Best Claims Processing Software for Cloud - Page 4

Compare the Top Claims Processing Software for Cloud as of October 2025 - Page 4

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    LEAP

    LEAP

    Flovate

    Optimize and automate your processes without writing a line of code by harnessing the power of low-code. You can utilize the array of functional building blocks within LEAP to create custom and flexible applications that will enable you to automate your processes. Apply your processes to one of our pre-configured industry solutions. With the majority of the configuration already in place, your LEAP solution can be created in days by our analysts – and even demonstrated so that you can see it in action. By joining together functional building blocks your solution is built in weeks, not months – leaving you with a high-quality solution, at a lower risk and cost. An impressive array of functions and features can deliver the outcomes you need, providing you with a solution that is right for your organization. Pay for usage, not users. Activity-based, rather than user-based licensing means you only pay for what you use. Plus setup costs are kept to a minimum.
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    Origami Risk

    Origami Risk

    Origami Risk

    Origami Risk provides integrated SaaS solutions designed to help organizations—insured corporate and public entities, brokers and risk consultants, insurers, third party claims administrators (TPAs), risk pools, and more, transform their approach to managing critical workflows, leveraging analytics, and engaging with stakeholders. Origami Risk is a 5-time Business Insurance Innovation Award Winner, and we've kept that title because we collaborate closely with our clients to develop solutions that address real-world challenges they're facing. Since our founding, Origami Risk has aimed to deliver industry-leading, real-world solutions for risk professionals around the globe. Our acceptance of the 2021 European Risk Management Award for Technology Innovation of the Year underlines this continuous effort. Fully-integrated, comprehensive solutions for reducing incidents & hazards.
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    CyberSource Medical

    CyberSource Medical

    ComCom Systems

    The market's most powerful and accurate solution for claims processing. CyberSource Medical Claims Scanning Solution, a complete turn key system for HMO, PPO, TPA, or Self Funded Organization, is installed at your location for automated data entry of CMS-1500, ADA-2006 UB-04 and enrollment forms. Using advanced "intelligent" features combined with your business rules, CyberSource recognizes, validates and formats the data from medical claim forms. Fuzzy Matching performs an intelligent search of your member and provider database correctly identifying the exact match. The matched data is then utilized to verify and correct data on the medical claim before being passed through to adjudication. The combination of industry-leading OCR efficiency, your business rules and “Fuzzy Matching” results in exceptional accuracy of the data from your medical claims forms.
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    PBM Express

    PBM Express

    Laker Software

    The core of PBM Express is the adjudication program. Claims undergo hundreds of edits to achieve accurate processing results, regardless of the difficulty of the plan design. The parameter drive program provides for an extremely flexible architecture that allows for client customization as needed. Laker's advanced software solution provides clients with superior performance and industry-leading uptime. As a technology leader, Laker continually updates and enhances our systems to meet the growing needs of our customers. Laker customers have the marketplace advantage of the fastest, most flexible and most durable system available. What’s more, Laker works closely with our customers to develop, test, and implement new products which allow them to better compete and win new business.​ Laker grows as our customer's claim volume grows. It is in the best interest of both Laker and our customer’s to provide changes to the software in a timely and efficient manner to allow for that growth.
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    Complete Claims

    Complete Claims

    Complete Health Systems

    Claims Adjudication for medical, dental, vision, prescription, short and long-term disability claims. Available for on-site license or as a hosted application (ASP). Microsoft technology: SQLServer database with a Windows front end. Acclaimed Customer service staffed by health care claims experts with a minimum of 12 years’ experience in the field. Support calls are logged with status available via the internet. Plan copy and modification feature enable quick setup of plans. Auto-adjudication using benefit codes built using business rules based on over 25 variables from both the claim and the claimant records made available to the adjudication engine. Inbound claims can be scanned images, EDI or paper. HIPPA EDI 5010 transaction sets. Re-pricing fee and UCR Schedules can be loaded on the system in advance of the effective date. The date-driven logic will re-price based on the date of service.
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    CLAIMExpert

