Alternatives to omni:us

Macaw AMS can be used to sell Insurance. Macaw AMS can be used by brokers, MGAs or MGUs, Program Managers, and Lloyds Coverholders to automate their operations. Macaw AMS was built with a customer-centric approach. It supports CRM, Sales and Underwriting. Customers, producers, and service providers can access self-service portals. Macaw AMS has built-in Document Management and Task Management capabilities. It is equipped with adaptors that allow for integrated and in-flow services such as eSignature, Payments, OFAC checks, Mass Emailing, Computer Telephony, and Mass Emailing, using 3rd Party Services. The data analytics part of Macaw AMS offers powerful data visualization with predefined dashboards, allowing users to easily upload datasets and view dynamic charts for clear, multi-dimensional insights. Interactive, real-time visualizations help uncover trends and insights, driving informed decision-making. Macaw AMS is hosted on cloud and tested for cybersecurity. The database is relational, and the core components of the Java-based application are written in Java. Macaw AMS is capable of processing 500-1000 policies per day at its peak. Macaw AMS is expected reduce per policy costs by 30%.

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.

APP Tech pioneered the incident-based approach to claims and risk management. Since 2003, we’ve delivered integrated technology solutions to hundreds of customers across North America — to improve claims-management efficiency and scalability, increase visibility, shorten response times, lower premiums, and prevent risk events. Cloud Claims by APP Tech is a top-rated risk management and claims software solution. IMS is a purpose-built software solution for self-insureds, TPAs, and companies who want to track their claims and losses. It helps users manage the entire claim lifecycle, from the initial incident report to issuing payments and collections. It offers a variety of features that allow users to have complete control over their claims, as well as risk information. These include incident management and claims management, workgroup tools as well as reporting, insurance tracking, and many other features. We’re proud of our 100 percent implementation-success rate and excellent customer-retention rate, a result of our commitment to understanding our clients’ needs and rolling out solutions that work for them.

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.

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.

Filing claims is a complex and crucial process. Because of its complexity and time-consuming nature, more than 60% of people don't file complex claims. Artivatic's dedicated claims platform allows insurance companies to facilitate digital claims journeys, self claims processing, automated risk assessment, fraud intelligence, claims payout, and self-claims processing. ALL YOUR CLAIMS NEEDS CAN BE MET IN ONE PLATFORM. End to End Claims Automation and Assessment Platform AUTO CLAIMS – HEALTH CLAIMS – TRAVEL CLAIMS – ACCIDENTAL ClAIMS ­ DEATH CLAIMS – FIRE CLAIMS SME CLAIMS — BUSINESS CLAIMS ­ COMMERCIALCLAIMS

Claims Manager is a complete, integrated RIMS system that streamlines your process from FNOL through settlement. Unique, configurable business rules engine automates workflow. It reduces duplicate and manual work, saves time, improves outcomes, and increases the value for all parties. Claims Manager's integrated solutions simplify workflow by allowing you to manage, adjust, and report on your property and casualty insurance claims. Claims Manager is an easy-to-use Risk Management Information System that provides tomorrow's solutions. Its intuitive interface seamlessly integrates into an automated workflow that can be accessed from any device, anytime, anywhere. It allows you to easily capture, benchmark and administer claims for all lines property and casualty insurance.

Innovator, connector, and leader in the insurance industry. We offer the UK's most comprehensive straight-through processing platform. Find out how our digital platform can help you meet your business needs. A digital experience that is seamless and agile will drive business transformation. Improved productivity is possible through the use of adviser and consumer self-service tools. Continual engagement with customers will result in a higher customer lifetime value. Customers and Adviser Portals allow customers to access policy documentation and make changes digitally in real-time. The components cover every aspect of the user experience, including full reinsurance reporting and integration with external portals and automated and clerical Underwriting. Flexible deployment - from complete deployment of the SSG Digital platform to individual components that can be integrated (e.g. Only underwriting, New Business only

One Inc is a single platform that allows insurance companies to process claims payments and premiums. It's the only solution that you need to provide a seamless payment experience. ClaimsPay® allows you to pay claims digitally and close claims faster. Digital claims payments can be delivered through preferred payment channels and methods to increase customer retention, reduce operating costs, and reduce compliance risk. You can give policyholders the digital payment options that they need without having to change your core systems or processes. Securely capture payment information without it being stored on your network. Reporting and reconciliation are quick, simple, and painless. You can put money back in your pocket by electronically processing outbound and inbound payments. No more long-winded paper checks or manual reconciliation and reporting.

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.

