Alternatives to QuickCap

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

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.

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

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™.

HealthAxis provides integrated solutions to payers, providers, and health organizations. These integrated solutions include an advanced claims processing system, TPA services, and actionable analytics. We simplify operations and improve patient and client outcomes. Healthcare is becoming more technologically connected, but it is still hindered by legacy technology, coordination problems, and information management. We aim to bring innovation to those who are struggling with these issues. Our client philosophy is to be a complete business partner. HealthAxis believes that our success is not based on selling our solutions, but rather on our business partners' continued success and growth. We empower our partners to bring value to the communities that they serve. We thrive with them as they grow their membership and expand their scope. Each member of our team is aware of their responsibility to help our partners realize their potential.

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.

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.

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

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.

Analytics-driven claims and remittance management software for healthcare providers. It is designed to automate workflows, increase resource utilization, prevent denials and accelerate cash flow. Your first pass claim acceptance rate will increase. Our comprehensive edits package will help you keep up to date with changes in payer rules and regulations. Automated tasks and intuitive workflows that are exception-based will increase productivity. Our flexible, cloud-based technology is available to your staff from any computer. Automated generation of secondary claims and explanations of benefits (EOB), from the primary remittance advisor, will help you manage your secondary claims volume. Predictive artificial intelligence (PAI) helps you focus on the claims that are most urgent. Avoid denials and errors before submission. You can process claims faster. Print and deliver primary paper claims. Collated claims and EOBs can be added for secondary claims.

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.

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.

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.

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.

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.

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.

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

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.

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.

Oracle's Digital Insurance Platform empowers insurers to deliver innovative solutions, and create exceptional digital customer experiences. This comprehensive insurance system streamlines operations, from sales channels to the back-office. It allows for rapid deployment of new products and seamless implementation of required changes. Real-time analytics provide insurers with valuable insights, allowing them to make informed decisions. The platform is designed to support both individual and group annuity and life insurance. It consolidates underwriting, policy processing and billing into a single system. Health insurers can benefit from simplified enrollments and premium billing. They also get to adjudicate claims more efficiently. This increases member satisfaction by providing transparent and personalized service. The platform also accelerates the lifecycle of bancassurance by ensuring real-time connectivity between insurers and banks, ensuring speed and consistency.

Amazing Charts Practice Management, a comprehensive solution for independent medical practices, is designed to streamline administrative tasks. This system was developed by a practicing doctor to automate processes such as capturing demographics of patients, scheduling appointments, checking insurance eligibility, and generating reports. It also determines the patient's financial responsibility at the point-of-care, maintains insurance payers lists, and ensures accurate and prompt billing to aid in payment collection efforts. The system has several key features, including the ability to view unpaid claim to ensure timely resolution. A claims manager reviews submissions to minimize denials. The system provides intelligent, interactive dashboards based on roles that automatically prioritize tasks across all office areas.

Wisedocs document processing platform features allow insurance companies, independent medical assessment firms, and legal entities process claims with greater speed, accuracy, efficiency, and precision. Automatically organized medical records according to date, service provider title, and category. Automatic page duplication saves up to 30% in time and money. Medical record sorting and reviewing can be a difficult administrative task. Wisedocs makes it easy for insurance, legal and medical firms to automate medical record reviews. Wisedocs creates a medical record index that is organized based on your needs. From the intelligent summary and medical record review, you can get important insights as well as easily searchable and indexed records.

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.

PwC SMART (Systematic monitoring and review technology) improves the efficiency and effectiveness in your inpatient and outpatient quality evaluation processes and allows for a mechanism to ensure quality and compliance review. SMART, along with the support of PwC Health Information Advisory will help you monitor coding quality and data quality. SMART Inpatient has over 1,000 pre-defined business rules which help to identify potential coding errors and document improvement opportunities. You can also modify business rules to suit your particular areas of interest. Data analysis and reporting help you assess the performance of your staff and identify education opportunities for Coding, Quality, and Providers. SMART Outpatient improves accuracy and identifies areas for workflow improvement and charge capture issues. It improves regulatory compliance and reduces the risk of incorrect coding.

Easily manage revenue cycle management, quality of care management, and staff management with a single sign-on portal. Our innovative tools simplify complex operations throughout the patient care journey for more than 47,000 providers sites. Inovalon's Provider Cloud simplifies administrative and clinical complexities, while improving the patient experience. Our SaaS-based solutions can help you improve financial and clinical outcomes throughout the patient journey. From creating front-end and back-end revenue-cycle processes for better reimbursement, to ensuring adequate staffing levels for optimal health care. All of this is managed through a single portal that will take your organization to greater heights in terms of revenue, staff equity and care quality. Enhance the efficiency, productivity and overall effectiveness of your organization. Find out what the Provider Cloud is capable of.

A new and more efficient way to process and settle claims. Modern, end-to–end solutions for settling claims for all lines, including property, liability, workers' compensation, and workers’ compensation insurance. ClaimRuler™, a cloud-based claims management software, is specifically designed for I/A companies and Third-Party administrators, CAT Adjusters and Insurance Carriers, as well as Self-Insureds and Municipalities. The platform allows for end-to-end claims processing. It includes built-in workflows, robust reporting capabilities and a fully automated diary system that streamlines the settlement of claims. ClaimRuler™, was designed to meet the needs of real people within the industry. Its intuitive and functional design makes it easier to work with forms, lists, documents, photos, and other information. ClaimRuler™, which adapts and scales with your organization, can be used by I/A firms, TPAs and insurance carriers, as well as municipalities and self-insured companies.

