Alternatives to Artsyl ClaimAction
Compare Artsyl ClaimAction alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to Artsyl ClaimAction in 2026. Compare features, ratings, user reviews, pricing, and more from Artsyl ClaimAction competitors and alternatives in order to make an informed decision for your business.
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RXNT
RXNT
RXNT is an ambulatory healthcare technology pioneer that empowers medical practices and healthcare organizations to succeed and scale through innovative, data-backed, AI-powered software. Our fully-integrated, ONC-certified suite of medical software—like Clinical EHRs, Practice Management, Medical Billing and RCM, E-Prescribing, Practice Scheduling, Patient Portal, and more—optimizes clinical outcomes and RCM for your practice. Used by tens of thousands of medical professionals—from large physician practices to medical billing companies—to drive growth, streamline business operations, and improve patient care across all 50 U.S. states. Our unified “Full Suite” system employs a secure, central database so your data passes through every product in real-time from anywhere, and more than 125 million prescriptions have been transmitted and over $7 billion in claims have been processed using RXNT. -
2
XpertCoding
XpertDox
XpertCoding is an AI-powered medical coding software by XpertDox that uses advanced AI, natural language processing (NLP), and machine learning to code medical claims automatically within 24 hours. It automates the coding process, enabling faster and more accurate claims submissions to maximize financial gains for healthcare organizations. Features include minimal human supervision, easy EHR connectivity, flexible cost structure, a significant reduction in denials and coding costs, a HIPAA-compliant business intelligence platform, risk-free implementation with no initial fee and a free first month, and higher coding accuracy. XpertCoding's autonomous coding solution helps healthcare providers and organizations get paid faster, accelerating the revenue cycle and allowing them to focus on patient care. Opt for XpertCoding for a reliable and accurate medical coding software solution for your practice. -
3
Healthicity Audit Manager
Healthicity
For medical auditing, Audit Manager streamlines the way you manage audits by merging audit workflow, management, education, and reporting into one easy-to-use, web-based solution. Audit Manager brings simplicity by helping you: Identify Revenue Evaluate financial impact. Minimize denials and identify up to 10%, per provider, in missed revenue with extensive reporting and analytics tools. Increase Efficiency Improve your auditing efficiency by up to 40%. Reduce the amount of time you spend completing audits with our user-friendly interface. Improve Accuracy Customize your audit templates. Include your own standards, MAC carrier guidelines, and claim scrubber tech for ideal results. Audit Manager features: Built-in Tableau integration for in-depth analytics and reporting. Flexible Audit Management: View the status, and each associated status, of every audit, by any auditor. E/M Calculator Automatically calculate E/M codes with a built-in calculator.Starting Price: $670/mo for 3 users -
4
Virtual Examiner
PCG Software
Virtual Examiner®, PCG Software’s flagship product, monitors the internal claims process of an organization to trend provider data for fraudulent and abusive billing patterns, and maximizes financial recoveries. PCG Software’s Virtual Examiner® allows healthcare organizations to enhance their current claims adjudication system with more than 31 million edits per claim. The software solution monitors an organization’s internal claims process to identify unclean claims and reduce payment for improper or erroneous coding to conserve premium dollars. Virtual Examiner® is more than a claims review solution with a focus on code combinations. It is a cost containment solution that evaluates the claim not only for abusive billing patterns but also identifies those claims that may involve third-party liability/coordination of benefits, case management opportunities, physician billing education and many other cost recovery reports. -
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ZOLL Billing
ZOLL Data Systems
Progressive revenue cycle management is, in many ways, the backbone of a thriving medical services operation. Controlling costs, increasing productivity, and accelerating reimbursements are essential activities that keep EMS agencies rolling. Yet efficiently progressing a claim through its lifecycle has traditionally been labor-intensive and prone to delays caused by documentation and coding inaccuracies. ZOLL® Billing is a cloud-based solution that enables revenue cycle professionals to turbo-charge billing performance and deliver more revenue. By automating workflows and eliminating billing errors, ZOLL Billing helps you process more claims with fewer resources and address compliance risk at the same time. Increase productivity and revenue with automated workflows that enable you to process more claims. -
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E-COMB
KBTS Technologies
EDI Compatible Medical Billing (E-COMB) is a web based solution for generating medical claims complying with the HIPAA transaction and code set standards, regulated by the US Government following the recommendations of American National Standards Institute (ANSI). The application is designed to generate, submit and reconcile the claims to the insurance carriers, guarantors and/or patients. This is one of the most important tools for doctors in realizing their revenue by reducing the turnaround time in the claims reimbursement. All the information related to environment of the Doctor’s Office/Hospital is grouped together as Master Data. This information is frequently used for claims processing and is less likely to change quite often. Master Data contains details of the Procedures, Diagnoses, Doctors, Payers, and Billing Providers etc. This data is created as part of the initial set up and can be updated easily at any time. -
