Alternatives to Us4U
Compare Us4U alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to Us4U in 2026. Compare features, ratings, user reviews, pricing, and more from Us4U competitors and alternatives in order to make an informed decision for your business.
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1
Service Center
Office Ally
Service Center by Office Ally is a trusted Revenue Cycle Management and patient payments platform used by more than 80,000 healthcare providers and health services organizations, which process more than 950 million transactions annually. Service Center is a cost-effective solution enabling providers to control their revenue cycle. With a user-friendly interface, Service Center helps providers check and verify patients’ eligibility and benefits, submit, correct, and check the status of their claims online, and receive remittance advice. Accepting standard ANSI formats, data entry and pipe-delimited formats, Service Center helps streamline administrative tasks and create more efficient workflows for providers. -
2
Cloud Claims
APP Tech
Improve claim outcomes with streamlined First Notice of Loss (FNOL), claim processing and flexible reporting. INCIDENT BASED CLAIMS MANAGEMENT Effective claims management is about more than simply managing claims outcomes. It is about having an automated process that ensures efficiency and accuracy across the organization, getting timely notice of losses, and taking swift action are keys to success. The incident-based approach of Cloud Claims covers all accidents and losses, delivering a complete picture of loss to executives and claims managers. Cloud Claims by APP Tech is an integrated solution that is highly configurable, with actionable reports to guide decision-making and a friendly UI so you can get work done faster and more confidently. Cloud Claims runs in the cloud, so there’s minimal IT burden and no installation required — just simple configuration, effortless system upgrades, best-in-class security, and the ability to scale quickly.Starting Price: $2,500 per month -
3
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. -
4
RefLynk
RefLynk
Feedback is aggregated & scored by reference relationship. This provides consistent feedback and comparison and it also allows for the easy consumption of a lot of data. Reports are available online or through an integration as html or PDF. RefLynk is used to collect feedback on candidates across many verticals that included pre-employment, stay employment, exit interviews, volunteers, internships and tenant screening. It is a highly configurable software that can be adapted to any use. RefLynk is an innovative reference checking solution. We have turned reference checks into hours not days. Using SMS/ texting technology we have mobilized the reference checking process. Waiting for days to receive reference feedback on a candidate when unemployment is below 3% is not possible. Many organizations are losing great talent to other companies because their reference checks are taking too long. -
5
PayorLink
PayorLink
PayorLink solutions offer more than just medical claims management on behalf of employers to take on a comprehensive platform approach in providing better employee benefits to reduce healthcare costs, promote healthy lifestyle, lifetime health and improve workforce productivity in the process. Rising employee health costs is a worldwide phenomenon and a growing concern for both payor companies and provider entities alike. PayorLink™ is designed to reduce payor health cost, motivate staff productivity and optimize provider claims quality resulting from in part, information exchange efficiencies directly between payor companies and affiliate provider clinic, medical centre or hospital. Enhanced with Employee Health Profile and Assessment tools for staff wellness and productivity realization. -
6
CenterPoint Payroll
Red Wing Software
CenterPoint Payroll software is a locally installed or cloud-based system that adds profits by reducing the time and money associated with payroll processing. System reminders can be set up to alert you when certain processes need to be performed or when taxes are due. (For example, pay your employee medical insurance bills on the 15th of the month or pay your taxes when your Federal Tax Liability account is greater than zero.) All 50 State tax calculations are included as well as unemployment, disability, and some local tax calculations. Paying your employees becomes an easy process in CenterPoint Payroll! Choose to enter detailed time sheets, or easily enter details by using pay defaults. Pull pay data directly from most time clocks into the CenterPoint system. Select hourly employees separate from hourly employees, bi-weekly versus weekly, and more. Save time by copying previous pay runs and use it as a starting point for a current pay run. -
7
Daisee
daisee
Daisee builds technology to provide access to deep insight into the behavioural and emotional dynamics of your customers with the most accurate AI-powered, fully-automated AQM available for more impactful coaching, improved commercial outcomes and compliance monitoring. Daisee analyzes and automatically scores 100% of customer interactions using a world-first automated, digital quality scorecard. This automatically surfaces quality assurance issues that require human intervention in the areas of communication, compliance and conduct. Daisee enables you to see far beyond words alone, surfacing the underlying emotion hidden deep within your interactions – what your customers are really saying, thinking, and feeling. Daisee helps organisations create practical business value immediately, with software that is incredibly flexible and easy to deploy across any telephony system. Globally Daisee operates in Australia, New Zealand and the USA.Starting Price: $89/month -
