Healthcare claims management software is used to streamline the medical claims process, which eases the relationship between provider and insurance company and efficiently speeds up the patient’s payment lifecycle. These solutions leverage automation features so hospitals and clinics can resolve or prevent any hurdles that can potentially disrupt the claims processing and billing workflow. Healthcare claims management software are sold either as standalone products or bundled within medical billing software, revenue cycle management software, or comprehensive medical practice management software. Users of healthcare claims management software include payers, health care providers, and insurance providers.
To qualify for inclusion in the Healthcare Claims Management category, a product must:
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Kareo makes it easier and more rewarding for you to run an independent medical practice. We offer the only cloud-based, clinical and business management technology platform dedicated to serving the unique needs of independent practices. Our software helps you find and engage with patients, run a smarter business, provide better care, and get paid faster. From the front office to your back-end billing, Kareo Practice Management streamlines the way you work. It’s easy to use and proven powerful by the more than 40,000 providers that trust it for their small practices. Unlike other companies that built their offering for large medical groups or hospitals, Kareo is purpose-built for the work flows and unique needs of the independent practice. The result is an affordably-priced platform without the bells and whistles that you don’t need.
eClinicalWorks Revenue Cycle Management (RCM) Services provides an alternative by allowing our staff of expert billers to handle back-office operations directly through the eClinicalWorks application, securely and accurately. Dashboards provide authorized users with transparency into the process and visibility into your practice’s financial performance in real time.
AdvancedBilling: Drive revenue with ease. All the tools you need to manage your A/R and claims processes in one database. Our robust clearinghouse automates manual processes and improves workflow. ClaimsCenter gives you auto-generated worklists, claims tracking & centralized billing. Easily identify issues with ClaimInspector that automatically scrubs claims for potential errors. Results are astonishing with nearly 100% first-pass claim acceptance. Healthier practice = healthier patients.
A single platform designed to enable cleaner claims, improve communication and speed up reimbursement
ClaimFirst is a market-leading automated Life and Health claim management software solution suitable for Insurance Carriers and Third Party Administrators (TPAs). Offering full lifecycle claim management, this flexible SaaS solution can be integrated into current business and workflow processes resulting in efficient and improved claim processing capability from claim intake, to adjudication, and through to payments. ClaimFirst supports both group and individual policy benefits in the claim management system. The system is claimant centric, and a claim examiner can see all insurance plans for each claimant across all lines of business, including historical claims. ClaimFirst can completely or partially overtake manual processing allowing quick and accurate processing of claims; which will reduce reserves, and improve customer and employee satisfaction. Hosted on Salesforce’s secure and reliable Force.com platform, this cloud-based software provides fast, anywhere anytime access, the flexibility to integrate with other applications, and the scalability to increase capacity as necessary. With fast implementation (in as little as 90 days) and continual software upgrades, ClaimFirst gives you a competitive edge.
Comindware Health Insurance Claims Management software provides for effective claims processing and enables elimination of inconvenient and error-prone paper and email-based operations taking all communications, data and processes into a unified working environment.
Helps you meet pressures with a full range of BPO and turnkey healthcare administration solutions, including advanced technologies and strategic consulting services designed to help you optimize member outcomes, focus on revenues, and manage risk to remain compliant
GeBBS Healthcare Solutions provides tailored revenue cycle management solutions that cut through the complexity with expertise, operational excellence, and a sophisticated approach.
HEALTHsuite is a comprehensive benefit administration system and claims processing software solution designed for health plans administering Medicaid and / or Medicare Advantage benefits. HEALTHsuite is a rules-based auto adjudication software solution designed to automate all aspects of enrollment/eligibility, benefit administration, provider contracting/reimbursement, premium billing, medical management, care management, claims adjudication, customer service, reporting and more.
Healthcare organizations of every size face common bottom-line challenges, including payer requirements, regulatory rules, and the need to manage your own financial process. The key to achieving great end results is strengthening your cash flow and patient billing process.
Delivering on the promise of health information technology, Henry Schein Medical Systems/MicroMD provides simple yet powerful EMR and practice management solutions that facilitate the delivery of superior patient care, automate incentive and quality reporting activities, and streamline operations for today's busy providers.
Oracle Health Insurance Claims Management supports the import, processing, and release of claims for payment. Authorizations can be recorded for the procedures that require permission in advance. Claimed amounts that are a result of an accident can be recovered from third parties
OSP Labs’ first-class healthcare claims management software solutions play a vital role in countering the rising medical claims denial rate and stringent federal regulations. OSP Labs’ medical claims processing software solutions are outfitted with intelligent integration capabilities that work in perfect synergy with existing administration systems, other OSP Labs’ healthcare software solutions, and future cloud-based innovations.
Parascript automates the extraction of meaningful, contextual data from image and document-based information to support transactions, information governance, fraud prevention, and business processes. Parascript software processes any document with any data from any source with its easy-to-use, image-based analysis, classification, data location, and extraction technology.
ProtoMED™ Practice Management Software tool offers the nation’s first Web-based electronic claims product that automatically links insurance claims with Medicare and BCBS payors who offers direct claims processing – There are no clearing house fees associated with this electronic processing! This scalable desktop solution provides complete medical management, sophisticated Claims Management Tools and Real-Time Billing solutions to your practice or facility.
Maximize all sources of revenue, reduce cost and expedite payment with a simplified and unified platform that integrates payment processing across HIS, PM and EMR systems—unlocking unprecedented, actionable insights for improved revenue cycle performance. No matter the size or scope of your organization, we can help you save time and effort so you can get back to helping those who need it most.