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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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eClaimStatus
eClaimStatus
eClaimStatus provides simple, practical, efficient and cost effective real time Medical Insurance Eligibility Verification system and Claim Status solutions that power value added healthcare environments. At a time when healthcare insurance companies are reducing reimbursement rates, medical practitioners must monitor their revenue closely and eliminate all possible leakages and payment risks. Inaccurate insurance eligibility verification causes more than 75% of claim rejections and denials by payers. Furthermore, refiling rejected claims cost an organization $50,000 to $250,000 in annual net revenue for every 1% of claims rejected (HFMA.org). To overcome the revenue leakages, you need a no-fuss, affordable and effective Health Insurance Verification and Claim Status software. eClaimStatus was designed to solve these specific challenges. -
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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. -
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Pro Health Billing
Pro Health Billing
Pro Health Billing's Medical Billing Software has simple tools that help with data entry, automated task that take only minutes to setup and very easy to use. You can print your first claim in 20 minutes! With tools like Auto-Codes, Repeat Last Claim and Auto Co-Pays. Pro Health Billing is a wrist saver! Small Medical Practice Companies love Pro Health Billing's Claim and Patient Scheduling Modules. Together they become a powerful tool that cuts your workload almost in half! With tools like Non Payment and Non Billed Alerts your revenue will increase as your workload shrinks! 'Pro Health Billing' is the best medical billing software to help you bring in more income and quickly! With our Claim Catcher Dashboard and our industry leading 'Revenue Cycle Manager' to fix those alerts, claims never go unnoticed! Know the status of all your claims with just a glance. -
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Claim Agent
EMCsoft
EMCsoft’s Claims Management Ecosystem assures that healthcare providers and billing companies deliver clean claims to insurance payers for proper claim adjudication. It is the integration of our versatile claims processing software Claim Agent and comprehensive fitting process called the Four Step Methodology into your claim adjudication process. This approach enables, supports, and automates your work process to maximize claim reimbursement. Request our free online demo for a great introduction into the functionality/features of Claim Agent and how it fits into your claim adjudication process. Claim Agent scrubs and processes your claims from the provider system to the insurance payers in a efficient, cost effective, and timely manner. The software is compatible with any system making implementation process quick and simple. We provide custom edits, bridge routines, payer lists, and work flow settings that are unique to each user. -
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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. -
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Iridium Suite
Medical Business Systems
Iridium Suite was developed with a focus on seamless processing of electronic claims and electronic remittances through its fully-integrated, web-based program. Shavara is an innovator in the field of medical billing software. Shavara's differentiator is the cumulative experience of 100+ years of laser focus in solving gaps and vulnerabilities in billing, coding and connectivity. Iridium Suite is purpose-built for Oncology. Built-in capability to enable Record & Verify integration; OncoChart integration; CureMD integration are powerful features matched to the requirements for Medical Oncology and Urology Billing Software. Shavara's Iridium Suite features leading-edge technology such as a built-in scheduler, a customizeable automatic medical claim scrubber, seamless electronic billing, and premium reporting. Iridium Suite is platform-agnostic, allowing you to use it as Medical Billing Software for Mac, PC, and even Linux systems.Starting Price: $425 per month -
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Semantic Health
Semantic Health
Next-generation medical coding & auditing with AI. Streamline your manual inpatient coding and auditing processes, improve coding and documentation quality, and unlock your team to focus on high-value work. Semantic Health drives improvement at leading hospitals. Semantic Health uses custom clinical AI and NLP algorithms, trained on millions of records by our world-class AI team, to parse through clinical and coded data which allows our coding and auditing engines to better understand nuanced clinical context, incorporate changing coding guidelines and rules, and suggest high-quality coding and auditing opportunities with clear evidence back to the clinical documentation. Save time and optimize your revenue cycle by adding AI to labor-intensive medical coding and auditing processes. Semantic Health offers hospitals and health systems a supercharged inpatient auditing platform for a 100% pre-bill review of claims data. -
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Precision Practice Management
Precision Practice Management