8
ResolvMD
ResolvMD
ResolvMD is an experienced full-service medical billing company that processes all health service claims (AHCIP etc.) on behalf of physicians. Our goal is to make physicians as confident and competent in their billing as they are in their practice through surfacing data-derived insights and democratized knowledge. We have the most modern, cost-effective, and secure platform on the market for processing claims. Our target audience are physicians (mainly specialists such as emergency physicians, urgent care, plastic surgeons, anesthesiologists, paediatricians, general surgeons etc.). They need a billing agent to process their health service claims. They value time, trust, cost, efficiency and knowledge. We are targeting physicians in Alberta today (mainly in Calgary, Edmonton, Red Deer, Medicine Hat, Lethbridge, Okotoks and any other centre with a population in excess of 25,000. -
9
Livesight
Livesight, a Spring Labs company
BusinessMatch+ provides a further 40+ business attributes like tax liens, judgement, UCC filings, revenue, employee count, normalized company name, layoff notifications, and more. Actionable scores and attributes to anticipate upcoming macro and microeconomic disruptions. Reduce additional verification referrals by predicting the likelihood of income overstatement at the time of application. Reduce costly VOE/I by accessing verification work your peer lenders have already completed, leveraging our secure data network technology. Layoffs, upcoming unemployment, macro and microeconomic disruptions - by industry and by geography. Predict if an employer is likely to be affected by upcoming disruptions.Starting Price: $.10 -
10
omni:us
omni:us
Seamless integration into existing claims systems. Automate processes and reduce costs. No longer is it a choice between saving costs and improving the customer experience. Better decisions with data-driven insights. Automate manual processes. Empower your claims personnel. Invest in your customers’ happiness. Seamlessly integrate incoming claims with your insurance core system. Tackle process inefficiencies with claim automation and watch your customer satisfaction skyrocket. Reduced manual claims incidence of low to moderate complexity by automating claims handling. Improved triaging and manual claims assignment increased case team effectiveness drastically. Decreased process time for remaining manual claims. Allowed a real-time claims settlement in significant amount of cases. Automated digital claims journey by applying FNOL-completeness check, coverage check, automated claims file creation. -
11
CoreLogic Claims Connect
CoreLogic Australia
CoreLogic’s Claims Connect is a powerful solution designed for the insurance industry to streamline and manage claims processes efficiently. The platform allows insurance companies to quickly assess property damage, automate claims handling, and access real-time property data, helping to accelerate claims resolution. By integrating advanced property data analytics, Claims Connect helps insurers improve decision-making, reduce processing times, and enhance customer satisfaction. With features such as automated workflows, reporting tools, and access to accurate property information, this platform optimizes the claims lifecycle from start to finish. -
12
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. -
13
Snapsheet
Snapsheet
Snapsheet makes claims simple. We do this through a suite of innovative insurance software solutions which transform insurance companies' ability to seamlessly manage claims, reduce cycle time, increase appraisal accuracy, and deliver payments effortlessly. We started it all with virtual appraisals, and followed that up with our leading claims management system. Today we are driving an industry-wide movement in claims by delivering solutions that enhance customer experiences while our customers create innovative, data-driven claims organizations. -
14
HomeWork Solutions
HomeWork Solutions
HomeWork Solutions provides a payroll and tax-compliance platform tailored for household employers, such as families hiring nannies, babysitters, senior-care aides, or other domestic staff, as well as small businesses. The platform manages federal and state payroll processing, unemployment and compensation filings, quarterly and year-end tax returns, and provides a mobile app for time-entry and approval by employees. It covers nationwide household-employment compliance, supports time tracking for weekly or bi-weekly payroll, and offers concierge-style support to simplify complex tasks like new-hire reporting and domestic-worker tax classification. Key services also include background checks, long-term-care processing, and full HCM capabilities for small businesses, including insurance and benefits administration, time and labor management, and HR consulting.Starting Price: $120 one-time payment -
15
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 -
