Best Healthcare Claims Management Software - Page 2
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Compare the Top Healthcare Claims Management Software as of April 2026 - Page 2
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QuickPractice
QuickPractice
You’ll begin to understand the power of QuickPractice during your trial period… AND, we’re so convinced that once you experience QuickPractice, you’ll want to keep it. You’ll see how time-consuming paperwork is reduced to easy routines on your computer. Boca Medical Therapy is a mid-sized, multi-specialty practice consisting of Physical therapy, Chiropractic, Medical and Neurology serving the Boca Raton, FL area for over 10 years. After purchasing QuickPractice in March 2007, they noted that the program has lessened the time spent on administrative tasks by more than 2 hours a day. After enrolling in QuickBilling they now are being paid in 7-10 days as compared to paper billing which took 30+ days and 20-30 days when billing electronically through another company. Control, monitor and manage every aspect of your healthcare practice with one powerfully simple program.Starting Price: $599 one-time payment -
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PLEXIS Payer Platforms
PLEXIS Healthcare Systems
PLEXIS’ suite of best-in-class apps has a proven record of giving payers the extended functionality necessary for modern core administrative ecosystems. From real-time benefit administration and adjudication to automatic EDI transmission and self-service customer portals, PLEXIS Business Apps have you covered. Passport provides essential connectivity from the core admin and claims management engines to PLEXIS business apps, your own apps, and existing in-house systems. With its flexible API layer, Passport delivers real-time integration with portals, automated workflow toolsets, and business apps. Connectivity is limitless. Streamline workflows with a centralized, modern core administration & claims management platform. Process claims in a timely and accurate manner, and automate the complexities of benefit administration to capture a quick ROI and deliver superior customer service. -
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PlanXpand
Acero Health Technologies
PlanXpand™ is Acero’s proprietary transaction processing engine, one that powers each of our products for health benefits administrators. Leveraging this engine, clients may choose to implement Acero’s products concurrently or incrementally. In addition to selecting one of our standard products, administrators also may choose to utilize PlanXpand™ to develop a custom solution to extend existing system capabilities. Acero’s unique, integrated solutions feature Service-Oriented Architecture, allowing health benefits administrators and insurers to add features and functions to existing adjudication platforms. At the same time, our sophisticated design and engineering enables real-time adjudication of every type of claim, all in direct interaction with the core claims system, resulting in more accurate processing, more satisfied customers and less need for claims adjustments. -
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OneTouch Claims Processing Software
Apex EDI
OneTouch is a tool that allows a user to conveniently transmit claims or statements to Apex, login to the Apex website, or search for claims that have been sent in the past all from of your computer desktop. In order for OneTouch to work, the user must be a registered client with Apex EDI and have a username and password setup. Once a user has a username and password OneTouch can be configured so the user can utilize the tools described. With OneTouch Search you can search your claim and statement files that have been sent to Apex from the convenience of your desktop. The OneTouch search feature allows you to search your statement and claim files for patient names, subscriber IDs, or several other options. After you click the search button you will be logged into your Apex webpage and shown the results of your search. To perform a search first choose what you want to search for by clicking on the magnifying glass dropdown menu. -
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Smart Data Solutions
Smart Data Solutions
Streamline Your Complete Healthcare Data Workflow. Smart Data Solutions has the tools and experience needed to streamline both your paper and electronic workflows. Our integrated validation, matching, and normalization tools ensure the highest quality data possible, increasing auto-adjudication and reducing manual processing. Whether you’re new to Smart Data Solutions or a long time partner, our development process helps guide you through projects to ensure the best possible position for overall success. Whether your needs are basic or complex, our staff will work with you to understand your needs and the impacts of your workflows. We believe in focusing on your goals, what you want to accomplish, and from that, identifying the best way to get there. Smart Data Solutions provides complete front-end pre-adjudication solutions for hundreds of Payers nationwide. Whether you need basic services or a completely custom workflow, Smart Data Solutions offers a variety of solutions. -
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Rivet
Rivet Health