Whether you're looking to outsource all of your revenue cycle management functions or just some of them, Precision Practice Management has the experience and expertise to help you stay on top of the constantly changing landscape in this most important area. Precision can successfully address all areas of revenue cycle management, from compliance, credentialing, coding, claims processing, clearinghouse edits and electronic lockbox to claim denial management, reporting, financial analyses and more. Your in-house staff may be doing a tremendous job in managing some or most aspects of your medical billing, but your office staff has many other important clinical functions to perform. Sometimes billing matters receive lower priority and suffer as a result. Precision's medical billing experts are focused entirely on medical billing and nothing else; that's all they do. -
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ImagineMedMC
Imagine Software
Manage your members' healthcare and networks with a cloud-based healthcare delivery system. Automate claims processing for managed care organizations. Includes eligibility, referral and authorization processing, provider contracting, benefit administration, auto claims adjudication, capitation (PCP and Specialty), EOB/EFT check processing, and EDI transfers and reporting. Deploy as a cloud solution or an in-house system. Ideal for managed care organizations (MCOs), independent physician organizations (IPAs), third-party administrators (TPAs), preferred provider organizations (PPOs), and self-insured groups. Streamline the complexities of administrating eligibility, referral authorization and claims processing. Features and functions maximize data integrity while reducing data entry. -
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QuickClaim
Hype Systems
We understand that people don't need their software to do everything. Especially not across specialties, practices, clinics, and hospitals. That is why we have created systems that are modular and will fit what YOU need. The front end (users) offers an intuitive, clutter-free interface; while the back end utilizes cutting-edge technology and database engines to ensure your data is safe and secured. And so you get paid... the first time! Used and loved by over 1,200 Ontario physicians, billing agencies and small to large multi-location clinics and hospitals. QuickClaim’s finesse has the feel of a well-thought-out tool. QuickClaim fulfills many roles. QuickClaim works with other systems like QuickReq, QuickDOCs and third-party systems via HL7 and flat files. Additionally, QuickClaim acts as the offline version of HYPE Medical during rare occasions of Internet failure. As an offline system, it runs independently of the Internet.Starting Price: $1400 one-time payment -
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NeuralRev
NeuralRev
NeuralRev is an AI-powered Revenue Cycle Management (RCM) platform that automates and accelerates end-to-end financial workflows in healthcare, reducing manual effort and errors while improving cash flow and operational efficiency. It automates insurance eligibility verification by connecting to clearinghouse networks in real time so patient intake and coverage checks happen instantly, and it handles prior authorization by assembling clinical and payer requirements, submitting requests electronically, and tracking approvals to reduce denials and delays. It also delivers real-time patient cost estimates by combining eligibility data with payer rules to improve transparency and upfront collections, and it streamlines medical coding, claim submission, claims processing, post-claim follow-up, and recovery, so teams spend less time chasing paperwork. -
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ediLive!
Texas Medical Systems
ediLive! claims processing software works with any NSF, ANSI, or print file claim image, allowing the HIPAA complaint transmittal of any practice management software's claim file. Additionally, ediLive! customers benefit from real-time connectivity and claim collections workflow management. ediLive! attaches all claim status messaging from payers directly back to the claim for easy follow-up and correction, taking all incomplete claims and compiling them into a single on-screen worksheet for fast corrections and resubmittal. If you use ediLive!, we have a wonderful product call claims scrubber that can help you to get your claims paid – not only faster, but better! Call our office to schedule a free on-line demonstration. We can scrub the first 100 claims for you as a free trial. Every coding error you make costs your practice money. -
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CMS-1500 Software
Med Claim Software
Our CMS-1500 software is an excellent choice for submitting claims by paper. Download a free trial. We can get you started with the software right away! Order online and our secure shopping cart will guide you through the process to receiving a code which will activate the software any time of the day or night. Type data on the screen as it would be typed on the form itself. Or import from excel (xls or xlsx). Print on pre-printed red Medicare forms or print the entire form in black & white. Align print perfectly with any printer. Save common data for quick completion and to eliminate redundant typing. UB-04 Forms are medical insurance claim forms used by facilities such as hospitals, inpatient and outpatient clinics and ambulatory surgery centers to bill insurance companies for services rendered. The CMS-1500 software functions on any Windows operating system. The software functions on networks or stand-alone personal computers and will work with any printer.Starting Price: $69.95 one-time payment -
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PulsePro Practice Management
Pulse Systems
