Best Core Administrative Processing Systems Software

    Healthcare Payer’s Core Administrative Processing Solutions support and simplify the solutions that healthcare payers use for administrative management and transactions processing.

    To qualify for inclusion in the Healthcare Payer’s Core Administrative Processing Solutions category, a product must:

    Evolve and accommodate regulatory changes and innovation in the payment sector
    Extend the capabilities and functionalities of existing processing and provider-facing systems

    Compare Core Administrative Processing Systems Software

    G2 takes pride in showing unbiased reviews on user satisfaction in our ratings and reports. We do not allow paid placements in any of our ratings, rankings, or reports. Learn about our scoring methodologies.
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    (17)4.2 out of 5

    Medisoft is a compact solution for the healthcare industry that deals with both clinical and administrative requirements of healthcare centers.

    (11)4.3 out of 5

    NaviNet Open Foundation consists of a series of layers: a platform, a set of network services, a suite of reimbursement-related and clinical applications, and a set of tools that customers can use to configure and customize the system.

    (10)3.7 out of 5

    Clinical Decision Support (CDS) system is a next-generation decision-support solution available to providers today.

    (9)3.4 out of 5

    Optum360 sits at the center of the health care financial exchange. It combines technology, methodology and expertise to help payers and providers collaborate. Its seamless, transparent revenue cycle capabilities strengthen and sustain the payer and provider relationship.

    (12)4.3 out of 5

    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.

    (3)4.7 out of 5
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    Founded in 1996 and headquartered in Oregon, PLEXIS serves healthcare payer administrative organizations serving over 50 million people in all 50 states and 15 countries. PLEXIS provides enterprise core administration processing solutions to healthcare payers, specialty groups (dental, vision, radiology, etc.), TPAs, delegated risk groups (IPAs, ACOs, MSOs), international insurers, and government healthcare organizations/program administrators. PLEXIS Payer Platforms feature highly scalable, hi

    (1)4.0 out of 5

    ABILITY COMPLETE puts together all-payer eligibility verification with a powerful workflow dashboard. You can assign and prioritize patients, payers and tasks, plus create individualized reminders and payer-specific notes to help staff more effectively manage multiple activities.

    End-to-end efficiency accelerates customer acquisition, boosts retention and promotes long-term growth prospects for health payer organisations.

    (1)4.5 out of 5

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

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    An analytics-driven claims and remittance management solution for healthcare providers who want to automate workflows, improve resource utilization, and accelerate cash flow.

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    CAQH, a non-profit alliance, is the leader in creating shared initiatives to streamline the business of healthcare.

    A single platform designed to enable cleaner claims, improve communication and speed up reimbursement

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    A clinically-based claims payment solution for payers that want to create and deploy flexible, automated rules to help improve payment accuracy, reduce appeals, and realize medical and administrative savings.

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    E-HAS is an Online / Offline Hospital Administration and Management Information System for Health Care organizations . E-HAS has a capability of data warehousing and business intelligence for consistent growth of organization and hospital system automation to significantly decrease manpower with accuracy.

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    ezCAC is an NLP-based HIPPA compliant computer-assisted coding software. It is designed to bring hospital clinical data and all patient related data together in one intuitive Enterprise Computer-Assisted Coding (CAC) platform.

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    Post Discharge Software is a patient follow up care management solution that helps you connect with recently discharged patients.

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    Empower your organization to adapt with a user-friendly solution, identifying and mitigating risk. While profitability improves, so will your patients experiences and outcomes.

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    HealthWare Systems offers a one-of-a-kind workflow and integration platform called Facilitator, which is built to meet the demands of the healthcare marketplace. Facilitator streamlines pre-arrival workflow, prior authorization, insurance verification, medical necessity checking, financial assistance screening, appeals management, release of information, and more.

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    Health Portal Solutions is a provider of custom, integrated web portals that saves Employers and Payers time and money by consolidating insurance data, products, and business processes into a single portal.

    The Health Catalyst Data Operating System (DOS) is a breakthrough engineering approach that combines the features of data warehousing, clinical data repositories, and health information exchanges in a single, common-sense technology platform.

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    Health iPASS is redefining the patient revenue cycle by improving the patient experience from appointment to payment. It helps providers promote price transparency, build trust and increase operating income by simplifying the check-in process and streamlining both time-of-service and residual patient payments.

    0 ratings

    End-to-end visibility from factory to patient

    Developed in close collaboration with hospitals, the Logibec FMS - Financial Management System is a complete administrative solution that adapts to the structure of each healthcare facility. It is an integral part of the Logibec Espresso software suite, and an integrated set of modules that drive information usage and exchange. This facilitates the automation of several financial workflows like accounting, budget management, accounts receivable and accounts payable management, and much more.

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    MediQuire is a performance management platform designed to leverage data (clinical, claims, demographic and others) to derive powerful insights about operational and clinical performance gaps of individual clinicians and provide the tools to clinicians and patients in order to close those care gaps daily.

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    MOMS Medical Billing and Practice Management software is designed to streamline physician billing processes in order to maximize reimbursement.

    Omni-HealthData Provider Master Edition is an information management solution that gives healthcare organizations the ability to simplify the data acquisition process, enabling faster data integration so that organizations spend less time on ETL processes and more time successfully executing business and regulatory transactions, such as claims processing, credentialing, contracting, and providing better access to care.

    0 ratings

    PlanXpand is a platform manages real-time, shared benefit accumulators; ACA cost-sharing reduction subsidies; CDH plan designs (HRA) for payors.

    0 ratings

    Salucro is a healthcare technology company, exclusively focused on patient payments. From online bill pay solutions to provider-facing payment integrations, the Salucro platform brings cohesive payment experiences to healthcare providers, patients, and third-party collection agencies. Salucro offers 16+ payment options, including PayPal, PayPal Credit, Venmo, and access to third-party financing. As a PCI DSS Level 1 Service Provider, Salucro belongs to an elite group of organizations worldwide t

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    Sutherland is a leading provider of consulting, process transformation services, information technology (IT) optimization, analytics, and design thinking solutions to the entire healthcare ecosystem.

    0 ratings
    Entry Level Price:£50 per month

    TM3 is market leading business management software for the healthcare, wellbeing and wellness industries. With TM3, you'll have the tools needed to streamline your client journey from acquisition to delivery whilst improving engagement at every point.

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    Check out the G2 Grid® for the top Core Administrative Processing Systems Software products. G2 scores products and sellers based on reviews gathered from our user community, as well as data aggregated from online sources and social networks. Together, these scores are mapped on our proprietary G2 Grid®, which you can use to compare products, streamline the buying process, and quickly identify the best products based on the experiences of your peers.
    High Performers
    eviCore Clinical Decision Support
    NaviNet Open
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