Alternatives to BRMS
Compare BRMS alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to BRMS in 2026. Compare features, ratings, user reviews, pricing, and more from BRMS competitors and alternatives in order to make an informed decision for your business.
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1
expEDIum Medical Billing
iTech Workshop
A secure, SaaS-based Medical Billing, RCM software that helps doctors to increase the collection, and receive faster payment with improved automation. Features like Seamless Insurance Eligibility Verification (IEV), Appointment scheduling, Claims scrubbing, Claim Status Inquiry (CSI),Auto Posting, and Public health clinic make the software efficient and easy to use. expEDIum SDK is available with several APIs to integrate EMR software seamlessly with expEDIum Medical Billing / RCM software. -
2
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. -
3
Cortex EDI
Cortex EDI
Cortex EDI provides medical, institutional, and dental practices with all the services they need to increase efficiency in the workplace. Our free medical billing software and claims clearinghouse software can help you streamline your workplace processes. We have the user-friendly tools you need to help you manage client billing and save you time. Our tools also provide you with such necessities as patient eligibility verification for private health insurance, Medicare, and Medicaid. We provide our free medical billing software to medical, institutional, and dental practices with no signup fees and no contracts. Sign up today to receive free training on how to properly use our practice management and medical claims clearinghouse software. Consolidate your various EDI service needs with Cortex EDI today to start streamlining your workplace processes. Cortex EDI is a leading clearinghouse and practice management software vendor for electronic medical transactions. -
4
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. -
5
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. -
6
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. -
7
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. -
8
FundOfficeXG
basys
FundOfficeXG from basys can dramatically increase your benefits administration efficiency by tracking every aspect of your contributions accounting and eligibility operations. The versatile and powerful FundOfficeXG administration suite from basys, coupled with convenient online self-service portals, provides everything you need to manage, track and calculate eligibility and employer contributions. FundOfficeXG includes a wide range of enhanced processing features, giving you an end-to-end solution for managing both remittance and collection of benefit contributions and eligibility for your members and their families – all built on our secure, time-tested calculation engine with highly configurable parameters you control. FundOfficeXG can simplify even the most complicated tasks, including multiemployer health eligibility, hour bank administration, retiree health benefits, premium billing and COBRA processing. -
9
MediClaims
WLT Software
WLT’s MediClaims system offers a cost-effective, straightforward, and efficient approach to benefit and claims administration. WLT’s rules-based architecture and integrated EDI processes allow claims to be processed quickly, easily, and accurately. MediClaims’ administration and processing capabilities encompass a range of benefit and claim types, from Medical, Dental, Vision, and Prescription Drugs, to Consumer-Driven Healthcare, Disability, and Capitation processing. With WLT’s MediClaims system, you have the flexibility to configure your groups for a single line of coverage or for complex benefit packages with multiple lines of coverage. No plan can work efficiently without support from reliable information systems. WLT makes a point of always working with the most advanced technologies, providing you with the most sophisticated and flexible systems available today.Starting Price: $1 one-time payment -
10
Garner
Garner
Garner delivers a data-driven platform that enables individuals, employers, and health plans to identify top-performing medical providers by leveraging one of the largest claims databases in the U.S., over 60 billion records covering more than 320 million patients. It uses more than 500 specialty-specific quality and efficiency metrics to analyze provider performance and diagnose outcomes, and a verified directory powered by AI that achieves approximately 92% accuracy for provider phone, address, and appointment-availability information. Providers flagged as “Top Providers” meet rigorous criteria, including evidence-based treatment, minimized unnecessary procedures, and efficient cost structures. Members can use a mobile app and concierge service to locate in-network Top Providers with available appointments, and when eligible, have certain out-of-pocket costs reimbursed for services rendered by these providers.Starting Price: Free -
11
DocVilla
PS3G