Patient cost estimates and upfront collection. Understand patient responsibility instantly with automatic eligibility and benefit verification checks. Hyper-accurate estimates based on your own practice data, creating better care and a healthier business. Send estimates via HIPAA-compliant text or email. It's time to treat 2020 like 2020. Collect more than ever with upfront mobile patient payments. Ditch the write offs and decrease patient AR. Run eligibility checks and provide accurate cost estimates, even for multiple payers, treatments, facilities or providers. Collect payment up front via HIPAA-compliant text or email. Reduce A/R days, collect more revenue and increase patient satisfaction all at once. Identify, analyze and resolve denials, as well as track ROI from reworked claims. Automate denial assignments to team members via Rivet, and leave notes and links along the way to resolve future denials even faster. -
7
TruBridge
TruBridge
In the ever-changing world of healthcare, business and financial health is critical to the success of your healthcare organization. Get the people, products and processes you need for success that goes beyond simply getting paid. Revenue cycle management suite that helps businesses manage claims scrubbing, and review patients' eligibility through verifications. TruBridge is in the business of helping hospitals of all sizes get paid faster and get paid more through a combination of people, products and process optimization. Our arsenal of RCM offerings ranges from revenue cycle consulting, to an HFMA Peer Reviewed® product to complete business office outsourcing. TruBridge has been helping hospitals, physician clinics, and skilled nursing organizations become more efficient at serving their communities for years. Today, our trained experts stand ready to do the same for your organization, enabling you to overcome the unique revenue cycle challenges you face every day. -
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EbixEnterprise
Ebix
EbixEnterprise is a comprehensive insurance management solution that streamlines policy management throughout its lifecycle. EbixEnterprise contains six components, Customer Relationship Management (CRM), health insurance exchange, policy administration, claims administration, data analysis, and consumer web portal. Each of the components is seamlessly integrated with one another, which allows data to flow between each other as dictated by the business need. SmartOffice CRM provides organizations with the ability to maintain agent/broker information, commission rates, manage sales pipeline, state license information. EbixEnterprise's Online Quoting Portal, HealthConnect, is the leading health insurance exchange for buyers and sellers of health insurance and employee benefits. EbixEnterprise Administration is a fully functional policy administration system that provides all of the tools that are necessary to manage policies, define plans, maintain plan rate information, etc. -
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Alaffia
Alaffia Health
Alaffia’s AI-powered system uncovers fraud, waste, and abuse in the most intricate healthcare claims to prevent and recover overpayments for payers and employers. Alaffia detects and corrects errors in misbilled claims before an improper payment is made. Alaffia empowers you to recover and save on overpayments previously made on misbilled claims. Overpayments on error-filled claims could be costing you hundreds of dollars per employee each year. Work with Alaffia to eliminate overpayments and drive more savings to the bottom line. The Alaffia system detects and corrects inaccurately billed claims, preventing overpayments. We work directly with your health plan or TPA for seamless integration and no disruption to your members. Our services are entirely contingency-based, so you only pay when we deliver savings. We ensure that providers aren’t charging your employees for services not rendered. -
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SSI Claims Director
SSI Group
Elevate your claims management process and decrease denials through unmatched edits and an industry-leading clean claim rate. Health systems require access to technology that facilitates accurate claim submission and rapid reimbursement. Claims Director, SSI’s claims management solution, streamlines billing practices and provides visibility by guiding users through the electronic claim submission and reconciliation process from beginning to end. As payers change or modify reimbursement criteria for services, the system actively monitors and incorporates these changes and requirements. And with a comprehensive mix of edits at the industry, payer and provider levels, the solution aids organizations in making the most of reimbursement efforts. -
11
Anagram
Anagram
Anagram Prosper puts money back in the hands of your patients — at no cost to your practice. Increase your margins, delight your patients, and forget courtesy discounts. We partnered with the best vendors to develop wholesale price lists that better align with the needs of you and your patients. Provide rebates on the same products you already stock. Incentivize your patients, drive more conversions, and collect more revenue. With Anagram Prosper, you can save patients money without offering discounts or lowering your margins. Use our rebate program to drive more sales and make your patients happy. Most patients don’t know about their out-of-network benefits. Anagram Access can pull real-time vision plan eligibility to maximize savings for your patients. With Anagram Access, you can quickly calculate how much your patient owes and how much their vision plan reimburses. -