PulsePro practice management system applies automated workflow logic to join financial, clinical and administrative processes into one package. PulsePro is easy to use and implement, offering advanced scheduling, patient registration, medical billing, coding and claims processing. And because implementation is quick and PulsePro is so easy to learn, your team will be up and running in hours — not days or weeks — performing daily tasks using an industry leading practice management system. Pulse is a leading EHR/PM Company that is a part of the Amazing Charts and Harris Healthcare family. We have a long history supporting medical practices with technology and value-added services. -
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iVEcoder
PCG Software
iVECoder, the decisive code tool with payor intellect, was built on the same intelligence of PCG's Virtual Examiner® claims review engine that healthcare payors worldwide have been using for 25 years. Users can enter multiple codes, and in just a single click, receive multiple answers on a single page. Ramp up coding accuracy and boost your bottom line by using the same billing and coding intelligence platform the payors use. iVECoder is PCG's Virtual Examiner® (VE) claims review engine. This advanced rules based engine —with 45 million edits— is used by healthcare payors throughout the USA and abroad. VE tells payors what to deny or pend for review. -
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Vyne Trellis
Vyne Dental
You have better things to do than sit on the phone. That’s why our real-time eligibility tool allows you to quickly verify your patients’ benefits, regardless of their plan. Gone are the days of paying transaction fees for claims, attachments, and checking eligibility! Our plan includes all features for one monthly fee. Subscribe to Vyne Trellis™ and gain the benefit of our team of industry professionals. With us, you can keep a tab on claims, claims that put money back in your firm’s pocket. Regardless of the size of your practice, our platform can handle any volume of claims. Vyne Trellis™ is integrated with the claims administrators and clearinghouses you need. Our dashboard sends you rejection reasons, status updates, and other smart notifications, so you can keep your claims moving. And if you get a little stuck on a claim, our support team is here to help! No more multiple tabs or windows. You can access virtually all of your data and documents, like ERAs and attachments. -
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ImagineBilling
ImagineSoftware
The industry’s first intelligent, multi-specialty medical billing software. Streamlining billing and patient collections for over 75,000 physicians across the country. Globalized data eliminates the need for duplicate entry. Visit-driven to allow for large volume and complex information. Flexible data structure accommodates requirements across multiple practices and specialties. Helping you get paid faster. Post payment manually or through electronic remittance. Automatically scrub claims for errors and missing information. Automatically refile insurance claims based on selected criteria. Fast review to evaluate and approve charges. Audit charges by modality, procedure, insurance, user, doctor or date of service. Intuitive reports for tracking the financial health of your front-end and back-end billing. Never lose another charge again. Integrates with your preferred clearinghouse or statement vendor. -
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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. -
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Clinicaid
Clinicaid.ca
ClinicAid helps you efficiently optimize your time by letting our cloud based medical billing software do the heavy lifting for you. Keeping patient care as your priority requires keeping administrative work to a minimum with next generation medical billing and coding software. Automatically add your practice and patient information to claims and avoid complicated workflows. ClinicAid physician billing software keeps your practice on track with powerful report options designed with feedback from our clients. That means you have detailed Remittance, Rejection, Efficiency, and other vital reports available at a click. The reporting within our medical billing software meets your changing practice needs. You can customize and save your own reports with up to 46 individual data points for maximum intelligence in your practice.Starting Price: $19 per month -
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ClaimBook
Attune Technologies
ClaimBook enables faster settlement of insurance claims, improved accountability and fewer rejections. It is well equipped with the features to address every part of the claims and evidence submission. ClaimBook supports international patient treatment with dedicated workflows, therefore enabling medical tourism. A built-in Rules Engine that disallows incomplete submissions, and knows what information and documents need to be submitted. This results in error-free submissions that are complete and guarantees that it is pre-authorized. ClaimBook's Smart Data Extraction can read documents uploaded to extract relevant data from the Hospital's Information System (if integrated with ClaimBook) to prevent the need for manual entries. ClaimBook also features Integrated Emailing by creating a virtual inbox in your dashboard. Withing the dashboard, emails can be composed, the design feature is similar to Microsoft Outlook. -
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PatientStudio
PatientStudio
