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.
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.
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.
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.
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
The Cirius Group has transformed healthcare revenue cycle business operations for over 35 years. Cirius delivers industry leading KPI's by streamlining business office functions with highly customized automation. We remove the manual effort from claims production, remittance, and reimbursement processes, relieving workloads with our software and business services. Continual software innovation, optimized EDI services, and dedicated support helps drive client’s success and sustains their results over the long term. Providers rely on Cirius solutions for consistent results over decades of adding facilities, managing growing claim volumes and adapting to ever-changing payer requirements. Complex billing environments are our specialty; large CBOs, major academic systems and cancer centers all rely on Cirius solutions to help ensure the sustainable cash flow they need. Offering: Contract Management Software Claim Editor and 837 Submission Software Payment Processing Software Cash Reconciliation Software Denial Management Software Revenue Cycle Consulting Cirius Business Services: Fully managed hands-free direct EDI services to all payers. Includes submission, tracking, re-submissions, reconciliation management, and correcting rejections. Available to all providers.
ClaimVantage offers industry-leading software for managing life, health, and absence claims efficiently and securely, helping you deliver superior customer service for a competitive edge. Hosted on the Salesforce platform, our configurable and intuitive cloud-based software is developed and updated by industry experts. We provide regular enhancements to keep you on top of market changes and industry developments. Our best-in-class solutions are fully integrated and can be accessed anytime, anywhere, helping you minimize fraud, streamline operations and improve productivity, while saving on implementation costs.
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.
DatixWeb is a web-based patient safety software for healthcare risk management applications, delivering safety, risk and governance elements through a variety of integrated software modules. DatixWeb is the first step towards improving patient safety and creating a culture of learning with a locally hosted product.
EzyMed Online 4 is a fully integrated Medical Practice Management software for General Practices, Radiology and Specialists Centres.EzyMed Online 4 encompasses all functions required for the Medicare Australia's Online Claiming Online process, Department of Veterans Affairs (DVA) Claims and Australian Childhood Immunisation Register (ACIR) claims.
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.