16
Conexia
Conexia
Provide authorizations, claims processing and payment in real-time at the point of care. Enhance care coordination and improved outcomes to lower medical cost while streamlining administrative processes. Engage providers at the point of care to capture and share data in real-time resulting in an unparalleled exchange of health information. We partner with our clients to implement risk management strategies that result in better outcomes with lower costs. We strive to improve the user experience for everyone involved in the ecosystem. We deliver a minimum 3:1 ROI for our clients to allow them to optimize their resources. Conexia has developed a core technology platform (ONE) that is customizable to meet the diverse regulatory requirements and operational processes for each client in each geography. In most cases, our initial implementation is an overlay on the payer’s existing technology ecosystem to create real-time processes. -
17
DWF 360
DWF Group
Our software is built on industry expertise and with expert consultancy. We use this knowledge to inform the business processes that need to be embedded into our platform. 360 delivers end-to-end claims and risk management transparency and integrity that allows our clients to lower their total cost of claims. We create better outcomes for our clients by providing cost-effective technology that transforms how they do business. Our software can be configured to specific client needs and is pre-built to ensure a smooth integration into existing systems, releasing in-house resources for value-added activities that allow businesses to differentiate and grow. -
18
Humanic
Humanic
Through our remarkable team of global payroll services experts and our revolutionary international payroll software, we provide an accurate, compliant, and integrated global payroll solution. Have employees working outside of the US? We centralize management of your entire global payroll within a single integrated database. Humanic has a full International Outsource solution that will manage all aspects of your International and Domestic Payroll. We'll navigate your federal, state and international compliancy to ensure accurate and timely filing of withholding, unemployment and other payroll tax obligations! Humanic HR is one of the most robust management system applications on the market today! -
19
CaseGlide
CaseGlide
CaseGlide is driving the revolution in claims litigation management. Gone are the days of disconnected and siloed claims systems, manual and inefficient workflows, and hundreds of emails passing between defense counsel and claims teams containing unstructured case data. With CaseGlide you can focus on strategy, data, and driving efficiency to improve your litigation management program. Our clients better predict and manage their case outcomes, assign the right attorneys to the right cases, work cases more strategically, and significantly reduce their litigation costs. As your defense attorney partners work your cases in the platform, integrations allow you to push important case data to your claims system, data warehouse, document management, or accounts payable system. It’s simple: the longer a case is open, the higher your costs. -
20
SpyGlass
Beacon Technologies
SpyGlass, our enterprise-class health claims management software, offers a powerful, flexible solution for precise and timely claims processing. SpyGlass makes benefit and plan setup remarkably straightforward. BenefitDriven, fully-integrated with SpyGlass, delivers eligibility, contribution accounting, and pension management to the Taft-Hartley industry with the full range of data and processes for Participants and Employers. HIPAA Director, our all-in-one EDI gateway & scheduler, works as a hub by allowing you to directly connect with vendor partners to help avoid transaction costs, manage batch transfers, and automate transfers. SpyGlass provides a deep, landscape view of your population, with the ability to easily drill down to the higher resolution details. Hundreds of unique reports, fully customizable dashboards, and total control over your system are at your fingertips. -
21
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. -
22
EvolutionIQ
EvolutionIQ
Our solutions drive lower loss costs, lower expenses, and higher customer satisfaction, and are proven at tier 1 carriers. EvolutionIQ enables the future of claim handling for complex lines of coverage, a deep partnership between skilled professional adjusters, and a highly specialized predictive guidance system. Equipped with clear prioritization, pro-active claim alerts, and rich context, empowered adjusters reduce losses and expenses while delivering an enhanced claimant experience. Reduce unwanted variability in the claims pipeline with a consistent, scalable claim guidance system. With the more efficient allocation of adjuster resources & fewer wasted claim reviews. With targeted claim investigations, litigation avoidance, and timely claim settlement. Our claims AI acquires and harnesses data to deliver the tactical guidance your team needs. EvolutionIQ combines structured and unstructured carrier data with our proprietary third-party data. -
23
Ventiv Claims
Riskonnect