Maximize your appointment calendar with improved visibility into your clinic's schedule and provider availability. View and schedule appointments across many providers, rooms or locations to ensure a steady patient flow. Automatically invite patients to complete patient intake online. Custom digital paperwork can be completed and submitted using a smartphone or personal device. The patient's data will sync directly to their patient chart. Reduce no-shows with perfectly timed patient reminders via email and text message. Patients and staff can communicate, confirm or reschedule with two-way text messaging. Easily generate claims from patient notes and suggested ICD-10 codes. Automatically scrub and submit claims electronically. Services to manage your entire billing process, from submission to payment collection. Quickly create defensible, legible, and comprehensive clinical notes with documentation templates, assessment reports and pre-populated patient data. -
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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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Centauri Health Solutions
Centauri Health Solutions
Centauri Health Solutions is a healthcare technology and services company driven by our desire to make the healthcare system work better for our clients and to provide compassionate support for individuals in need. Our analytics-powered software enables hospitals and health plans (Medicare, Medicaid, Exchange and Commercial) to manage their variable revenue through a custom-built workflow platform. While our tailored support of their patients and members provides them with access to life-enhancing benefits. Our solutions include Risk Adjustment (Medical Record Retrieval, Medical Record Coding, Analytics and RAPS/EDPS Submissions), HEDIS® and Stars Quality Program Management, Clinical Data Exchange, Eligibility and Enrollment, Out-of-State Medicaid Account Management, Revenue Cycle Analytics, Referral Management & Analytics, and Social Determinants of Health. -
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EzyMed Online 4
Top Tech Computing Systems
EzyMed Online 4 is a fully integrated Medical Practice Management software for General Practices, Radiology and Specialists Centres. Developed for the Australian medical practice environment, 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. EzyMed Online is a comprehensive system designed to manage your practice efficiently with just a few clicks of the mouse. A secure database management ensures your system consistently maintains its performance even with a million or more records. From the time a patient is registered at the reception, the consultation is tracked by EzyMed Online 4 and stored in the patient’s database as paperless recording. The patient’s medical history can be retrieved at anytime even to all appointments ever recorded. -
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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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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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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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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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iMedX
iMedX
iMedX, Inc. provides clinical documentation and revenue-cycle solutions designed to help healthcare providers focus on patient care rather than administrative burdens. The platform supports AI medical coding, standard medical coding, clinical documentation, abstraction of core measures, and revenue-cycle-management workflows. Their AI medical coding offering, part of the ‘RCM Companion Suite’, uses advanced machine-learning to improve accuracy, reduce denials, and accelerate payments by automating case-routing, pre‐populating codes, guiding coders in real time, and surfacing documentation gaps before claims leave the organization. Users gain features such as intelligent case routing to the right coder, autonomous resolution of routine cases, in-moment assistance through an AI assistant, and embedded audit tools that identify missed reimbursement, documentation errors, and compliance risks. -
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Flash Code
Flash Code Solutions
Flash Code™ is a coding product designed for the healthcare community. Our goal is to provide exceptional, simple to use, cost-effective software which is provided with unsurpassed customer service. We are a division of Practice Management Information Corporation - the leading independent publisher of coding books. Our team can provide a complete solution to meet your coding and compliance needs via our software and print products. Thanks for taking a few moments of your valuable time to explore what Flash Code can do for you. The merger creates an opportunity for MCCS to provide sophisticated electronic coding and compliance solutions to the health care industry. From the physician checking for medical necessity codes at the point of care, to the insurance manager validating diagnosis codes, or the benefits analyst reviewing health insurance claims for correct coding initiative compliance, MCCS provides a solution to facilitate the process. -
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PowerMed Billing
PowerMed
PowerMed Billing has been built from the ground up to be state-of-the-art. With its powerful feature set, numerous reporting options and electronic claims processing, it will meet the needs of any busy practice. The software can be configured to each individual user's style, including screen appearance, custom navigation commands, and even individual language settings. It contains a full ICD coding library, customizable CPT, HCPCS, super codes, and enterprise-level patient demographics. Because Billing and EMR are essentially one program, all coded visits and claims are automatically pulled for electronic processing or for standard UB92 or CMS1500 printing. Complete with full search and reporting capabilities, practice managers have immediate access to an extensive library of predefined productivity and financial reports broken down by providers, payors and individual patients. -