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Veradigm Payerpath
Veradigm
Veradigm Payerpath is an end-to-end revenue cycle management suite of solutions built to assist organizations to improve revenue, streamlining communications with payers and patients, and boosting practice profitability for practices of all sizes and specialties. Eliminate missing information, incorrect coding, and data entry error to ensure clean claim submission. Ensure claims pre-submission are correctly coded, have no missing information, and are error-free. Compare performance against peers at the state, national, and specialty levels to optimize productivity and improve financial performance with advanced analytical reporting. Remind patients of their appointments and confirm their insurance coverage and benefits information. Automate the billing and collection of patient responsibility. Veradigm Payerpath’s integrated solutions are practice management (PM) agnostic, interfacing seamlessly with all major PM systems. -
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AltuMED PracticeFit
AltuMED
Conducting thorough checks on the financial eligibility of the patients, running their insurance’s analysis and monitoring discrepancies, the eligibility checker covers all. If however any error does creeps in the data submitted, our scrubber working on deep AI&ML algorithms is capable of scrubbing errors be it coding errors, incomplete or wrong patient financial information. The software, at present, has 3.5 Million edits pre-loaded in its memory. To further streamline the process, automatic updates are issued by the clearing house to inform about the status of in-process claims. Covering the entire billing spectrum from verifying the patient financials to working on denied or lost claims and also has a through follow-up feature for appeals. Our intuitive systems warns if a claim could be denied, taking corrective actions to prevent it but also is capable of tracking and appealing for lost or denied claims. -
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EvenUp
EvenUp
Powered by millions of records, EvenUp turns medical docs and case files into AI-driven demand packages for injury lawyers. EvenUp's team of injury experts uses AI to craft demand packages, freeing up time for your case managers and attorneys to focus on case strategy. Expand your caseload without adding to your staff. EvenUp's demands get better with use and more affordable with scale. EvenUp's demands a claim for every head of damage, leading to 30% higher claims on average. Our demands leverage 250K+ verdicts and settlements. EvenUp's clear exposition of each injury and damage accelerates settlement negotiations with adjusters, leaving less room for low-ball offers. An AI-driven solution for winning personal injury claims. We handle the paperwork while you focus on winning. Our team of injury experts, including former defense counsel, economists, and technologists, has prepared thousands of demands. A dedicated team member will tailor our services to your firm's needs. -
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Valenz Health
Valenz Health
Our single end-to-end platform of fully integrated health plan solutions delivers value and simplifies the complexity of healthcare for employers, members, providers, and payers. Valenz integrates member-centric services with data-driven insights, connecting the dots with personalized service and guidance for high-quality care and improved outcomes. We engage early and often with results-driven education, support, and services to avoid more serious and costly health events. With Valenz, you can have a healthier member population while also achieving plan and member cost savings, year after year. For the tools and transparency you need to make cost-effective, quality-first decisions, let’s find your path to smarter, better, faster healthcare today. With a suite of fully configurable solutions integrated into one ecosystem strategy, the Valenz healthcare ecosystem optimization platform offers extensive visualization of cost, quality, and utilization opportunities. -
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Wisedocs
Wisedocs
Wisedocs' document processing platform features enable insurance companies, independent medical evaluation firms, and legal entities to process claims with more speed, accuracy, and efficiency. Automatic organized medical records by date, service provider, title, and category. Automatic page duplication saving up to 30% of your time and money processing extra pages. The administrative hurdles with medical record reviews and sorting can be a challenge. Wisedocs has made automating medical record reviews a breeze for insurance, legal, and medical firms. Wisedocs will create an organized medical record index with insights based on your custom needs. Get important insights and easily searchable and indexible records pulled from the medical record review and intelligent summary. -
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TriZetto
TriZetto