Lower costs by administering claims with unparalleled efficiency and accuracy. With 500+ global customers and counting, Ventiv is one of the premier leaders in the risk management, insurance claims and advanced analytics space. Helping some of the biggest brands on the planet with products like our industry leading risk analytics solution. -
24
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. -
25
VCA Software
VCA Software
Dreaming of happy, efficient claim handlers; fast, accurate claims resolution; and 5-star policyholder ratings? Our agile, future-ready platform enables your people to perform like rockstars, and equips your company with scalable, intuitive processes to fuel profitable growth. By simplifying and automating the workflow, our clients reduce the cost of the claims journey by as much as 30%. VCA Software is one of the most scalable and integration-friendly platforms in the market. Our robust features, at a mid-range price point, make us a favorite among TPAs and adjusting firms. Yes, VCA is lightning fast, but the system is also whip-smart – equipped with a cutting-edge analytics suite so you can make fact-based decisions. You can count on VCA for industry-leading uptime, privacy, and data security. Our Tier 1 data centers are located in the USA, UK, Canada, and Australia. Our solutions can be easily customized to meet your team’s unique requirements.Starting Price: $65 per month -
26
Aatrix Ultimate Payroll
Aatrix Software
Aatrix Ultimate Payroll™ is powerful payroll software designed by Mac users for Mac users. Ultimate Payroll combines an easy to use interface with an impressive set of features perfect for small businesses. Mac users can choose the features that fit. Small companies can keep things simple, while larger companies can take advantage of the more powerful features. Using Aatrix Ultimate Payroll™ for Mac Payroll will make processing payroll a breeze! Complete your payroll in minutes with this easy to use application. Process payroll on your Mac for unlimited number of employees and departments. Track your employees' hours, vacation time, sick time and holidays. Automatically calculates deductions and creates liability payments. Plus many more time-saving features just right for your business. The best way to avoid costly unemployment claims and other employee-related liabilities is proper documentation. Aatrix now offers a comprehensive set of forms for employee and payroll management. -
27
PY Payroll
EmpowerFinancials
Unlimited number of pay types including regular, hourly, salary, overtime, etc. Effective on/off date for pay rates. Limits by pay period and/or YTD. Deductions. Unlimited number of deductions per employee. Vary the frequency of each deduction as monthly, annual, pay period, quarterly, etc. Limits by pay period, YTD, and LTD. Calculate and collect arrearages. Direct deposit any deduction. Retirement Plans. Employer paid. 401K and 403B plans. Support all federal, state, and local taxes. Support Social Security and MDC. Calculate FUTA and state unemployment. Table driven definition for entitlement accruals such as vacation, holidays, floaters, and other excused leaves. Employees are automatically enrolled based on eligibility by seniority and/or hire date. Complete audit trail of accrued and time taken LTD. Table driven setup for all benefit plans including medical, dental, insurance, etc. Automatically calculate employer paid benefits. -
28
Neospin
Sagitec Solutions
Sagitec’s Neospin™ pension administration software is a fully integrated, browser-based software system with comprehensive functionality for administering pension benefits. Sagitec Neosurance ™ is a fully integrated, browser-based application providing comprehensive functionality for unemployment insurance, disability insurance, and paid family leave. Sagitec HealthConnect is an enterprise SaaS platform for Medicaid member engagement, empowering your members to engage in their health. It is deployed on HITRUST certified Microsoft’s Azure cloud. Xelence™ is Sagitec's low-code/no-code platform. It is a visual software development environment that allows citizen developers and IT professionals to design, test, and deploy complex applications. Build simple consumer to complex enterprise applications without traditional programming. It is a visual environment, offering drag and drop features, and incorporates in-built enterprise architecture. -
29
ClaimsControl
Claims Control
Our goal is to digitize the data exchange between all claims handling participants: insurers, brokers, their customers, loss adjusters, and all others. Use our platform to account and share your claims or connect your claims system to our API hub to get integrated with your partners. Connect your claims system to our API hub to start exchanging the data with your partners. Direct integration of all claims systems is impossible, therefore information is exchanged manually. This slows down the process, increases costs and complicates claims process automation. The purpose of ClaimsControl is to enable digital data exchange for all insurance claims handling process participants. If you develop any solutions related to claims management, let's talk and find the ways how we could help you to exchange the data with other systems or how we can provide your solution to our users.Starting Price: $400 per year -
30
Five Sigma
Five Sigma