    CLAIMExpert

    Acrometis

    The Acrometis flagship claims processing solution offers unparalleled workflow management, with documents automatically routed by a configurable rules engine. Based around claim assessment scoring, body part to claim compensability matching, jurisdictional directives, relatedness scoring and a host of other claim elements the Acrometis business rules are designed to reduce claim duration and costs. CLAIMExpert automatically processes 65 percent of incoming medical bills and non-medical documents with no user intervention. Documents requiring adjuster intervention are flagged and sorted for easy review and straightforward decision making. Automatically processes incoming documents with NO adjuster intervention. Clients typically see between 11 and 23 points medical loss improvement in the first year. CLAIMExpert contains rules for over 190 different document types, quickly handling whitemail and any other documents that come across your adjuster’s desk.
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    LMS Suite

    LMS Suite

    Street Solutions

    LMS enables efficient trading and management of residential whole loans. You can monitor the entire loan pipeline, handle third-party reviews, and fund/settle loans on a streamlined, automated basis. Sellers can lock and price loans on a flow or bulk basis that fit your product’s eligibility guidelines through our portal. They can upload credit documents and satisfy conditions raised during reviews. Securely upload and store credit documents at a trade, pool, and loan level. Exchange documents with third-party vendors through secure integrations. Direct orders to appropriate diligence vendors based on product & volume. View & resolve third-party reviewer’s results using automated vendor data feeds. Generate funding schedules with amortized balances, calculated interest and fees.
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    TotalEclipse

    TotalEclipse

    Startech Software

    Startech Software’s TotalEclipse™ product is a fully featured single-database Claims Management & Medical Bill Review Software application. Representing the culmination of over three years of development and testing, TotalEclipse™ is designed by real claims adjusters, bill reviewers, and administration managers who use this mission-critical software to do their jobs every day. Many companies develop their software with the user in mind. TotalEclipse is developed with our users involved. The result is an application designed around real-world workflow with a strong focus on making easily available the information most often needed on the job. Eclipse offers the specific processing power, functionality and reporting capabilities you need to maximize productivity while controlling costs. The single-database backend is scalable for use with either the Microsoft SQL Server™ or Oracle™ platform.
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    TrackAbility

    TrackAbility

    Recordables

    Liability claims management software solutions from Recordables. Software solutions to improve claims management including General Liability, Auto, Property, Incidents, and more. Recordables Liability insurance tracking software organizes incidents and claims that include auto, property, and general liability policies. Tracking all liability and risk incidents and claims, TrackAbility provides comprehensive liability claims tracking software solutions Benefits of TrackAbility liability claims management include start to finish injury liability claims management from incident through completion. Create customizable liability claim types with user-selectable criteria. Safety professionals and field users can collaborate on claims and reports, continuing to add pictures and videos for incidents or claims. Receive a holistic view of financial data necessary for claims management, such as payments and losses based upon individuals, locations, policy specifications, and other data.
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    Fermion Merimen
    We are a market leader in providing a collaborative and information exchange platform for the insurance industry. As the pioneer in offering Software as a Service (SaaS) for the motor insurance industry, we have successfully deployed this model throughout the insurance ecosystem communities. We have enabled our clients to grow without disproportionate overheads and provided rapid transformation capabilities with lower risks and predictable cost using our infrastructure.
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    V3locity

    V3locity

    Vitech Systems Group

    V3locity®, Vitech’s cloud-native administration, engagement, and analytics platform, is a transformative suite of complementary applications that offers full life cycle business functionality and robust enterprise capabilities. It marries core administration with a revolutionary digital experience. Its modular design enables flexible, agile deployment strategies. V3locity employs an advanced, cloud-native architecture that leverages the unique capabilities of AWS to deliver a solution with unparalleled security, scalability, and resiliency.
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    ppoONE Connect
    This application automates the repricing of claims in a Web environment. WebCR verifies provider participation and patient coverage, validates dates of service, and identifies possible duplicate claims. It is supported by a data management team and system, WebDM, that works to ensure accuracy and currency of data. This application automates the repricing of claims in a client/server environment. WebCRX verifies provider participation and patient coverage, validates dates of service, and identifies possible duplicate claims.
    Starting Price: $1000.00/month
  • 13
    PCRS

