Alternatives to SSI Claims Director

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.

Independent practices require complete solutions to maximize provider and patient well-being. Each Tebra product is designed to modernize and optimize the patient-practice journey. The combined platform provides a complete operating platform that offers added value for patients and providers. Connect your practice with everything you need to keep current patients happy and attract new patients. Transform your practice by empowering patients through every communication touchpoint. Deliver a unique frictionless experience that is easy to use and builds trust. Modern, certified EHR system that meets the needs of today's provider. Delivers everything your practice requires. Providers have full control over how they deliver care, thanks to eRx, ELabs, and robust charting.

OpenPM offers a fully integrated billing and claims management system that automates accounts receivables management while producing extensive reports to help you better manage your organization. As a browser-based application, OpenPM provides a level of access to your system never before possible. Our real-time claims management features will improve your cash flow and streamline billing and claims follow-up processes. We welcome you to explore OpenPM further and contact us for a customized demonstration for your practice. Medical billing software, revenue cycle management solutions, practice management software, practice management system, medical practice management, EMR integration, EHR integration, practice management scheduling, patient scheduling, online patient billing, patient billing, automatic patient billing and payments, patient payments, electronic patient payments

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.

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.

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.

Keep revenue flowing by using a powerful tool to speed up reimbursements. It includes eligibility checks, claims tracking, audits, appeals, remittance and remittance administration for both government and commercial claims. Use an advanced rules engine to instantly scrub claims against the latest CMS and commercial payers rules. This allows you to correct any errors before claims are sent out. Verify eligibility for all payers when uploading claims and flag errors to edit before submission. Automated workflows for audit responses and appeal submissions as well as ADR tracking will reduce days in A/R. Customize staff workflows based on claim type and action required. Automate the submission of secondary claims to prevent late filings. Automated workflows can increase revenue by increasing audit and appeal success rates.

Collaboration for patient care requires constant connectivity. It is important to simplify how you exchange this information with your payers. Availity makes it easy for payers to work together, from the initial check of a patient’s eligibility to the final resolution of your reimbursement. You need quick and easy access to information about your health plan. With Availity Essentials, a free, health-plan-sponsored solution, providers can enjoy real-time information exchange with many of the payers they work with every day. Availity Essentials Pro, a premium, all-payer option, is also available to providers by Availity. Essentials Pro can improve revenue cycle performance, reduce claim rejections, and help to capture patient payments. So you can concentrate on patient care, Availity will remain your trusted source for payer information. Providers can integrate HIPAA transactions into their PMS through our electronic data interchange (EDI), clearinghouse, and API products.

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.

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.

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.

The first intelligent, multi-specialty software for medical billing. Over 75,000 physicians have used the software to streamline billing and patient collections. Globalized data eliminates duplicate entry. Visit-driven data allows for complex and large volumes of information. Flexible data structure allows for multiple specialties and practices to meet their requirements. We make it easier to get paid faster. You can either send payment electronically or manually. Automatically scrub claims for missing or incorrect information. Based on a set of criteria, automatically refile insurance claims. Rapid review to assess and approve charges. Audit charges by modality and procedure, insurance, user or date of service. For tracking your financial health, intuitive reports are available. Never lose another payment again. Integrates with your preferred clearinghouse, statement vendor.

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.

Accelerate payment and reduce administrative burdens. Our claims management solutions, which have a network of 8,000+ payers and a long-standing partnership with 650+ practice managers, can lead to fewer pending cases and less manual intervention. Transmit professional, institutional dental, workers compensation, and other claims quickly and accurately for fast reimbursement. Provide a simple and seamless financial experience to meet the shift towards healthcare consumerism. Our patient engagement solutions enable you to have informed discussions about eligibility and financial responsibility, while reducing obstacles that could impact patient outcomes.

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.

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.

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.

Our total clinic solution streamlines workflow and speeds cash flow. Our team of revenue and medical billing experts can help practices see improvements in their bottom lines, including fixed-cost reductions. Partnering with our revenue services team will give you more time to concentrate on patient care and engagement, which is what you do best.

Your bottom line and overall success of your organization will depend on how well you manage your revenue cycle. It doesn't matter how many people seek your services, if it takes months to get the expected payments. You don't need to spend hours tracking down the payments that you have worked so hard for. There is a better way than the traditional to maximize healthcare reimbursement. Quadax can help you create a strategic plan that is sustainable, scalable, and manageable. We will also help you select the best technology solutions and services to fit your business model. You can improve patient experience, financial performance, and operational efficiency with us as your partner.