Five Sigma set out on a mission to allow claims organizations to innovate. With the set of claims management tools and unique platform, Five Sigma's suite is what Insurers need to bring their claims operation to the rapidly changing world. With our suite of Claims-First Cloud-Native and User-Centric products, we enable adjusters to handle claims better and faster. With Automating administrative tasks, Adjusters can focus on making the right decisions, while the system takes care of everything else. Clive™ by Five Sigma is the industry's first AI-powered claims adjuster, transforming how claims are processed by insurers, MGAs, and TPAs. Leveraging advanced AI and automation, Clive streamlines the entire claims lifecycle, from FNOL (First Notice of Loss) through to settlement. The AI agent enhances claims handling efficiency, accuracy, and cost reduction by automating tasks. -
31
Shift Claims
Shift Technology
Shift Technology’s Claims solution uses Agentic AI to transform how insurers handle claims from start to finish. It combines automation with human collaboration to assess, triage, advise, and process claims across both simple and complex cases. Shift’s AI Agents are trained with insurance expertise and continuously learn through its “insurance common sense layer.” They handle tasks like policy coverage review, liability evaluation, fraud detection, and damage assessment. Seamlessly integrated with existing claims systems, the platform ensures no disruption while improving efficiency and accuracy. The result is faster resolution, lower costs, and better customer satisfaction for insurers and policyholders alike. -
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HealthAxis
HealthAxis
HealthAxis equips payers, providers and health organizations with integrated solutions from an advanced claims processing system and TPA services to actionable analytics. We streamline operations and improve client and patient outcomes. As healthcare becomes more technologically enabled, it remains inhibited by coordination challenges, legacy technology, and information management. We strive to bring innovation and a growth mindset to all struggling with these challenges. Our client philosophy is to serve as a complete business partner. HealthAxis believes our success does not stem from selling our solutions but from our business partners’ sustained success and growth. We enable our partners to add value to the communities they serve. As they build their membership and scope, we flourish with them. Every level of our team understands our responsibility to help unlock our partners’ potential. -
33
FBCS Enterprise
DSS
FBCS Enterprise is a centralized system for guiding decisions about non-VA Purchased care to improve fee basis claims management and adjudication through efficient claims processing. A web-based solution, CTM Plus streamlines workflows and provides oversight to resolve consult and Return to Clinic (RTC) tracking pain points, and ensure patients are called and scheduled on time. Purchasing analytics help to reduce cost and waste, for greater overall accountability. Expired and recalled items are also monitored automatically to keep patients safer. Delayed or misplaced orders can have significant consequences for your bottom line and quality of care. Time spent sorting through paper records and scrolling through screens is time you won’t have for patients. Checking every patient for opioid prescriptions can be an exhausting, multi-step process. DSS PDMP streamlines everything into one simple step. -
34
I-CAPS
W.O. Comstock & Associates
I-CAPS is an Intelligent Claims Administration System that addresses all functional areas of the health claims payment environment with a single common architecture that spans the needs of payers including membership, billing, enrollment, mailroom, claims, network management, contracting, pricing, utilization review and customer service. Our Intelligent Claims Administration System (I-CAPS) and our coding compliance software (Advanced Value Scale-AVS) , support knowledge-based decision-making to help our clients contain costs. Guaranteeing the integrity of Provider information has never been easier with (Advanced Network Administrator-ANA) while our (RB-UCR) is the industry's first Resource-Based, Usual Customary, and RESPONSIBLE fee schedule based on RBRVS and NCCI. Need a check-up for your plan or provider, use Cost Containment Audit and Recovery Services (CCARS) for a completely noninvasive audit retrospective look at claims effectiveness. -
35
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. -
36
EvoClaim
DWF Group
Claims management software that is ideal for claims, complaints and customer service. Settle claims quickly, reduce the cost per claim and manage claim load with trend analysis, fraud detection and intelligent reporting. Easy cloud-based access one central resource for real-time information sharing and actioning. Built-in report generator to create your own ad-hoc reports and intelligent MI through to heatmaps, dashboards, and trend analysis. Our systems have no restrictions built-in, maximizing your ability to link with any of your back-office systems. Microsoft-based enterprise technology that scales with your business. Less onboarding time means your team can hit the ground running. Empower your managers with automated and “real-time” reporting. Smoother onboarding for legacy systems and multiple technology requirements. Multi-sector expertise for easier discovery, development, and integration. -
37