DocVilla is a comprehensive, multi-specialty, mobile-friendly, HIPAA-compliant cloud-based health technology platform that integrates EHR/EMR, telehealth, e-prescribing, patient engagement, medical billing, analytics and reporting, direct primary care, inventory management, remote patient monitoring, and more into a unified, configurable suite. Providers simply sign in to access a customizable electronic medical records system with secure messaging, video visits, controlled-substance e-Rx, and a free patient portal for scheduling, payment, and secure communications. The platform streamlines workflows by automating eligibility checks, claim submissions, charge posting, insurance eligibility and claim filing, ERAs/EOBs, medical dictation and speech-to-text, patient consent forms, lab integrations, electronic fax, and automatic appointment reminders.Starting Price: $100 per month -
12
NovoHealth Dental
NovoDynamics
Our platform automatically flags and prioritizes anomalous claims for review. NovoHealth Dental ensures exceptional claim quality and offers real-time analysis. Our platform provides accurate and consistent dental disease assessment. The future of dental claims processing is here. Our proven AI platform is in use within some of the country's largest dental payer organizations. We offer pilots to demonstrate the value of our solution. NovoHealth Dental saves time and money by making dental insurance claim review faster, easier and more efficient. It helps your analysts uncover anomalies that may indicate errors, omissions or potential fraud. We use AI to quickly verify and assess the quality of submitted claims and their attachments. The platform quickly, accurately, and consistently assesses dental diseases. Our AI fingerprints and analyzes every claim and attachment to detect high-confidence anomalies. -
13
MedClarity
Medusind
MedClarity is Medusind's turnkey RCM technology. MedClarity is a robust, web-based medical billing and practice-management software. The solution comes with a range of tools to enable medical practices of all sizes to take full control of their front-office and revenue operations. In addition to offering intuitive navigation and workflows, MedClarity boasts an advanced rules engine for clean claim submission, smart scheduler, comprehensive reporting and business analytics, real-time insurance eligibility verification, denial management and claim status lookup, and integration more than 30 EMR platforms. -
14
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 -
15
Boast
Boast
Boast is the only R&D tax credit solution that combines technical and R&D tax expertise with AI to simplify claim preparation and maximize returns. Boast helps you easily identify and claim more innovation capital with our secure, AI-driven platform and in-house R&D tax expertise. From project identification and strategy to evidence collection, we don’t miss a thing. That’s why thousands of innovative companies use Boast every year to get higher claims, with less effort, and peace of mind. More than 98% of Boast claims are delivered without an audit. When our customers do hear from the CRA or IRS, we recover up to 95% of the estimated claim. We represent you at every step during the audit so it’s not a burden to you or your team. Boast’s AI-driven platform continuously identifies eligible R&D work and investments throughout your product development. Our in-house technical team also checks in proactively to ensure we don’t miss any eligible R&D tax credit claim opportunities. -
16
Endo-Exec
DSN
Endo-Exec is decision-support software engineered for maximum interoperability with today’s most advanced diagnostic and clinical devices. You’ll find integration with the leading technology providers in their respective fields to be instantaneous, seamless, and extremely reliable. Introducing practice management software that delivers true clarity. Endo-Exec® v20 practice management software is a profoundly deeper, more complete understanding of your patients and your practice from comprehensive digital records and advanced analytics at your fingertips at all times. In a minimum of keystrokes, you can monitor insurance eligibility and track claims, assess potential drug interaction, or even go fully digital with an optional, fully-embedded Electronic Medical Record (EMR) module that already sets the standard for dental specialist practices. Endo-Exec is decision-support software engineered for maximum interoperability with today’s most advanced diagnostic and clinical devices. -
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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. -
18
PracticePro
MTBC
MTBC provides more than just medical billing services. We help doctors automate their manually handled tasks. PracticePro™ simplifies every step of the practice management and medical billing process, right from the initial scheduling of an appointment to the provision of quality service and remittance tasks following every patient’s visit. These technologically advanced medical billing solutions automate your office’s labor-intensive jobs, allowing you to focus more on patient care rather than administrative chores. It takes the stress out of preparing claims by auto-populating fields and providing built-in tools like diagnosis and CPT code lookups. An advanced collection of billing rules and real-time error alerts are built into the workflow to prevent mistakes, so you can prepare claims quickly and accurately. Provides real-time insurance eligibility verification. -
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Amazing Charts Practice Management
Amazing Charts