    PCRS

    PCMI

    Allows users to provide real-time rates and contracts to dealer menus via eRating and eContracting. Users are able to issue policies with electronic signatures and present products to consumers through their own point of sales channels and/or their partners. Having 140+ partners in our network gives dealers the ability to connect to the eMenu or DMS system of their choice. Our policy administration software supports billing, commissions, cancellations, and different statuses of the policy throughout its lifetime, allowing for seamless coverage rating, contracting, and contract remittance. Being fully integrated with your accounting system lets you create, manage, and modify your agents, dealers, coverages, and contracts. This also grants your agents direct access via our Agent Portal. Our F&I software gives the Dealer Principal and Field Representatives access to integrated reports for F&I sales, forecasting, and overall dealership performance in real-time with powerful analytics.
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    SSG Digital

    SSG Digital

    iPipeline

    Innovator, connector and leader for the insurance industry. We have the most extensive straight-through processing platform within the UK. Explore how our digital platform addresses your business needs. Business transformation powered by increased agility and a digital end-to-end experience. Improved productivity fueled by adviser and consumer self-service capabilities. Higher customer lifetime value through proactive ongoing engagement with customers. Customer and Adviser Portals – users access policy documentation and update personal and policy details and features digitally, in real time. Components cover every facet of the user experience including full reinsurance reporting, external portal integration, and automated and clerical underwriting. Flexible deployment – from full end-to-end SSG Digital platform deployment, to discrete integrated individual components (e.g. underwriting only, New Business only).
  • 15
    InsuraSphere
    InsuraSphere is a full suite of products and solutions that grows with your business. InsuraSphere is the complete suite of products designed by insurance people, for insurance people. Keep track of essential information across your business, like policies, quotes, claims, agents, and more — all in one place. Streamline your processes by using InsuraSphere’s integrated policy form management system. Give your stakeholders access to the information and workflows they need with agent and insured portals. Grant agents the ability to rate, quote, and issue their own policies based on your company’s business rules and role-based permissions. Customize your company workflows by added third-party integrations. InsuraSphere is designed for the evolving needs of carriers and agents. Whether you’re just starting, moving from a legacy system or want to bring your policy admin into one single product, InsuraSphere is designed to grow with your business.
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    ClaimSuite

    ClaimSuite

    Whitespace Software

    The Whitespace Platform is the truly digital platform for the global (re)insurance marketplace. Contracts created and processed using Whitespace are made entirely of data. When digital data is used as the vehicle for risk transfer (not Word or PDF documents), the potential benefits of digital transformation of your business become realizable. And the possibilities are endless. Increases in speed, accuracy, availability, and quantity of in-depth data for risk analysis, all provide significant benefits to Brokers and Carriers. Above all, insurers act in the interests their customers, for whom a digital connection can mean real-time access to the risk placement, quicker payments and faster responses on claims. The complete end-to-end process is supported; with Whitespace, brokers and underwriters create risk submissions, collaborate on contracts, communicate via real-time instant messaging, request and provide quotes, bind, sign and endorse (re)insurance contracts digitally.
  • 17
    Polygonal

    Polygonal

    City Computers

    Polygonal builds upon the strength and rich functionality of earlier versions and combines it with the latest Microsoft VB.Net and Business Intelligence technology to provide a comprehensive solution able to respond efficiently and quickly in the dynamic market of today. Polygonal, a modular, multi-currency, underwriting, policy/claims administration software solution integrated with transactions, reinsurance, accounting, messaging, data warehouse reporting, document management, and workflow modules to provide a full end-to-end business process with tangible results. Polygonal, designed from a business prospective using City Computers specialist team. We have many years' experience working in the insurance market as practitioners as well as solution providers.
  • 18
    ALYCE Claims Management
    ALYCE is specifically designed for self-insureds, municipalities and small TPAs handling Workers’ Compensation, Auto Liability, Auto Property, General Liability, and Property claims. ALYCE has an intuitive design with important data elements on the main claim page, including the claim’s financial summary, with all of the other important details available with a quick scroll or a single click. Multi-tiered infrastructure for employer reporting requirements, based on locations and departments. Recoveries, including salvage, subrogation, and excess carrier payments. Automated scheduled and repeating payments with diary alerts. Automatic diaries based on events, time lines, and financial transactions. Automatic generation of form letters to claimants, lawyers, and other claim parties.
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    ClaimScape

