Insurance claims management software helps insurers manage and evaluate insurance claims. Insurance claims management systems allow agents to manage the claims process with automated workflows, ensuring that all claim details are recorded within a centralized system of record. Claim details can include litigation, negotiation, settlement communications, relevant policy information, and claim assessments. Insurance claims management systems are commonly used by both independent and enterprise insurance agencies to support agents manage their clients’ claims. Insurance claims management products can help insurers reduce claims management costs, reduce fraudulent claims, and enhance customer experience. Insurance claims management products can be implemented either as a standalone solution or as part of an integrated insurance suite.
To qualify for inclusion in the Insurance Claims Management software category, a product must:
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Applied Epic is the industrys most technologically advanced, flexible and secure cloud-based agency management system, providing powerful automation capabilities and a greater level of visibility across an entire book of business. The system offers a single, open application with integrated capabilities to efficiently manage customer relationships, policy and benefits administration, sales automation, and financial accounting processes.
The # 1 ranked Claim management system for independent adjusters, TPA's, MGA's, & Mutual Ins. Co.'s. System does not apply to Public Adjusters. Entire system is based on the input from our 1000's of Users. Integrates with Outlook, Quick Books, Xactimate, Xactanalysis, Symbility, NFIP/NFS, LEDES and Google Maps.
QuickCap is an advanced healthcare claim processing system built for IPAs, PHOs, MSOs and other management organizations. It is designed to process EDI and manual claims, capitation, eligibility, referrals, authorizations, premium billing, case management and other healthcare related items.
A1 Tracker is a customizable claims management software to streamline your businesses. A1 Tracker software covers a vast array of claims management needs, including workflow approvals, notices, letters, and document management. Track approval workflow, costs, payments, and reserves. Offered as fully hosted and self hosted with technical support, data migration, and full training.
DataCare provides software solutions for the workers' compensation industry to better manage medical treatment and billing. Their Medical Process Manager and UR platforms help integrate a medical aspect to the claims workflow and expedite the communication process between the URO and requesting physician.
ClaimBook helps hospitals by accelerating overall discharge process of insurance patients, enhances Hospital revenue collection by increasing effective bed care days in hospitals for new admissions and preventing revenue leakages in payment collections from TPA/Insurance companies. Integration with TPA backends for all TPAs and Hospital HIS systems helps in accelerating the overall claim processing cycle with TPA. Automatic TAT Analysis, Automated TPA Reminders and Aging reports help hospitals to track the TPA aged and defaulted cases.
ACD delivers the leading virtual claims workflow technology that flexes to an auto insurer’s specific business needs. ACD's AutoLink® incorporates multi-channel methods of inspection into one, unified platform. ACD provides mobile self-service photo estimating, the largest crowdsourced on-demand field appraisal network, collision repair shops and salvage - all to help lower costs, deliver faster cycle times, improve accuracy and increase customer satisfaction.
Web based P&C Claims Administration System supporting a wide range of claim processing requirements. TPA, SIR Entities, Risk Managers. Client-centric workflow, Email integration, Messaging and Alerts, Shared Calendar, Litigation Support, Document Management - store any format including MP3 and DVD, Form Letters, Stat Reporting, Robust Transaction Processing - Reserving, Payment/Check Issuance and Recoveries.
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.
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.
IMS is an industry-leading claims/risk management system, covering all commercial lines including P&C, workers' compensation, auto, and general liability. IMS accurately manages the entire claims lifecycle, from first report of incident through issuing payments and collections.
Robotic Process Automation (RPA) is designed to enable insurers to direct more resources into key activities like enrolling more customers and adjudicating insurance claims.