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. -
38
TotalEclipse
Startech Software
Startech Software’s TotalEclipse™ product is a fully featured single-database Claims Management & Medical Bill Review Software application. Representing the culmination of over three years of development and testing, TotalEclipse™ is designed by real claims adjusters, bill reviewers, and administration managers who use this mission-critical software to do their jobs every day. Many companies develop their software with the user in mind. TotalEclipse is developed with our users involved. The result is an application designed around real-world workflow with a strong focus on making easily available the information most often needed on the job. Eclipse offers the specific processing power, functionality and reporting capabilities you need to maximize productivity while controlling costs. The single-database backend is scalable for use with either the Microsoft SQL Server™ or Oracle™ platform. -
39
HealthRules Payer
HealthEdge Software
HealthRules® Payer is a next-generation core administrative processing system that provides transformational capabilities to health plans of all types and sizes. For more than ten years, health plans implementing HealthRules Payer have been able to quickly address market opportunities and stay in front of their competition. HealthRules Payer is unlike any other core administrative solution because of its use of the patented HealthRules Language™, an English-like vernacular that delivers a revolutionary new approach to configuration, claims processing and transparency of information. HealthRules Payer helps transform health plans looking to grow, innovate and compete beyond any other core system today. -
40
Thoughtful AI
Thoughtful.ai
Thoughtful AI offers a comprehensive, AI-driven solution for healthcare revenue cycle management (RCM). With its human-capable AI agents, such as EVA for eligibility verification and CAM for claims management, the platform automates the most complex and time-consuming RCM processes. Designed to boost efficiency and accuracy, it reduces operating expenses, minimizes denials, and accelerates payment posting. Trusted by leading healthcare providers, Thoughtful AI provides seamless integration, guaranteed ROI, and the ability to reduce cost-to-collect, all backed by HIPAA-compliant security and performance-based guarantees. -
41
Mitchell WorkCenter
Mitchell International
Auto insurers need tools to simplify physical damage claims processing from the first notice of loss (FNOL) to settlement. Mitchell WorkCenter is an open, end-to-end modular solution that allows you to configure the modules and integrations specific to your unique business needs. Achieve better outcomes through improved accuracy and efficiency, while lowering the total cost of ownership. Our platform provides you with the ability to send and receive all information straight into your claims management system. With a proven track record of projects implemented in 90 days or less, your IT department will find integration with Mitchell WorkCenter simple. No two businesses work the same way. With WorkCenter, you can configure and manage your software based on your business needs. Access our entire suite or select certain features that best fit into your claims management workflow. -
42
Aclaimant
Aclaimant
Empower your employees to drive productivity and reduce the total cost of risk with the RMIS built to deliver insight and results. Active risk management is a strategy where you empower your employees to more productively manage risk by leveraging technology that is centralized, connected, scalable, and data-driven to deliver results. Successfully decrease accidents, claim lag time and case duration using Aclaimant’s centralized system that connects your risk management office to incidents in the field. Reduce the cost of claims through better prevention and better mitigation to ultimately improve your insurability. Better utilize superior risk and safety talent with mobile-first, modern technology and automation. Aclaimant keeps your team focused and improves talent appeal, morale, and retention. Get access to case studies and content to better understand how you can put the Aclaimant platform to work for you and your team.Starting Price: Free -
43
Claims Manager
JDi Data
Claims Manager is a comprehensive, integrated RIMS system built to streamline your process from FNOL to settlement. A unique, configurable business rules engine automates workflow, reduces manual and duplicate work, saves time, and improves outcomes for all stakeholders. Claims Manager’s integrated solutions streamline workflow by helping you administer, adjust, and report your property and casualty claims. Claims Manager is a versatile, and simple to use Risk Management Information System that offers tomorrow’s solutions, today. Its intuitive interface seamlessly integrates with an automated workflow that is accessible anytime, anywhere, from any device. Letting you easily capture, benchmark, administer, and report claims for all lines of property and casualty insurance. -
44
PowerClaim
Hawkins Research