    ClaimScape

    DataGenix

    Emerged in the year 2000, DataGenix is strongly resolved to provide TPAs, adjusters, and insurance companies with modern claims processing solutions. We understand that claims processing and health benefits management can include several complications. So that your business does not suffer any losses, our experts have created the advanced ClaimScape software that can automate the entire adjudication process. The goal of our business and the Claims software is to resolve the perplexities that hinder the reach of unmatched customer experience for your clientele network. Keeping in mind the modern trends and requirements, we can assure your business's optimum growth with our software products. We have won the trust of top TPAs of the nation and are willing to serve more.
  • 20
    POWEReob

    POWEReob

    Unicomp Corp. of America

    Insurance payment posting, like so many other tasks, falls under the proverbial 80/20 rule. The 20% of your payments that are still posted from paper EOBs take 80% of the overall payment posting work, if not more. Not so with POWEReob. POWEReob is a combination of free software and a pay-per-transaction service that will convert the paper EOBs you still receive from some payers into electronic remittances files in the ANSI 835 or NSF format. These files can then be used for automated payment posting to your practice management software, electronic secondary claims billing and denials management. POWEReob can work with any practice management that accepts remittance files from 3rd party sources (not just from their designated clearinghouse). For those that don't, we'll work with your practice management or clearinghouse so you, too, can benefit from the labor savings resulting from 100% electronic remittances.
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    FINEOS

    FINEOS

    FINEOS

    The FINEOS Platform provides clients the only complete end-to-end SaaS core product suite that includes FINEOS AdminSuite enabling quote to claim administration as well as add-on products, FINEOS Engage to support digital engagement and FINEOS Insight for analytics and reporting. The foundation of your digital insurance strategy. The FINEOS Platform seamlessly blends FINEOS AdminSuite + FINEOS Engage + FINEOS Insight + Platform Capabilities to create the most modern single core insurance platform for Life, Accident and Health. Legacy core systems utilized a ‘one size fits all’ business technology approach that no longer fits the needs of an agile business. Today, consumers, employers and brokers have access to powerful SaaS computing platforms and software tools that set a much higher bar for an insurer’s digital strategy. Monolithic insurance software models of the past focused solely on details of the insurance contract.
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    ClaimAdept
    This product is an end to end claims system. The primary functions are claims adjudication, claim workflow and payment disbursement. The flexible design allows the addition of adjudication modules on a line of business basis. Each new line of business added reuses the core functionality of the system. This system takes advantage of the user friendly windows screen design and makes use of a relational database to store information within the system. The software platform is Powerbuilder with an SQL database such as Oracle or Sybase. This combination of software supports a client server based environment that is capable of processing large volumes of claims. Installation and training are available and source code is included as part of the licence fee. Expert staff is available for customizations and tailoring of the system to meet any special requirements identified by the client. All modifications are available with detail design and support for acceptance testing.
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    InsurancePlus Software Series

    InsurancePlus Software Series

    United Systems and Software

    USSI is proud to present its entire line of professional insurance software solutions designed and developed as an all-encompassing turnkey administration offering. USSI's comprehensive software solutions ensure that your insurance company is operating at the highest level in an ever changing and competitive marketplace. USSI's InsurancePlus Individual Life and Health Administration software solution manages books of business for traditional and non-traditional Life and Health insurance companies. Product lines supported include Whole and Term Life, Interest Sensitive, Final Expense, Annuities, Supplemental Health, etc. USSI's InsurancePlus Group Life and Health Administration software solution manages books of business for Group Health insurance companies, Self-Insured Funds, and TPA's. Supported plan offerings include Point of Service, Major Medical, Term Life, High Deductible, Traditional Indemnity, etc.
  • 24
    HealthQx

    HealthQx

    Change Healthcare

    Accelerate your value-based initiatives by quickly analyzing and understanding episode costs. Build provider adoption and engagement with data-driven, evidence-based discussions about total episode costs and individual provider practice patterns. Drive cost and quality improvements by targeting variations in care delivery and provider performance. Empower value-based strategies through analytics, providing insights to help guide network optimization and clinical transformation. Identify value-based care opportunities through an analysis of episode costs, leveraging clinically validated episode definitions. Target providers to engage in value-based discussions through an analysis of utilization, costs, and care variations. Leverage episode analytics to help optimize network designs, transform clinical guidelines, and improve consumer engagement. Streamline episode budget creation by defining average episode costs and associated clinical services.
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    Conexia