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.

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.

EXPEFLOW's workflow intelligence unlocks a new normal for hybrid work environments, digital transformation and "paperless" processes. Our no-code workflow intelligence allows your employees to concentrate on customer engagement and growing your company. Workflows are lengthy, manual, and often error-prone processes that require employees to repeatedly try to find missing information or key pieces of data. EXPEFLOW's intelligent QuickStart files help you to focus on your customers while increasing operational accuracy and efficiency. Our platform is completely non-code and you are in complete control. Our user interface makes it easy to design your workflows, without the need for additional resources or developers. To create a better customer experience, engage employees and increase productivity. Flexible workflows are essential because customers and industries are different. Our platform has the expertise and domain knowledge to help you work smarter and better.

bestPT is a cloud-based, complete billing and practice management software. BestPT is a cloud-based software solution that allows private practitioners of all sizes to manage their revenue and payments, as well as track claims. BestPT integrates with webPT and Cedaron EHR systems to streamline billing processes, making the office's workflow easier.

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.

EbixEnterprise, a comprehensive insurance management system, streamlines policy management through its entire lifecycle. EbixEnterprise consists of six components: Customer Relationship Management, Health Insurance Exchange, Policy Administration, Claims Administration, Data Analysis, and a Consumer Web Portal. Each component is seamlessly integrated with the other, allowing data to flow between them as required by the business. SmartOffice CRM allows organizations to manage state license information, broker information, commission rates, sales pipeline information, and agent/broker information. EbixEnterprise's Online Quoting Portal HealthConnect is the most popular health insurance exchange for buyers or sellers of health insurance and employee benefits. EbixEnterprise Administration provides all the tools necessary to manage policies, create plans, maintain plan rates information, and so on.

Context4 Health Plans Suite is a modular, cloud-based technology platform that protects the integrity of your health plans and allows you to accurately price them. Our team of certified clinical, dental, and healthcare professionals provides immediate, defensible Fraud, Waste, and Abuse detection. A combination of accurate data and cutting-edge cloud technology creates a defensible and proven medicare reference-based pricing solution (RBP). Professional support is available to ensure compliance and efficiency with more than 100 healthcare data sets. Advanced medical coding software that expedites claim submission and minimizes denials.

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.

Eligible's APIs make it easy to integrate insurance billing experiences into your applications. These accreditations are a guarantee to patients and providers that Eligible adheres to the highest standards of privacy and security while processing millions upon millions of healthcare cases every month. We understand the importance of a well-established and tested information security program in meeting customer and Eligible goals. We are pleased to announce that our Type II SOC2 review was successful. This certification allows us to assure our customers and all companies with whom we interact that we are fully aware of our responsibilities in protecting protected health information. Your end users will receive exceptional patient insurance billing experiences. Simple APIs allow you to run estimates, verify insurance and file patient claims.

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.

We know that not everyone needs their software to do everything. This is especially true for hospitals, clinics, specialties, and clinics. We have designed systems that can be customized to fit your needs. The user interface (front end) is intuitive and clutter-free. While the back end uses cutting-edge technology and databases engines to ensure that your data is secure and protected, it also makes it easy for users to use. So you get paid the first time! Over 1,200 Ontario doctors, billing agencies, small to large multi-location clinics, hospitals and clinics have used and loved QuickClaim. QuickClaim's finesse gives the impression of a well-designed tool. QuickClaim can fulfill many roles. QuickClaim can be used with QuickReq, QuickDOCs, and third-party systems via flat files and HL7. QuickClaim also acts as an offline version of HYPE Medical in rare instances of Internet failure. It is an offline system that runs independently from the Internet.

KMR Claims Processing manager is a state of the art, fully integrated, customizable, claims processing solution for TPAs and Self-Insured. Our system allows for electronic claims, integrates seamlessly with Document Imaging systems, can process debit cards, and is fully HIPAA compliant.

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.

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.

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.

Aquarium'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.

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.

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.

EMCsoft's Claims Management Ecosystem ensures that healthcare providers and billing firms submit clean claims to insurance companies for proper claim adjudication. It's the integration of our flexible claims processing software Claim Agent, and a comprehensive fitting process called The Four Step Methodology into the claim adjudication process. This approach automates, supports, and facilitates your claim adjudication process in order to maximize claim reimbursement. Request our free online demo for a great introduction into the functionality/features of Claim Agent and how it fits into your claim adjudication process. Claim Agent processes your claims quickly, efficiently, and at a cost-effective rate. The software can be used with any system, making it easy to implement. We offer custom edits, bridge procedures, payer lists, work flow settings, and custom edits for each user.

CaseworksPro is a web-based, affordable claims administration system that can be used to support a wide variety of claim processing needs. CaseworksPro was developed by Insurance Technology Solutions and is designed for carrier claims departments, self insured retentions (SIRs), and third-party administrators. This simple-to-use software offers many features, including SIR client-centric workflows and policy data capture, oneff and scheduled payment, user-defined access permissions and check printing, electronic reporting, NCCI and ISO code capture.

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.

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.

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.

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.