Veradigm Payerpath, an end-to–end revenue cycle management suite, is designed to help organizations improve revenue, streamline communications with payers, patients, and boost practice profitability for all sizes and specialties. To ensure a clean claim submission, eliminate missing information, incorrect code, and data entry errors. Make sure claims are submitted correctly coded, contain no missing information, are error-free, and have no missing information. Compare performance to peers at the national, state, and specialty levels to maximize productivity and improve financial performance. Notify patients about their appointments and confirm their benefits and insurance coverage. Automate billing and collection of patient liability. Veradigm Payerpath integrate solutions are practice management (PM-agnostic) and interoperable seamlessly with all major PM system.

The eligibility checker does it all: It checks the financial eligibility of patients, runs their insurance analysis, and monitors discrepancies. Our scrubber, which uses deep AI&ML algorithms, is capable of removing errors in data, whether it's coding errors, incorrect or incomplete patient financial information. The software has 3.5 million edits stored in its memory. To streamline the process further, automatic updates from the clearing house are sent to inform the status of claims in-process. The system covers the entire billing spectrum, from verifying patient financials to working with denied or lost claims. It also has a thorough follow-up feature. Our intuitive system warns you if a claim is at risk of being denied and takes corrective action to prevent this. It can also track and appeal for lost or denied claims.

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.

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.

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.

The adjudication program is the core of PBM Express. Claims go through hundreds of edits to ensure accurate processing results, regardless how difficult the plan design is. The parameter drive program allows for a flexible architecture that allows clients to customize as required. Laker's innovative software solution delivers superior performance and industry-leading uptime to clients. Laker is a technology leader and continually improves its systems to meet our customers' growing needs. Customers of Laker have the advantage of the most efficient, flexible, and durable system on the market. Laker works closely alongside our customers to develop and test new products that allow them to compete and win new business. Both Laker and our customers have the best interests to make changes to the software quickly and efficiently to allow for this growth.

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.

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.

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.

QuickCap by MedVision Solutions is an administrative and clinical process management solution that allows users to focus on the business, not paperwork. QuickCap gives users scalable control over their workflows and information, allowing them to work smarter. QuickCap provides users with a customizable dashboard that allows them to control their workflow and automate their processes for speed. QuickCap makes claims processing easier and streamlines it. QuickCap allows users to quickly determine profitability for individual providers using analytics.

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™.

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.

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.

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.

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.

Zentist is an advanced technology platform that automates insurance revenue cycle management (RCM), for dental practices. Zentist uses machine learning and robotic process automation (RPA), to automate tedious billing tasks at a time when dental practices are losing an estimated $2.1 million due to legacy billing systems. Zentist's platform can be easily scaled to meet the increasingly complex billing needs of modern dentistry, which has seen a lot of consolidation and unprecedented pressures to scale RCM. It minimizes human error, maximizes insurance payouts, provides advanced analytics on revenues, and improves patient-provider relationships.

DrChrono's all-in-one medical practice management, electronic medical records and medical billing platform will help you increase efficiency in your medical practice. DrChrono empowers doctors to better serve patients with its simple interface and dozens more advanced features. Users can easily schedule patient appointments, edit and check patient charts, and manage billing.

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.

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.

Centauri Health Solutions, a healthcare technology and service company, is driven by the desire to make healthcare more efficient for our clients and provide compassionate support to those in need. Our software, powered by analytics, allows hospitals and health plans (Medicare and Medicaid, Exchange and Commercial), to manage their variable income through a custom-built workflow platform. Our tailored support for their members and patients gives them access to life-enhancing benefits. Our solutions include Risk Adjustment, Medical Record Retrieval and Medical Record Coding, Analytics, RAPS/EDPS Submissions, HEDIS®, and Stars Quality Program Management. Clinical Data Exchange, Eligibility, Enrollment, Eligibility, and Revenue Cycle Analytics. Referral Management & Analytics. Social Determinants of health.

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.

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.

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.

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.

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.

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.

eClaimStatus offers simple, cost-effective, efficient, and cost-effective real-time Medical Insurance Eligibility Verification system. Claim Status solutions are designed to create value added healthcare environments. Medical practitioners need to be vigilant about their revenue and avoid any payment leakages at a time when healthcare insurers are cutting reimbursement rates. Inaccurate eligibility verification can lead to more than 75% of claim rejections or denials by payers. Refiling rejected claims can cost organizations $50,000 to $250,000 annually in net revenue (HFMA.org). You need a simple, affordable, and reliable software to verify and track your health insurance claims. These are the specific challenges that eClaimStatus was created to address.

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.

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.

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.

Like many other tasks, insurance payment posting falls under the 80/20 rule. The 20% of your payments that are still deposited from paper EOBs make up at least 80% of the overall payment post work. POWEReob is a better option. POWEReob is a combination software and a pay per transaction service that converts paper EOBs from certain payers into electronic remittances file in the ANSI-835 or NSF formats. These files can be used to automate payment posting to your practice management software as well as electronic secondary claims billing. POWEReob will work with any practice management that accepts remittances files from third party sources (not only from their designated clearinghouse). We will work with any practice management that accepts electronic remittances.