Accelerate payment while decreasing administrative burdens. With 8,000+ payer connections and longstanding partnerships with 650+ practice management vendors, our claims management solutions can result in fewer pending claims and less manual intervention. Quickly and accurately transmit professional, institutional, dental, workers compensation claims and more for fast reimbursement. Meet the shift to healthcare consumerism head on by providing a straightforward and seamless financial experience. Our patient engagement solutions empower you to have informed conversations about eligibility and financial responsibility while reducing hurdles that may impact patient outcomes. -
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Inovalon Claims Management Pro
Inovalon
Keep revenue flowing with a powerful tool that speeds up reimbursements with eligibility checks, claims status tracking, audits and appeals, and remittance management for government and commercial claims, all in a single system. Leverage an advanced rules engine that immediately scrubs claims against the most up-to-date CMS and commercial payer rules, allowing you to correct errors before claims go out the door. Verify eligibility across all payers during claim upload and see flagged errors so claims can be edited before submission. Decrease days in A/R with automated workflows for audit responses, appeal submissions, and ADR tracking. Customize staff workflow assignments based on the type of claim and action needed. Automate secondary claims submissions to stop timely filing write-offs. Increase claims revenue with automated workflows for faster, more successful audits and appeals. -
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Oracle's Digital Insurance Platform empowers insurance providers to deliver innovative solutions and exceptional digital customer experiences. This comprehensive insurance management system streamlines operations from sales channels to back-office processes, enabling rapid deployment of new offerings and seamless implementation of necessary changes. With real-time analytics, insurers gain valuable insights into their business, facilitating informed decision-making. The platform supports both individual and group life and annuity insurance, consolidating underwriting, policy processing, billing, and claims into a single, efficient system. Health insurers benefit from simplified enrollments, premium billing, and claims adjudication, enhancing member satisfaction through transparent and personalized services. Additionally, the platform accelerates the bancassurance lifecycle by providing real-time connectivity between banks and insurers, ensuring speed, consistency, and reliability.
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20
RevCycle Engine
Aptarro
RevCycle Engine applies built‑in, customizable rules and AI‑powered automation to correct coding and charge errors at the source, ensuring billing data is accurate before claims are submitted. By integrating seamlessly with EMRs and practice management systems, it ingests claims data in real time, applies industry‑proven rules tailored to each organization’s needs, and fixes errors automatically, reducing preventable denials and costly rework. Streamlined workflows prioritize and route only complex or exception claims for human review, boosting team efficiency and reducing burnout. With AI‑driven charge accuracy, the platform increases clean claim rates, lowers cost‑to‑collect, and stabilizes cash flow, all visible through clear dashboards and real‑time insights. Scalable automation handles high claim volumes without overtime or late‑night efforts, while features such as charge accuracy validation, denial prevention, coding review optimization, payment collection support, and more. -
21
Silna Health
Silna Health
Silna Health’s Care Readiness Platform handles all prior authorizations, benefit checks, and insurance monitoring upfront to make sure patients are clear to receive care while providers gain capacity to focus on treatment. Its AI‑powered engine manages the entire prior authorization workflow, from tracking upcoming authorizations and sending weekly reminders to submissions and follow‑ups, automatically applying industry‑proven rules and escalating exceptions for human review. Specialty‑specific benefit checks verify coverage, accumulations, authorization requirements, and visit limits in real time, delivering accurate quotes at intake. Continuous insurance monitoring flags lost coverage, detects new plans, and safeguards against eligibility lapses. Designed for zero extra headcount, Silna ingests data directly from EMRs and practice management systems, offers configurable rule sets and strategic guidelines, and presents clear dashboards with incremental revenue insights. -
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HEALTHsuite
RAM Technologies
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. RAM’s Medicare Advantage-in-a-Box offering is unique in the industry; the product of RAM’s extensive experience in Medicare Advantage and an unwavering commitment to changing our industry. HEALTHsuite Advantage™ and eHealthsuite™ are the cornerstones of our pre-configured Medicare Advantage-in-a-Box offering. HEALTHsuite Advantage is a fully integrated suite of modules providing our clients with an unmatched solution to administer their Medicare Advantage and Special Needs Plans (SNP’s). -
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QuickCap
MedVision