CaseGlide is the leader in claims litigation management. Gone are the days when claims management was disconnected and siloed, manual and inefficient workflows, hundreds of emails between defense counsel and claims teams, and unstructured case data, are gone. CaseGlide allows you to focus on strategy, data, efficiency, and improving your litigation management program. Our clients can better predict and manage the outcome of their cases, assign the right attorneys for the right cases, work more strategically and reduce litigation costs. Integrations allow you to send important case data to your data warehouse, data warehouse, document management or accounts payable systems as your defense attorney partners work on your cases in the platform. It's easy to see that the longer a case remains open, the more expensive it will be.

Expert makes it easy for agents to work with you and your insureds. Expert is a key asset to your company and will help you retain and grow it. Switch to [dot]Expert to make your company Grellow. This flexible and easy-to-use software allows you to manage every aspect of a policy's lifetime. You have complete control over your policy rating, management and underwriting. Automate your routine while reducing operational costs by batch processing and automation. A comprehensive report library displays all the data you need from your business. You can improve customer satisfaction by making claims processing faster and making it easier for agents and insurers to access the data.

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.

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.

A modern, rules-based solution for life insurance policy administration that supports new business underwriting and policy issuance, billing and collections, and claims processing for Individual Life, Annuity, and Group Insurance, all from one platform. For optimal long-term efficiency, consolidate your policy processes to rethink your business. A rule-based, digital life insurance policy management system allows you to scale up or down and creates a digital ecosystem that improves customer experience. A highly flexible, rules-driven policy administration system allows you to quickly set up, manage, and bring your group insurance products to market. A single platform for managing life insurance policies, individual and group. It creates hybrid products and works with other businesses. A componentized solution increases business agility by sharing business rules. This will increase speed to market, drive process automation, and reduce operational costs.

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.

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.

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.

RMIS is designed to provide insight and results. Empower your employees with the RMIS to drive productivity, reduce total risk costs and deliver insight. Active risk management is the strategy of empowering your employees to manage risk more effectively by leveraging technology which is centralized and connected, scalable and data-driven. Aclaimant’s centralized system connects your risk office with incidents on the ground, allowing you to successfully reduce accidents, claim lag times and case duration. Reduce the cost of your claims by improving prevention and mitigation. This will improve your insuranceability. Automated, mobile-first technology and automation will help you better utilize your superior safety and risk talent. Aclaimant improves the morale and retention of your team and keeps them focused. Access case studies and other content to learn how to put the Aclaimant platform into action for you and your staff.

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

Auto insurers require tools to make physical damage claims processing easier, from the first notice (FNOL), to settlement. Mitchell WorkCenter is a modular, open-ended solution that allows you customize the modules and integrations to meet your business needs. You will achieve better results through increased accuracy and efficiency while lowering your total cost of ownership. Our platform allows you to send and receive all information directly into your claims management system. Mitchell WorkCenter integration is simple for IT departments. Mitchell WorkCenter has a track record of completing projects in less than 90 days. There are no two businesses the same. WorkCenter allows you to configure and manage your software according to your business needs. You can access the entire suite or choose specific features that will best fit your claims management workflow.

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.

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.

Polygonal takes the strengths and rich functionality of previous versions and combines them with the most recent Microsoft VB.Net technology and Business Intelligence technology. This comprehensive solution is able to quickly and efficiently respond to the changing market. Polygonal is a modular, multi-currency software solution for underwriting, policy/claims management, transactions, and reinsurance. It integrates with accounting, messaging, document management, document management, and workflow modules to provide an end-to-end business process that delivers tangible results. Polygonal was designed using City Computers' specialist team. As both solution providers and practitioners, we have many years of experience in the insurance industry.

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.

We can help you build and launch new products, improve your operations efficiency, or gain a better understanding of your clients to improve customer experience. More than 40 years of experience in the general market will help you connect brokers and MGAs to insurers to provide the best personal and commercial insurance lines. Reliable software will allow you to expand your business and bring new lines of business to the market. A team of experts will assist you in solving your specific problems, increasing efficiency, revenue, and reducing operating costs. You'll receive guidance throughout the design, build, and delivery phases and beyond.

Unified solution that provides a 360o view of all aspects of the P&C insurance lifecycle. A powerful, rules-based, multistate underwriting module automates the collection and creation of quotes, endorsements and cancellations. It also saves time and allows you to generate premium. A modern, streamlined and collaborative approach to claims adjudication reduces combined ratios. Facilitating information exchange with brokers can help increase business. From streamlining and standardizing information intake to giving brokers access to the information they require at any time, You can control which submissions your underwriters are looking at. Your policy holders will be able to access their policy information, claim intake and review, and online bill payment. This will increase customer satisfaction and retention. You choose the features you offer your customers to ensure the best user experience.

