Alternatives to TotalEclipse

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.

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

AZZLY Rize is the premier clinical and business platform for addiction treatment and mental health organizations. As a modern technology platform, AZZLY Rize is a system that can scale with you. Use as little or as many of the features and functions available based on your program and staff needs. Key features for OUTPATIENT Programs include e-check-in, scheduling, appointment reminder, Zoom telehealth, treatment plans, progress notes, assessments and surveys. For RESIDENTIAL Programs: census, medication management, bed board, withdrawal management, DrFirst e-prescribing, EPCS, PDMP and labs. For all Programs: alerts, patient engagement, 5 star implementation and support services, and seamless electronic billing and claims submission. As a true all-in-one platform, we empower treatment centers to take control of their compliance and revenue cycle management and reporting requirements. As a purpose-built tool for mental health and substance use disorder programs, we offer a flexible pricing plan to replace dated technology. Use our compliant Master Library of Forms or we configure your documentation forms to match what you use today. Hosted in Microsoft Azure Private Cloud Network for added security and HIPAA privacy.

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.

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.

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.

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.

myClaimStatus is the best tool for your staff to save time and reduce waste. You can get real-time, actionable information about all your claims. myClaimStatus's suite data tools makes it easier to reconcile claims faster. It doesn't really matter how small or large you are. MyClaimStatus allows you to save more on every claim. Are you efficient in your work? MedX medical claims services use robotic process automation in order to maximize workflow efficiency. You can easily reconcile reimbursement rates and your contracted amount to ensure you get what you deserve. You can drill down to see real-time data on every healthcare claim from any payer, regardless of the dollar amount. This is not your typical healthcare claims processing software. Optimize AR follow up activities to work by exception, and get more done in a shorter time.

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.

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 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.

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.

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.

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.

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.

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.

This product is an all-in-one claims system. The product's primary functions include claims adjudication, claim workflow, and payment disbursement. Flexible design allows for the addition of adjudication modules to be added on a per-line basis. The core functionality of the system is reused for each new line of business. This system makes use of the user-friendly windows screen design and uses a relational database to store data within the system. Powerbuilder is the software platform. It can be used with an SQL database like Sybase or Oracle. This combination of software allows for a client-server based environment that can process large amounts of claims. Installation and training are provided. Source code is included in the license fee. Expert staff can customize the system and tailor it to the client's requirements. All modifications can be made with detailed design and support for acceptance testing.

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.

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.

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.

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).

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.

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.

Risk Manager uses Microsoft SQL Server, which allows the creation of custom views or queries for reporting purposes. ODBC-compliant applications can also be used without dependence on ERIC Systems. Risk Manager is constantly under development. Updates are published regularly. Our policy regarding updating is simple. We provide newer versions without additional charges to the standard technical support agreement. User logins are given dollar limits for individual check or reserve transactions. You can not exceed the total paid to date or total incurred thresholds at the enterprise level without acknowledgment. Client suggestions are the basis of our policy for developing new program features and standard reporting.

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

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.

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.

Quick Silver Systems' Mercury allows Automobile, Property, and Casualty insurers to rate, quote, bind, make payment, and report claims online. Online document access, bill payments and the first notice of loss will reduce customer service calls. Modular API-based system allows seamless integration to existing or new data providers. Digital document production is possible and the system can be used on any device. Our visual work-flow creator allows you to create custom, event-driven work-flows. Get the most current information about Written, Earned and Unearned premiums. You can automatically save every page, card and report to share with associates. You can collect currency in any digital format, including ACH, EFT and Electronic Checks, Credit or Bank Card.

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.

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.

FACTS®, a family of products, supports multiple lines of business within a single system: Health, Indemnity, TPA, PPO, HMO, PHO, IPA, MSO, Group Administration, COBRA, section 125-Integrated Flexible Benefits, Workers' Compensation with Integrated Managed care for 24-hour coverage. The FACTS®, system infrastructure was built on HIPAA-compliant standards since the inception. FACTS®, is fully committed to providing a clear and simple path to HIPAA compliance - well ahead the federally mandated compliance deadlines. FACTS®, a fully integrated, interactive Internet-based and voice-based system, provides healthcare professionals with 24 x7 access to claims and benefit information. It also allows for real-time transactions like EDI claim uploads.

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.

Users can provide real-time rates, contracts and dealer menus via eRating or eContracting. Users can issue policies with electronic signatures, and present products to customers through their own sales channels or their partners. Our network has 140+ partners that allow dealers to connect to the eMenu and DMS systems of their choice. Our policy administration software allows for billing, commissions and cancellations. This allows for seamless coverage rating, contracting and contract remittance. Integrating with your accounting system allows you to create, manage, modify, and change your agents, dealers and coverages. Your agents also have direct access to our Agent Portal. The F&I software allows the Dealer Principal and Field Representatives to access integrated reports for F&I forecasting, sales, and overall dealership performance in real time with powerful analytics.

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

Our software is built with industry knowledge and expert consulting. This knowledge is used to inform the business processes that are to be integrated into our platform. 360 provides end-to-end claims management transparency and integrity, which allows our clients to lower the total cost of their claims. Our clients get better results by using cost-effective technology that transforms the way they do business. Our software is customizable to meet the needs of our clients. It can also be integrated into existing systems to facilitate integration. This allows for in-house resources to support value-added activities that help businesses differentiate and grow.

This application automates repricing claims in a Web-based environment. WebCR verifies provider participation, validates dates and identifies duplicate claims. WebDM, a data management system that ensures accuracy and currency of data, supports it. This application automates the repricing and pricing of claims in a client/server setting. WebCRX verifies provider coverage and patient participation, validates dates and identifies duplicate claims.

ALYCE is designed for self-insureds and municipalities. It handles Workers' Compensation, Auto Liability and Auto Property claims. ALYCE's intuitive design features important data elements on the main claim pages, including the financial summary. All other details are available with a quick scroll, or a single click. Multi-tiered infrastructure to meet employer reporting requirements, based upon locations and departments. Recoveries, including salvage and subrogation as well as excess carrier payments. Automated repeating and scheduled payments with diary alerts. Automated diaries based upon events, financial transactions, and time lines. Automatic generation of form letters for claimants, lawyers, or other claim parties

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.