Amazing Charts Practice Management is a comprehensive solution designed to streamline administrative tasks and enhance the efficiency of independent medical practices. Developed by a practicing physician, this system automates processes such as capturing patient demographics, scheduling appointments, pre-registering patients with insurance eligibility checks, and generating analytical reports. It also determines patient financial responsibilities at the point of care, maintains insurance payer lists, and ensures prompt and accurate billing to assist in payment collection efforts. Key features include the ability to view unpaid claims to ensure timely resolution, a claims manager who reviews submissions to reduce denials, and an integrated secure connect clearinghouse for high-level support and quick responses to payer changes. The system offers intelligent, interactive role-based dashboards that automatically prioritize work lists across all office areas.Starting Price: $229 per month -
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DentalXChange
DentalXChange
Submit claims online using your practice management software or direct online entry. Check patient eligibility, plan benefits details, and claim status. Easily attach documentation to a claim without having to use any other service. Create a fully functional, professional website for your practice featuring web portal capabilities. Allow patients to view and pay their statements and give office staff access to your DentalXChange dashboard directly through your practice's website. Offer patient education videos to your patients on your website to help them visually understand their treatment options. Send statements to your patient's email with a secure web link to give them the option to pay online. Market your practice and increase your visibility with free inclusion in our nationwide online dental provider community. Manage your staff hours online and calculate your payroll with ease. -
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SettlementDriver
SettlementDriver
SettlementDriver is an online dispute resolution (ODR) platform designed to streamline and automate the settlement of bodily injury claims, particularly in the insurance industry. It utilizes artificial intelligence to analyze medical records, calculate damages, and generate settlement proposals, aiming to expedite the claims process and reduce administrative costs. SettlementDriver offers features such as automated document management, secure communication channels, and integration with existing claims management systems, facilitating a seamless workflow for insurance adjusters and legal professionals. By leveraging technology, SettlementDriver seeks to enhance the efficiency and accuracy of settlement negotiations, ultimately benefiting both insurers and claimants. -
22
Beagle Labs
Beagle Labs
Streamlining the claims process from end to end. Technology-driven, people-centric, and built on integrity. A robust claims service interaction platform for insurance carriers, MGAs, captives, and self-insured entities. Deployments, claims organization, and advanced file management at your fingertips. At Beagle, we understand the unique challenges faced by insurance service providers and independent adjusters when it comes to claims handling. Our core software functionality is designed to streamline the process, reduce costs, and provide rapid responses to your claims. Our technology brings efficiency and expertise to every step of the adjustment process. Express claims and inspection responses that reduce liability and drive efficiency. New policy inspections, policy renewals, and daily losses. Beagle was developed to handle the processes required on a daily basis. Streamlined claims handling by leveraging the latest technologies that enable a more efficient resolution. -
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Claims Software
Claim Ruler
A new and smarter way to process and settle claims. Modern, end-to-end solutions to settle claims for all lines of property, liability, and workers’ compensation insurance. ClaimRuler™ is a cloud-based claims management system designed specifically for I/A firms and Third-Party Administrators, CAT Adjusters, Insurance Carriers, Self-Insureds, and Municipalities. The platform supports end-to-end claims processing with built-in guided workflows, robust reporting capabilities, and a fully automated diary system to streamline the settlement of claims. ClaimRuler™ was purposefully built to service the needs of real people in the industry. Its functional and intuitive approach to design makes working with forms, lists, documents, and photos a simpler and more natural experience. From I/A firms, TPAs, and insurance carriers to municipalities and self-insured corporations, ClaimRuler™ adapts and scales along with your organization. -
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Axxess Home Health
Axxess
Increase your organization’s cash flow by processing claims from Medicare, Medicaid and all other commercial payers. Automated processing of all payer claims in real time from anywhere at anytime ensures your claims get processed and get paid faster. Automatically submit and track your claims from anywhere at any time with real-time claims status updates. You are assigned a dedicated account manager that is a certified health care claims manager. You even have their mobile phone number. Diversify your revenue sources and improve your cash flow with our automated, anytime, anywhere claims processing with complete visibility to all your electronic funds transfers (EFT) and payment projections. Process, track and fix claims in real-time to capture all your revenue while eliminating costly time-consuming processes. Automate Medicare eligibility verification and claims processing. -