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Assurance Reimbursement Management
Change Healthcare
An analytics-driven claims and remittance management solution for healthcare providers who want to automate workflows, improve resource utilization, prevent denials, and accelerate cash flow. Increase your first pass claim acceptance rate. Our comprehensive edits package helps you stay current with changing payer rules and regulations. Heighten your staff’s productivity with intuitive, exception-based workflows and automated tasks. Your staff can access our flexible, cloud-based technology from any computer. Manage your secondary claims volume through automatic generation of secondary claims and explanation of benefits (EOB) from the primary remittance advice. Focus on claims that need your attention with predictive artificial intelligence into problem claims. Resolve errors faster, and avoid denials before submittal. Process claims more efficiently. Print and deliver primary paper claims, or add collated claims and EOBs for secondary claims. -
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StreamCare
StreamCare
Increase script adherence and patient convenience while strengthening your bottom line with our comprehensive solution. Our software provides a full suite of services from medication sourcing through claim reimbursement. Our business model is one of true alignment, guaranteeing that we are only compensated when a claim is successfully reimbursed and ensuring that we protect your reputation and referrals. Our solution is a game-changer for pharmacies. No longer an afterthought, Workers’ Comp prescription claims can now help drive profitability in a meaningful way. Transmit your Workers’ Comp claims directly from your pharmacy software to ours and spend more time focused on patient care. Let our experienced reimbursement team and industry-tailored software handle all the paperwork, phone calls, and headaches of reimbursement. -
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CureAR
TechMatter
CureAR is an AI-powered medical billing and revenue cycle management software designed for in-house billers, billing companies managed-service providers and DME companies. The software consolidates eligibility verification, charge capture, AI-assisted coding suggestions, claim scrubbing, electronic claim submission, ERA ingestion, and automated payment posting into a single cloud-hosted system. It is configurable for specialty billing rules and supports multi-tenant operations for practices that handle multiple client accounts. Key Features: AI-assisted coding and claim scrubbing: Machine learning highlights likely coding errors and applies payer-specific validation rules before submission. Real-time claim status and alerts: Tracks claims from submission to adjudication and surfaces exceptions for prioritized follow-up. ERA ingestion and automated posting: Electronic remittance advice handling with configurable reconciliation workflows reduces manual posting effort.Starting Price: $129/month/user -
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Dr. Bill
Grouse Software Labs
Dr. Bill makes billing on the go easy and pain free. Add a patient in as little as 3 seconds and submit a claim with just a few taps. Remove the pain of manual data entry, paper, index cards and clunky software. Take a picture of a patient label and log your claims in seconds. We alert you in real-time with tips and suggestions to help you maximize your billing. No need to memorize codes. Select from a list of favorites or simply search by keyword. Our easy-to-use app makes billing simple and convenient. As new patients roll in, Dr.Bill keeps up. All it takes is a simple snap of a patient’s label to add their profile information to your account. Find the Right Codes Quickly. When it’s time to find the code you need, Dr.Bill is ready. We make it easy to search and even save the ones you use the most. Get Helpful Tips. It pays to know the ways to maximize your claims. Dr.Bill keeps you up to date with tips and suggestions.Starting Price: $30 per month -
43
ARIA Coding Services
CompuGroup Medical US
ARIA Coding Services is designed to assist healthcare providers in navigating the complexities of medical coding, ensuring accurate documentation and timely reimbursements. The service offers three customizable levels to meet varying practice needs. Experts conduct monthly reviews of coding denials and rejections, providing recommendations to improve standard operating procedures and offering optional baseline evaluations of Evaluation and Management (E&M) documentation. Specialists review documentation to confirm coding accuracy, examining superbills, invoices, claims, E&M visits, surgeries, procedures, tests, modifiers, and ICD-10 usage. They deliver regular reports and address discrepancies to enhance coding procedures. A comprehensive service where specialists handle coding directly from provided documentation, ensuring proper entry of charges, thorough documentation in patient notes, and correction of coding rejections or denials as needed. -
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KMR Medical Claims Manager
KMR Systems
KMR Claims Processing Manager is a state-of-the-art, fully integrated, customizable claims processing solution for TPAs, Self Insured and Claims Administrators. Our system includes a comprehensive Medical & Dental Reimbursement module, allows for electronic claims, integrates with Document Imaging systems, has the ability for debit card processing and is totally HIPAA compliant. -
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Hi-Tech Series 3000
Hi-Tech Health