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

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

AUSIS (Full-stack Behavioral underwriting) AUSIS allows insurance companies to offer in-depth underwriting, scoring and decisions in real time. AUSIS reduces cost, time, risk, fraud, and increases efficiency, decision power, alternative score, and more. AUSIS increases STP from NSTP. It also allows non-invasive methods to aggregate health data from AQI and Location, Mortality and Social, Photo, Video and Health Devices. Weather, Sanitation, and more. AUSIS can reduce the policy issuance cost by up to 40%

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

To win and satisfy today's empowered customers, you need the right process foundations to support your digital business. Fadata's connected solutions will keep you in the game. Today's insurers are searching for the right digital business foundations. This includes the ability to quickly respond to new business opportunities, easy connectivity, and other capabilities that will help them stay ahead. Fadata's insurance platform, INSIS (Insurance Process Platform) is the most comprehensive and comprehensive solution across all major lines. INSIS allows you to release products faster, increase engagement with customers and partners, speed up processes, improve operational control and compliance, and make them more efficient. All capabilities are integrated on one platform that is highly flexible.

Agility is the only way to respond. The Tia Solution was designed to meet the ever-changing requirements of niche, major league, and mid-sized insurers who want to bundle services and promote them for better customer engagement. Think standardization and automation. Think machine learning and artificial intelligence. And think: Software-as-a-Service, IoT, open source and REST APIs. Our digital ecosystem allows you to cover every link in every insurance value chain and lets you pick the modules that you need to communicate with users. Over 20 years of experience in developing insurance software have taught us that change is the only constant. Software that helps insurers around the world target their users quickly, and not just the system requirements, is what we develop. We are proud of our Scandinavian heritage and listen before we launch. Then we turn our meticulous attention into new design standards. In close collaboration with customers, partners, and peers, we are creating the future of insurance.

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.

Kanverse AP Invoice Automation platform intelligently automates document processing workflows for enterprises. Kanverse brings together multiple AI technologies - Computer Vision, Natural Language Processing, Machine Learning, and Fuzzy Logic, along with Business rules and workflows to accomplish end to end automation. Automate invoice and other accounting documents ingestion, extraction, processing, validation, and publish processed data to downstream business applications (e.g., Oracle EBS, Oracle Fusion, NetSuite, Microsoft Dynamics, Majesco, etc.) Kanverse AI engine combines multiple cutting-edge technologies which deliver up to 99.5% data extraction accuracy: out-of-the-box Leverage AI and automation to process a multitude of document types; convert unstructured and skewed data into actionable insights and reduce operational costs across business processes. Intelligent automation eliminates manual, repetitive, and time-consuming activities; staffs, can focus on other business-critical activities. Also, helps to Protect PII Data and Prevent Fraud.

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.

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

The transaction costs of vouchers are reduced by efficient checks, integrated expertise, and high levels of automation. Sumex Core is the foundation for automated electronic invoice verification. It includes the business components and workflows that can be assembled and parameterized in modular fashion. Effective invoice verification is possible only if the reference data and tariff are current and accurate. Sumex reference data are compiled from publicly accessible sources, processed in a timely fashion, and made available on Sumex tariff server. The data can also be accessed by experts within the context of current billing. DRG Expert supports the control of billing for services in acute healthcare, as per SwissDRG regulations. DRG Expert provides case data within the context of regulations, includes statistical key figures, and offers what-if analyses.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Damco's InsureEdge Insurance Software is an all-in one software designed to help insurance companies gain maximum value from its extensive modules. This highly configurable and customizable software features the best insurance processing functions in the industry. InsureEdge is suitable for multiple insurance lines and can efficiently and effectively manage and streamline workflows to increase profitability, performance, and accuracy. It supports a variety daily operations via back office automation and other modules such as customer relationship management, policy administration and claims processing. InsureEdge, an insurance software that is flexible and scalable, is the key to future-proofing your business.

Software for specialist insurance broking management. Software engineers built it. Software solution for insurance policy administration. Customer relationship management (CRM). Manage personal and commercial clients with multiple addresses and contact information. Monitor communication and drive marketing. Track and manage multiple policies and quotes. Record detailed risk information. Automate underwriters' quote requests. Record, manage and report on insurance claims. Prepare custom financial reports. Enforce FCA compliant documentation. Clear visibility of client data, with quick access to more detail. Ability to view multiple clients simultaneously. Visualize the location of your client and plot geographical data such as flood or subsidence. Customer service is easier when you have easy access to client information. Document storage and processing. Integrated workflow tasks, events, and notes.