25
DentalPlus
DentalPlus
DentalPlus is an affordable and reliable solution that puts you in total control of your daily practice processes. Designed by a dentist, for dentists. DentalPlus brings together all the tools you need to efficiently run your practice. You can quickly and easily manage appointments, create treatment plans, record clinical notes, complete medical forms, send reminders, create reports, manage claims and much more. DentalPlus is a British product, with bespoke functionality to meet your exact needs, such as multi-practice groups and record conversion.Starting Price: $105.24 per month -
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PerioVision
Henry Schein One
PerioVision is a unique practice management solution for unique practices. Built for the surgical periodontist, it includes the exact tools and detailed reporting you need to provide excellent care and increase your profits. Based on user input and technical innovations, PerioVision is continuously improving. Its comprehensive patient records, customizable charting, and flexible platform allowing you to practice your way, flawlessly. PerioVision can help you reduce the paper in your practice. Its flexible architecture lets you choose from a number of technologies to create an office that works for you. Its comprehensive reports help you track and improve referrals, production, collections, and more. PerioVision allows your practice to go digital. Medical and dental electronic health records (EHR) are both embedded in one system. You can easily cross-code, using medical codes and dental codes as needed for billing, insurance claims, and record-keeping. -
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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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Practice EHR
Practice EHR
Practice EHR is a cloud-based electronic health record and medical practice management software designed for small to mid-size practices. The platform is customizable to internal medicine practices, chiropractors, physical therapists, family medicine, podiatrists, psychiatrists, and various other specialties. Core features of Practice EHR include electronic medical records, medical billing, patient scheduling, and medical billing services. These applications are available as part of one integrated suite. Electronic medical records are offered as a stand alone feature for practices that need a simplified solution. Other features include: e-prescribing, lab integration, procedure workflows, narrative reports, tablet PC support, patient portals, and ONC-ATCB 2015 edition certification. Eligibility inquiry, claim scrubbing, and workers’ compensation claims are offered for practices that choose to utilize the medical billing application.Starting Price: $179.00/month -
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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. HIPAA 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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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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Kovo RCM
Kovo RCM
Kovo RCM is a revenue cycle management and medical billing service platform that helps healthcare providers streamline billing processes, optimize reimbursements, and reduce administrative burden so clinicians can focus more on patient care. It delivers end-to-end RCM services that include insurance eligibility verification, claims submission and tracking, denial management and appeals, coding support, credentialing, patient billing and collections, and custom reporting and analytics to provide clear financial insights and improve cash flow. Kovo RCM supports a wide range of medical specialties, including cardiology, anesthesiology, radiology, mental and behavioral health, internal medicine, surgery, EMS and ambulance services, wound care, and more, offering tailored billing expertise for the unique coding and reimbursement challenges each field faces. -
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I-Med Claims
I-Med Claims
I-Med Claims provides top-tier medical billing and revenue cycle management (RCM) solutions, trusted by healthcare practices across the U.S. We handle all aspects of RCM, from eligibility verification to denial management, helping practices streamline operations and maximize reimbursements. With billing plans starting at just 2.95% of monthly collections, we offer affordable solutions that enhance financial workflows, maintain compliance, and improve cash flow. By outsourcing billing to us, practices can focus on patient care while benefiting from reduced claim denials and faster payments. -
33
MedOffice
ClaimTek Systems