Series 3000 is a cloud-based claims administration solution for businesses within the healthcare industry. No matter what your adjudication, reporting, or plan needs are, this platform reduces time processing claims and increases productivity as it assists with: •Client management •Benefits input •Electronic claim submissions •Claims processing •Real-time status tracking Our built-in database efficiently manages clients and employee benefits. This platform allows users to make real-time updates including: •Claims statuses •Currency conversion •ACH deposits and disbursements •Document printing No matter what happens, our cloud-based software is reliable, and we pride ourselves on 99 percent up time. Series 3000 is HIPAA compliant and ensures secure data management and backup. We upgrade our communications and IBM hardware every two to three years and maintain System Critical Support with all our vendors, keeping our technology up to date.Starting Price: $3500 per month -
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AveaOffice
Avea Solutions
Designed specifically to mirror the typical patient journey from pre-admission to post-discharge, yet flexible enough to adjust to your unique processes, every staff member is guided to push workflows forward effortlessly and capture the information needed to ensure clean claims and maximum reimbursements. From patient intake and benefit verification, across every Utilization Review, marking attendance and getting claims out the door, working denials and collecting payment, we’ve got you covered. It has never been more critical to work smarter and not harder in the industry. We’ve raised the bar when it comes to liberating your teams from the burden of manual processes and workarounds with our automation and powerful claim rules engines. Managing your revenue cycle is like watching dominoes fall in a harmonious pattern. Continuous industry changes, new payer rules, declining reimbursements, tighter margins. -
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Majesco ClaimVantage
Majesco
Digital technologies are having a significant impact on insurance, and those keeping pace with this evolution are on track to maintain a competitive advantage. Traditional claim management tools, involving multiple systems, paper files and manual processes, are being replaced with cloud-native enterprise claim management platforms. The Majesco ClaimVantage Claims Management Software for L&H platform streamlines the claims process through the full life cycle of a claim, from intake through payment calculation, integrating multiple systems to improve the flow of information across your business. Improve the customer experience and drive operational effectiveness with accurate and timely claim decisions. Built on the Salesforce Lightning Platform, Majesco ClaimVantage Claims Management Software for L&H enables insurance companies and TPAs to modernize and optimize their claims operations today and into the future. -
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P3care Medical Billing Software
P3 Healthcare Solutions
Medical billing software prices vary from company to company. As a HIPAA medical billing company, we use software that is compliant and free from bugs. Not every source code meets the requirement of medical billing and coding. Therefore, we use the one that is authentic and has faced the test of time. Medical billing software is provider-friendly, and, virtually assists with billing problems. It is designed to handle calculations of reimbursement, financial data, and revenue cycle management to an advanced level of certainty. Medical billing software has the ability to track every part of the medical billing workflow, from making appointments to processing reimbursements. The following functions define its role in essence. -
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PMS Insight Medical Billing
PMS Insight
PMS Insight is a full-service and highly organized, medical billing service company dedicated to provide complete, custom-made, claims billing and patient accounting services. Our Medical Billing Services team are specialized in efficient and revenue generating billing practices and successfully meet with the demands of various needs of the health care industry. Our Medical Billing Services extends to Houston, Dallas, Austin, Los Angeles, New Jersey and Boston. In any organization dedicated to patient care managing medical billing can be a huge burden and a distraction from the core strength of patient care. Working with a professional medical billing service like PMS Insight guarantees that professionals are at work efficiently managing claims billing, authorization, appeals, patient billing and follow up. We at PMS Insight have streamlined our processes over the years and manage transactions through electronic processing, and integrated medical billing software. -
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RapidClaims
RapidClaims
Reduce administrative costs and improve reimbursements, all while maintaining compliance. Supercharge your RCM process with RapidClaims AI-driven magic. Slash admin costs, boost reimbursements, and stay compliant effortlessly. Streamline your coding process, and automate or empower your coders with our personalized solutions. Code thousands of charts with speed and precision while catering to unique client requirements. Our Large language model can interpret unstructured data, creating a longitudinal patient record by converting notes into structured codes and disease patterns. Never make the same mistakes twice. Create mass-level coding-related rules with plain English and easily apply them to your charts at scale, segregated by specialty, code type, and coders. Gain a deeper understanding of code-level trends for different sites and take action to improve the revenue cycle. Our platform analyzes charts to identify claim denial patterns and helps you capture them.
