use of new technology and data sources to support new products. It allows for rapid response to future changes and allows for transformation.

Rapidly analyze and understand episode costs to accelerate your value-based initiatives. Data-driven, evidence-based discussions about episode costs and individual provider practices patterns will increase provider adoption and engagement. Targeting variations in care delivery and provider performance can help drive cost and quality improvements. Analytics can help you guide network optimization and clinical change by empowering value-based strategies. Analyzing episode costs and using clinically validated episode definitions to identify value-based care opportunities. Engage providers in value-based conversations through analysis of utilization, care variations, and costs. Use episode analytics to optimize network designs, improve consumer engagement, and transform clinical guidelines. By defining the average episode cost and the associated clinical services, you can streamline episode budget creation.

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.

Advanced Insurance System (AIS), which is available to all sizes of organizations, is intended to be an out-of the box solution. Customers can also modify and deploy products quickly, while also taking advantage of the wide range of configuration capabilities of the software. This modular integrated system can be used to interface with other platforms or as a complete policy administration solution. It can be used for Personal, Commercial, and Specialty business lines. AIS makes it easy to create new lines. AIS gives agents and insurers the functionality they need to grow their business. AIS provides automation and self-service functionality in a highly competitive market to increase sales and save time. AIS gives you the competitive advantage that you've been searching for.

Snapsheet makes claims simple. We do this through our suite of innovative insurance software solutions which transform insurance companies' ability to seamlessly manage claims, reduce cycle time, increase appraisal accuracy, and deliver payments effortlessly. We started it all with virtual appraisals, and followed that up with our leading claims management system. Today we are driving an industry-wide movement in claims by delivering solutions that enhance customer experiences while our customers create innovative, data-driven claims organizations.

Recordables offers software solutions for managing liability claims. Software solutions for improving claims management, including Auto, General Liability, Property, Incidents, etc. Software that tracks incidents and claims for insurance policies, Recordables Liability, organizes auto, property, general liability policies, and more. TrackAbility offers comprehensive liability claims management software solutions. This software tracks all claims and liabilities. You can create customizable liability claims types using user-selected criteria. Safety professionals and field workers can collaborate on claims and reports, continuing with the addition of photos and videos for incidents and claims. You will have a complete view of financial data that is necessary for claims management. This includes information about payments and losses, as well as data on individuals, locations, policy specifications, etc.

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

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

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.

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.

Venue™, 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.

Our solutions are proven to be successful at Tier 1 carriers and have lower loss costs, lower expenses and higher customer satisfaction. EvolutionIQ is a partnership between highly skilled professional adjusters and a highly specialized predictive guide system that enables the future in claim handling for complex lines. Empowered adjusters can reduce expenses and losses by providing clear prioritization, proactive claim alerts and rich context. A consistent and scalable claim guidance system will reduce the unintended variability in the claims process. This system allows for more efficient use of adjuster resources and less wasted claim reviews. Targeted claim investigations, litigation avoidance, timely claim settlement. Our claims AI harnesses data to provide the tactical guidance your team requires. EvolutionIQ combines unstructured and structured carrier data with third-party data.

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.

ClaimBook facilitates faster settlement of insurance claims, better accountability, and fewer rejections. It has all the necessary features to handle every aspect of the claims and submit evidence. ClaimBook allows international patient treatment through dedicated workflows. This allows for medical tourism. The built-in Rules Engine disallows incomplete submissions and knows which information and documents are required. This ensures that submissions are error-free and complete, and that they have been pre-authorized. ClaimBook's Smart Data Extract can read uploaded documents to extract relevant data from ClaimBook's Hospital Information System (if ClaimBook is integrated with ClaimBook). This will eliminate the need to manually enter data. ClaimBook offers integrated emailing, which allows you to create a virtual mailbox in your dashboard. Emails can be written using the dashboard. The design feature is similar with Microsoft Outlook.

Reduce costs by administering claims in a way that is unparalleled in efficiency and accuracy. Ventiv is a global leader in risk management, insurance claims, and advanced analytics. Ventiv is helping some of the world's biggest brands with products such as our industry-leading risk analytics solution.

Streamlining claims from beginning to end. Integrity, technology, and people are the foundations of this platform. A robust platform for interaction between insurance carriers, MGAs and captives. You can manage your files, deploy applications, and organize claims. Beagle understands the unique challenges that insurance service providers and adjusters face when it comes time to handle claims. Our core software functionality is designed for rapid response to claims, cost reduction, and to streamline the process. Our technology provides efficiency and expertise at every stage of the adjustment process. Express inspection and claim responses that reduce liability, and increase efficiency. New policy inspections and policy renewals. Beagle was designed to handle the daily processes. Claims handling is streamlined by leveraging the most recent technologies, allowing for a more efficient solution.

We transform how you do what you do to empower what you do. Your customers are concerned about how fast you and your company can compete in a market where everything is moving too quickly. Your teams must be able to work quickly and efficiently, rather than waste time sifting through data or manual processing. We can help. We empower your employees with faster, more flexible solutions that increase speed and accuracy. Everything we do is innovative. We are always looking for a better and more efficient way to do something. Ask our AI research lab. Our solution is not universal. Your team's efficiency could be improved by a little customization to address ground-level issues.

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

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.