    Conexia

    Conexia

    Provide authorizations, claims processing and payment in real-time at the point of care. Enhance care coordination and improved outcomes to lower medical cost while streamlining administrative processes. Engage providers at the point of care to capture and share data in real-time resulting in an unparalleled exchange of health information. We partner with our clients to implement risk management strategies that result in better outcomes with lower costs. We strive to improve the user experience for everyone involved in the ecosystem. We deliver a minimum 3:1 ROI for our clients to allow them to optimize their resources. Conexia has developed a core technology platform (ONE) that is customizable to meet the diverse regulatory requirements and operational processes for each client in each geography. In most cases, our initial implementation is an overlay on the payer’s existing technology ecosystem to create real-time processes.
  • 26
    CLAIMSplus

    CLAIMSplus

    Addiox Technologies

    Expedited claims. Multiple interfaces sync with your corporate brand. Digitized data environment that can be accessed from anywhere, at any time. Health and Life processing via faster systems that aligns with your processing needs. Speeding up the claims life cycle to match the influx of your claims—while reconciling and resolving the more complicated claims at record velocity. It’s in. It’s out. No interruptions or claims processing delays. CLAIMSplus moves claims faster, working with employers, TPAs and insurers with robust in-the-cloud processing platforms. CLAIMSplusis in the business of optimizing processes and expediting medical claims through secure, reliable and efficient electronic claims management. More to the point, our technology—first and foremost—manages claims quickly and efficiently. We’ve asked our clients, and the timescale of the claim is the most important element for claims processing.
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    Claim Leader

    Claim Leader

    ClaimLeader

    Claim Leader develops and provides technology solutions to automate the communications and workflow processes across the business enterprises of insurance claims organizations. Our software solutions allow to simplify your operations, while providing superior productivity through an advanced, and integrated web platform. Feature-rich modules within Claim Leader systems create a simplified workflow for internal administrators and on the field users. Management tools allow internal users to dispatch assignments to field staff, sort workload, pinpoint files for review, and streamline workflow.
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    Terra

    Terra

    Terra

    Antiquated on-premise systems are a liability. Streamline your claims operations and improve efficiency with Terra's Automation, Integration, and Intelligence. Terra's products include Claims Management, Policy Management, Benchmark, and an Ancillary Services Marketplace. Manage risk with Automation, Cloud-Native, Integration, and Intelligence! Terra is a Cloud-Native Risk Management Information System for Property & Casualty Insurance.
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    ClaimLogik

    ClaimLogik

    Claim Central Consolidated

    Connect everyone in your property claim. ClaimLogik connects everyone in a property claim from first notice of loss through to completion. Property assess & repair ecosystem. We connect everyone in your property claim from start to finish. Stakeholder Management. ClaimLogik connects EVERY stakeholder in a claim with real time access, to complete tasks and manage activities at the right time, in the right order and with complete transparency. All stakeholders have access to workflow modules that have been customized to enable them to track, manage and complete tasks throughout the claim. Stay connected. All stakeholders connected on one claim. Complete transparency on claim status for all stakeholders. Line of sight for all activities across the entire claim. Digital contracts between Insurer and supply chain. Service level agreements with all suppliers and trades KPI management to measure and compare supplier performance. Automated exception management when tasks fall outside SLAs
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    Enterprise Health Solution

    Enterprise Health Solution

    HM Health Solutions

    HM Health Solutions provides an end-to-end solution to health plans. Get the support you need and business outcomes you want from one comprehensive health plan administration platform: the Enterprise Health Solution. Platform applications and tools manage functions from sales through enrollment and billing, including claims, provider and clinical management, and customer service. The Enterprise Health Solution (EHS) is the only proven end-to-end solution, and can move your member seamlessly from enrollment to claims payment. You’ve heard others claim to offer a fully integrated solution. What they don’t specify is that you may need to purchase all modules in sequence to achieve this integration. On the Enterprise Health Solution, health plan administration has always been the one and only focus. No other company rivals our expertise in the health plan payer space.