MedVision Solutions' QuickCap is an administrative and clinical data process management solution that lets users focus on business and not the paperwork. With QuickCap, users have scalable control over their workflow and information to work smarter. QuickCap features a customizable dashboard for ease and gives them automation of their process for speed. QuickCap also streamlines claims work that makes users' work easier. QuickCap also allows users to easily determine profitability for individual providers with analytics. -
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NeoMED EHR
NeoDeck Holdings
Since this platform was developed taking into consideration the high costs that affect health care providers when managing their practice, NeoMed 4 has a billing module and all its capabilities integrated as part of the system. The NeoMed 4 platform is accessible through the Internet and was designed with the collaboration of several expert professionals including doctors, nurses, billers, coders, administrators, and financiers to ensure that all the required aspects of a medical practice are included. This team of consultants ensures that the shortcomings that the industry in general has pointed out in recent years will become a thing of the past. An application to capture images through any mobile device, eliminating the need to enter data from lab results, health plan cards, etc. and adding the information to the medical record on the fly. -
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Noble*Direct
Noble House
In 1989, Richard M. Mehan, founder and CEO of Noble House, Designed Noble*Direct software, with four goals in mind: to design a software that is easy to use, efficiently gets the job done, to innovate current and new features, and the most important goal is to make his customers happy. With his son, Evan Mehan coming into the scene, his plans are to establish the four goals at hand and take Noble House to the next level. Training new billing personnel becomes a quick and painless process allowing you to spend more time providing optimal service to your clients. Noble*Direct has many fully automated features that allows providers to run their company smoothly as possible while growing their patient clientele. We listen to our clients and learn their needs. This is why we continue to design and implement new features to assist in streamlining day to day processes. -
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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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Chart Talk
Mighty Oak Technology
Chart Talk gives you many options for configuring how you use the program, create documents, submit claims, and work with your patients. Easily send, edit claims and receive remits electronically. Patients have secure information to their health information 24/7 from any web-enabled device. A full day of claims can be submitted in seconds by single providers or staff. Chart Talk Billing Service can even be your outsourced billing specialists. Create custom templates, attach files, import received documents. The Chart Talk file cabinet is a versatile document repository to securely store and access patient records. Fully encrypted, backed up, and secured. Your PHI is protected 24/7 when you use Chart Talk. Our intuitive web-based calendar lets you, schedule patients, in seconds accurately and efficiently. Chart Talk comes with tons of clinic reports. Users can access patient, financial, and performance data from any web-enabled device. -
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MediSYS
MediSYS
With a single sign-on solution for PM and EHR, our total clinic solution streamlines workflow, speeds cash flow and maximizes reimbursement. With our team of medical billing & revenue experts, practices typically see bottom-line improvements including fixed-cost reductions. Plus, partnering with our revenue services team gives you peace of mind knowing that you have more time to focus on patient care and patient engagement — what you do best! Empower your team with our industry-leading implementation, training, support, data migrations and interoperability. Proven tools to allow today’s patients and providers to better manage their health. Continued education and training based on industry requirements and guidelines. Connect quickly and efficiently with patients with built-in tools designed specifically for medical practices. -
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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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Medical Office One
Biosoftworld Medical Software
Medical Office One. A HIPAA Compliant - NPI Compliant and feature-rich medical billing software package. Fast and easy to use, it allows the creation of the new CMS 1500 02/12 or UB-04 claims. Provides full customization, excellent reporting features and points of integration with popular software packages including Microsoft Word, Excel & Outlook. Data for claims can be entered directly or can be retrieved for the Electronic Medical Records portion of the software. Print the CMS 1500 and UB-04 Form, or send claims electronically to clearinghouses. Medical Office One provides QuickBooks® integration, an advanced SOAP Notes module, and a powerful chart generator. You can create additional databases for unlimited providers - practices! and handle all from the same interface. Start a successful medical billing from home business. Handle with one software package billing and clinical side of your healthcare practice. A powerful CMS 1500 Form Filler or UB-04 Form Filler.