Do not be worried about trying something new. This software was designed to be easy to use and flexible. All information is stored on secure servers in the cloud. There are no installations, just go to the website from any device and log in. Updates are no longer something you have to worry about. We will publish updates to the website at regular intervals. Everyone in your company now shares a custom database. If you need to change the price of a common item to match pricing in your area, everyone in your company will be able to use that same item. PowerClaim XML is a complete stand alone property adjusting software package. It allows you to quickly complete estimates as well as create photo sheets, diagrams, captioned reports and more. PowerITV Replacement Cost Calculator is a web-based solution that allows you to find the replacement cost of practically any structure quickly and accurately using timely data provided by the Craftsman Book Company.Starting Price: $99 per month -
45
AGO Insurance Software
AGO Insurance Software
AGO Insurance Software, Inc. has been a recognized leader in software and services for property and casualty insurance firms, and we have provided proven, cost effective business solutions to insurers of all sizes. Our products include solutions for policy administration, claims processing, accounting, bureau reporting and expert systems. Our software can streamline your operations, making your business more efficient, productive and profitable. Our System is designed in a modular fashion which can be installed as a completely integrated system or separate modules that can be licensed individually. This provides the flexibility of collaboration with existing legacy or third party systems. -
46
Total Loss Pro
Vemark
The frequency of total loss claims continues to rise, now accounting for some 20 percent of collision and liability losses across the auto insurance industry. Yet, far too often, carriers’ total loss operations lack cohesive integrated digital workflows, leading to excessive costs, customer dissatisfaction, and poor visibility and oversight. Enter Total Loss ProTM from Vemark. It’s the one solution you need to transform total loss claims processing from a frustrating black hole to a well-oiled machine while allowing you to keep up with the rapid pace of change. Faster settlement for Improved policyholder experience and satisfaction. Higher employee morale from reduced frustration, and fewer tedious processes. Increased visibility and transparency for data-driven decision-making. Auto claims that result in a total loss are more complex than vehicle repair claims. Total Loss Pro is a cloud-based solution that improves all stages of this complex salvage vehicle workflow. -
47
Evolent Health
Evolent Health
Driving breakthrough clinical and administrative results. Evolent Care Partners, Midwest health system ranked third in the nation for both total shared savings and percentage of savings off of benchmark. Evolent Care Partners enables independent primary care physicians with the capital and resources needed to participate and succeed within two-sided payer contracts, while limiting their financial risk. New Century Health delivers cost and quality improvements in oncology and cardiology by using clinical evidence to guide care decisions that are supported by both payers and providers. Evolent Health Services simplifies health plan operations through comprehensive services that are powered by a modern and integrated platform, and a true strategic partnership model. Explore insights and news on value-based care, population health, health plan administration and other health care transformation topics. -
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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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FINEOS
FINEOS
The FINEOS Platform provides clients the only complete end-to-end SaaS core product suite that includes FINEOS AdminSuite enabling quote to claim administration as well as add-on products, FINEOS Engage to support digital engagement and FINEOS Insight for analytics and reporting. The foundation of your digital insurance strategy. The FINEOS Platform seamlessly blends FINEOS AdminSuite + FINEOS Engage + FINEOS Insight + Platform Capabilities to create the most modern single core insurance platform for Life, Accident and Health. Legacy core systems utilized a ‘one size fits all’ business technology approach that no longer fits the needs of an agile business. Today, consumers, employers and brokers have access to powerful SaaS computing platforms and software tools that set a much higher bar for an insurer’s digital strategy. Monolithic insurance software models of the past focused solely on details of the insurance contract. -
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ClaimsXPress
Insurity
In insurance, no interaction has a greater long-term business impact than a claim. It’s the moment of truth for insurers and policyholders. ClaimsXPress maximizes insurers’ opportunities to deliver distinctive experiences that drive positive results. Claims service is a major differentiator for insurers, no matter the market. ClaimsXPress helps insurers enhance the claims experience, earn customers’ loyalty and drive more business from distribution channel partners. Nimble companies know they can grow faster with efficient processes and systems that are able to scale. ClaimsXPress is designed with insurers’ growth in mind. Speed is valuable, in claims response and access to data. ClaimsXPress is a top performer in both areas, enabling users to accelerate their objectives.
