Best Healthcare Claims Management Software - Page 9

HxPro

HxOne is the premiere healthcare payer solutions company that offers customized solutions for commercial and governmental health benefit administrators.

ImagineMedMC

Manage your members' healthcare and networks with a cloud-based healthcare delivery system. Automate claims processing for managed care organizations.

Inovalon Direct Data Entry Verification

Direct Data Entry Verification™ is a specialized solution that provides secure, online access to the Fiscal Intermediary Standard System (FISS) for Medicare Part A claims. It enables billing teams to enter new claims, check claim status, update claims, append Return to Provider (RTP) claims, and validate claim information in real time through a secure web-based connection. Intended for large acute and post-acute organizations, the solution serves revenue cycle teams that rely on FISS as part of their Medicare Part A claims workflow. It is best suited for organizations that primarily need secure, direct access to FISS to support Medicare Part A billing workflows. Organizations often need to support experienced Medicare Part A billers who are most effective working directly within FISS while also providing newer team members with secure, reliable access to the system. Direct Data Entry Verification helps organizations maintain established billing workflows while giving staff the tools they need to manage claims efficiently and confidently. It also scales to accommodate growing teams without per-user licensing limits, making it easy to expand access as organizational needs change. As a CMS-approved Network Service Vendor (NSV) and the largest and longest-standing network service vendor for Medicare connectivity, the solution provides organizations with dependable access to FISS. Key capabilities include: Connect securely to FISS to enter claims, check claim status, append RTP claims, perform updates, and validate claim information in real time. Support organizations of any size with a web-based application that allows additional users without per-user licensing limits. Access Medicare Enterprise Data Centers and Medicare Administrative Contractors (MACs) through a single, secure connection. Use built-in TN3270 access optimized for FISS to provide efficient connectivity from virtually any location. Maintain secure access through HIPAA-compliant connectivity while using an existing internet connection. The solution is designed for billing teams, revenue cycle leaders, and healthcare organizations managing Medicare Part A claims that require dependable, real-time access to FISS. It also integrates with Inovalon's Claims Management Medicare Pro™ for organizations that use both solutions as part of their Medicare claims management workflow. By combining secure connectivity, nationwide access, and real-time claims processing in a single application, Direct Data Entry Verification helps organizations maintain efficient billing operations while supporting the way their teams already work. Customer experience: “Everybody at Inovalon cares. I feel like we’re not just a number. It’s like your success is our success. It’s been like that from day one. There is no substitute for that.” — Allendys Gonell, Billing and EDI Manager, Careficient Direct Data Entry Verification is part of Inovalon's revenue cycle management suite, which was top rated by Black Book Research. Based on evaluations from more than 1,300 hospital and health system finance and revenue cycle leaders, the suite earned recognition for its full provider cloud RCM platform breadth and eligibility, benefits verification, and real-time payer rule interpretation capabilities.

Intelihub

IVR Converter

IVRConverter.com is a fast, secure, and easy to use Interactive Voice Response (IVR) Conversion Tool designed to help healthcare professionals translate Medicare IDs, MBI numbers, PTANs, and member names into the precise keypad format required by IVR systems. Tailored for real world billing, eligibility and insurance verification calls, this tool eliminates the need for manual conversions by automatically generating IVR ready numeric or alphanumeric entries compatible with Medicare, BCBS, WPS, CMS, NGS, and Railroad Medicare IVR menus.

Lassie

Lassie puts dental practices on autopilot. It uses AI to post insurance payments, reconcile EOBs, and surface denials so front office teams can collect cash up to 4 times faster while freeing 90% of the hours they used to spend on manual data entry.

Medicare Repricer

Milliman Health ClaimsRef

Milliman Medicare Reference Pricer

Naviquis

Naviquis is a fully automatic real-time payment integrity system with automated healthcare claims editing, analysis, and Fraud Waste Abuse (FWA) detection/prevention. We provide accurate and precise editing for both medical claims.

NeoDeck Holdings

Bilingual English/Spanish EHR with SNOMED-CT-based data coding.

Netsmart Claims Adjudication

Netsmart Clearinghouse & Third-Party Liability

NextGen Office

NextGen Healthcare’s private practice solution, NextGen®️ Office, helps practices simplify, automate, and unify clinical care—in person and virtually—so practices can save time and focus on what matters most: patient outcomes. As a HIPAA compliant, cloud-based EHR, patient data is accessible from any device with an internet connection; virtual visits are embedded directly into clinical workflows; revenue cycle management tools facilitate optimal reimbursement; and a state-of-the-art patient portal helps keep patients engaged in their care, from anywhere. Combining these capabilities into one seamless system frees practices from the confinements of onsite care delivery and opens the door to a virtual practice. With NextGen Office, providers can touch, talk, or type encounter notes directly into the clinical documentation. NextGen Office includes MIPS reporting/dashboards; automates insurance eligibility; empowers patients to schedule appointments, request refills, and schedule telehealth visits; and connects the care team through direct messaging and referral exchange. The NextGen Office team is dedicated to helping practices achieve operational excellence, improve clinical outcomes, advance clinician and patient satisfaction, and foster healthier lives. NextGen Office grew from a company founded in 1998 by two doctors with one goal—to make medical offices run more efficiently. Company founders designed a solution to accommodate physician and staff workflow with easy-to-use, affordable technology that adapts to the provider’s workflow and is accessible from anywhere. Now more than 124,000 providers across the United States use solutions provided by NextGen Healthcare.

Noble*Direct v11

Noble Direct is a comprehensive software solution for DME companies.