More Americans are insured than ever before. Outsourced medical billing is expected to surpass “in-house” billing and nearly triple by 2024! Personalized one-on-one training to fit Your schedule, pace and background. Training from the Comfort of your home. No travel necessary. Growing, steady and recurring income. Generate multiple streams of revenue by offering a dozen practice management services. Work with any Medical & Dental specialty In the U.S. with no territorial restrictions. Excellent marketing campaign provided. ClaimTek is a market leader in the world of Health Information Technology (HIT) being the owner and developer of its software applications MedOffice® DentOffice® EHR Manager® and VisitTek.® Leverage the power of ClaimTek’s established branding, proven business model, world-class training & support, and our cutting-edge technology. For full details or to chat with one of our Business Development Managers, leave your information below. -
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CLARA Analytics
CLARA Analytics
CLARA Analytics brings AI to claims management with CLARAty.ai, the top-rated casualty Claims Intelligence Platform. Designed for risk professionals, CLARAty.ai incorporates Document Intelligence and Claims Guidance, ensuring a smarter, more efficient claims process. The platform also features an AI-driven Claims Management assistant that supports adjusters at carriers, MGA/MGUs, reinsurers, and self-insured organizations. By leveraging the power of AI and machine learning, CLARAty.ai helps reduce loss costs and operational expenses while streamlining claims handling and decision-making. -
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Sana Benefits
Sana
We’ve made it simple. Benefit packages for employers with full medical, dental, vision and more without the headaches or hidden fees. Get real savings and top notch, modern benefits for you and your employees. If your employees love free smart toothbrushes and great dental coverage, they will love our partnership with beam dental. We took the traditional health plan and made it better. From co-insurance to referrals, our motivation has been simple: give it all and then some. We’ve done away with the old-school network. All of our plans are PPO Plus. This means you get access to our extensive Sana Care ecosystem and provider network, plus you can invite any provider you want without paying out-of-network fees. We break it down so you understand exactly what you’re getting, how much you’re paying, and why. All the info you want and nothing you don’t. Manage your organization’s benefits more easily than ever before. -
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Pazcare
Pazcare
Give your employees’ the insurance plan they want. Pazcare ensures a seamless experience while they exercise their insurance claims. Unlike any retail health insurance plan, group medical insurance is highly customizable according to your needs. In simple words, you only pay for what you choose. Road accidents are one of the top 10 causes of death in India. Protect your employees with group personal accident insurance from unfortunate accidents and expenses. Employees are relieved from the hassle of going through medical check-ups under Group Term Life Insurance Plans. We don't require medical check-ups and reports to buy a group term insurance from Pazcare. -
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Experian Health
Experian Health
Patient access is the starting point for your entire revenue cycle process. Ensuring correct patient information on the front end reduces the errors that cause rework in the back office. 10 to 20 percent of a health system's revenue is forced to remediate denied medical claims and 30 to 50 percent of those occur during patient access. By adopting an automated, data-driven workflow—not only are you reducing the errors that lead to claim denials, you’re also improving access to care for your patients through capabilities like online scheduling options that are available 24/7. Access is further improved by reducing the friction around patient billing by leveraging real-time eligibility verification to deliver accurate patient estimates at registration. Increase staff efficiencies by improving registration accuracy. Correct discrepancies and errors in real time to avoid costly denials and rework. -
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Artsyl ClaimAction
Artsyl Technologies
Processing high volumes of medical claims through intelligent automation helps businesses deliver higher levels of efficiency that does more than reduce costs. For organizations that rely on manual processes, managing medical claims documents and data is labor-intensive and error-prone, injecting unnecessary risk into the process. With ClaimAction medical claims processing software from Artsyl, your organization can improve margins, minimize touch points and eliminate processing bottlenecks. Capture medical claims data without the need for custom software coding. Route claims data and documents automatically to the right claim examiner, based on your business rules. Configure complex benefits and reimbursement rules to streamline processing and reduce payment delays. Respond quickly to changing government regulations and support data, document and process compliance. -
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Veritable
314e Corporation
