Best Healthcare Claims Management Software

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:

  • Digitize the submission of claims
  • Streamline interaction between health care providers and health insurance agencies
  • Mine the databases that maintain patient medical data
  • Comply with regulatory and industry standards like HIPAA
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    Kareo
    (48)4.5 out of 5
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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

    athenahealth is a leading provider of network-enabled services and mobile applications for medical groups and health systems.

    Availity solves the communication challenges between healthcare stakeholders, creating a more transparent exchange of information between health plans, providers, and technology partners.

    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.

    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.

    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.

    CareCloud helps medical practices manage patients to payers and everything in-between. CareCloud's cloud-based platform helps high-performing medical practices grow by improving efficiency, increasing margins and optimizing the patient experience. Our comprehensive suite of tools covers patient management, revenue cycle management (RCM), electronic health records (EHR) and patient experience management. For more information, visit www.carecloud.com.

    The HSP Payer Suite provides a single-source database, core administrative system, web portals, and open system with web services to quickly automate current and future healthcare regulations and business processing requirements.

    LexisNexis MarketView delivers medical claims-based intelligence to healthcare organizations across the United States.

    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.

    TriZetto offers consulting, IT, and business process solutions to streamline the deployment and adoption of technologies and improve operations for payers and providers in the health care industry. TriZetto solutions are designed to improve efficiency, accuracy, compliance, and results throughout the health care system.

    Allscripts Payerpath® is an Internet-based suite of solutions that addresses every step in the reimbursement cycle.​

    Practice Management solution lets you manage patient records, insurance eligibility, documents, and billing in one place to maximize staff efficiency.

    Medical, dental and vision claims, health benefits administration, and claims adjudication software in one solution.

    ImagineBilling Practice Management Software improves cash flow, simplifies processes and provides unprecedented, real-time productivity monitoring by streamlining the billing/collections workflow to help clients achieve peak performance and measurable results.

    iSALUS Billing and Scheduling Services is a billing and scheduling software that has integrated clearinghouse service that allows you to get your claims paid, as well as submit e-claims, post ERA payments, verify patient insurance eligibility, and more.

    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

    Improve efficiency and effectiveness with a claims management desktop that modernizes your underwriting environment on an enterprise scale.

    This software is designed to help optometrists better manage and analyze their business and clinical operations.

    Quick Practice is a medical practice management software that includes electronic billing service, calendar, patient database, and more.

    Improving efficiencies within the healthcare billing process through automation and seamless integration.

    TruBridge is a service provider focused on providing business office, consulting and managed IT services to community healthcare organizations.

    AcceliCLAIM manages every step of the Medicaid claiming process, from performing Medicaid eligibility checks, to building and submitting claims, to processing remittance files. The system performs complex validation routines to ensure only eligible services are claimed and includes a suite of reporting tools designed to help you identify where additional data can drive greater reimbursement.

    AccuReg offers a full suite of all critical front-end RCM process solutions that hospital Patient Access departments need.

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