Veritable accelerates patient insurance eligibility verification and claims-status checks by providing instantaneous results in a clean, intuitive interface. It supports real-time, batch uploading of patient lists to verify eligibility across more than 1,000 payers (including national Medicare and all state Medicaid) and multiple service types. It also enables tracking of claims status, from submission through reimbursement, so practices and billing companies can proactively identify issues to reduce payment delays and denials. Key benefits include automating eligibility and claims workflows to reduce manual entry and phone calls, improving front-desk patient experience by validating coverage and copayments at check-in, and offering seamless integration for both technical and non-technical users with strong data-security controls. It includes a “Code Explorer” for instant lookup of ICD-10-CM, ICD-10-PCS, HCPCS Level II, and CPT codes.Starting Price: $50 per month -
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Painworth
Painworth
PainWorth PRO is a professional-grade platform designed to streamline the settlement of bodily injury claims through automation and data-driven insights. It enables legal and insurance professionals to efficiently manage multiple claims, calculate various heads of damages, including pain and suffering, income loss, and medical expenses, and generate comprehensive reports such as mediation memos, case summaries, and medical chronologies. It leverages artificial intelligence to analyze thousands of similar cases, providing users with comparable case data to inform settlement decisions. PainWorth PRO also offers features like medical record retrieval, evidence summaries, enhanced research tools, and metric reporting to support professionals in achieving faster and more accurate claim resolutions. By automating administrative tasks, the platform aims to reduce overhead costs and minimize disputed claims, ultimately enhancing efficiency and consistency in the claims process. -
41
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. -
42
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. -
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MedicsPremier
Advanced Data Systems
Keep your practice on track with MedicsPremier (MedicsPM), a reliable practice management software from Advanced Data Systems. MedicsPremier comes with a wealth of tools that enables practices to streamline operations and get paid more, faster. This includes specialty-specific scheduling, automated patient workflow, patient information management, tax rates, products and inventory, specialty-specific EDI, patient statements, and integrated document scanning. With our system, get out-of-network alerts while scheduling patients. Access the patient responsibility estimator for an approximation of what they’ll owe after insurance. Remind patients about their copayments. Perform pre-appointment batch eligibility verifications. Get proactive alerts on claims likely to be denied. Yes…protect your revenue in advance! -
44
Virtual Benefits Administrator (VBA)
Virtual Benefits Administrator
Virtual Benefits Administrator (VBA) is the industry's leading cloud-based benefits administration software solution. With a robust functionality and unlimited flexibility, VBA allows users to build and manage medical, vision, dental, disability, Medicaid, Medicare, Medicare Supplement, care management, long-term care health benefits, health savings accounts (HSAs), flexible spending accounts (FSAs), health reimbursement accounts (HRAs), and COBRA. -
45
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. -
46
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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Eligible
Eligible
Eligible's powerful APIs are the easiest way to add insurance billing experiences into your applications. These accreditations assure patients and providers that Eligible has accomplished the strictest compliance with privacy and security best practices while processing millions of healthcare cases each month. We fully understand the role of a mature and proven information security program in meeting Eligible and customer goals. We are happy to announce the successful completion of our Type II SOC2 review. Achieving this certification helps us assure our customers and the companies with which we interact that we understand our responsibilities in keeping protected health information safe. Instantly deliver exceptional experiences for patient insurance billing to your end users. Run estimations, perform insurance verifications and file patient's claims all with simple APIs.Starting Price: 3% Fee -
48
ALYCE Claims Management
Brightwork
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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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). -
50
ClaimEOT
ClaimEOT
ClaimEOT is a web-based software designed to perform forensic delay analysis, helping users accurately track project delays and determine eligible extensions of time (EOT) and compensable delays. The application utilizes a single as-built program to analyze project timelines from start to finish, identifying critical delays, concurrent delays, and excusable delays. It provides detailed insights into the project’s status and calculates compensable delays, enabling contractors, consultants, and legal professionals to make informed decisions. ClaimEOT is ideal for contractors, subcontractors, claims consultants, clients, and legal professionals needing an efficient way to assess delay claims. ClaimEOT’s Features ClaimEOT automatically performs Forensic Delay Analysis, and: ⦁ Instantly identifies Critically Delayed Activities and concurrency; ⦁ Provides daily insight into Project Delay; ⦁ Identifies Dynamic Critical Path; ⦁ Automatically drafts Notice of Delay Events;Starting Price: $5
