Alternatives to W5 Claims
Compare W5 Claims alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to W5 Claims in 2025. Compare features, ratings, user reviews, pricing, and more from W5 Claims competitors and alternatives in order to make an informed decision for your business.
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Speedy Claims
SpeedySoft
Speedy Claims became the top CMS-1500 Software by providing the best customer service imaginable to our thousands of clients all over America. Medical billing isn't the kind of thing most people get excited about - it is just a tedious task you have to do. But while it will never be a fun task, it doesn't have to be as difficult or time consumimg as it is now. With Speedy Claims CMS-1500 software you can get the job done quickly and easily, allowing you to focus on the things you love about your job, like helping patients. With a simple interface, powerful features to eliminate repetitive work, and unrivaled customer support, it's simply the best HCFA 1500 software available on the market. A powerful built-in error checking helps ensure your HCFA 1500 form is complete and correctly filled out, preventing CMS-1500 claims from being denied.Starting Price: $29.95 per user per month -
2
AZZLY
AZZLY
AZZLY Rize is the premier clinical and business platform for addiction treatment and mental health organizations. As an all-in-one substance use disorder and mental health specific EHR, Patient Engagement and RCM platform, we serve small, medium, and large clinics. Key features for OUTPATIENT Programs include: scheduling, appointment reminder, Zoom telehealth, treatment plans, progress notes, assessments and surveys. For RESIDENTIAL programs: census, medication management, bed board, withdrawal management, DrFirst e-prescribing, EPCS, PDMP, labs. For all levels of care: alerts, patient engagement portal, electronic billing and claims submission built in. AZZLY Rize empowers your staff through its 5 star training and support services, its simplicity and automation. As a true all-in-one EHR/PM/RCM platform, improved compliance, workflow and accurate billing are achieved real-time. We proudly serve programs in over 33 states and are hosted in Microsoft Azure's private cloud network.Starting Price: $50/user/month -
3
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 -
4
Duck Creek Claims
Duck Creek Technologies
Duck Creek Claims is a comprehensive claims management solution designed to streamline the entire claims lifecycle for insurers. From the initial report to final settlement, it automates workflows, simplifies data analysis through integrated analytics, and ensures seamless integration with existing systems. Key features include dynamic first notice of loss (FNOL) capabilities, automated assignment based on adjuster skills and workload, instant access to policy and coverage data, and efficient adjuster workflows. By enhancing operational efficiency and reducing manual workloads, Duck Creek Claims enables faster claims resolution, improved customer satisfaction, and compliance with the latest regulations. -
5
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 -
6
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. -
7
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. -
8
ScanNStore
DocuStream
ScanNStore is a full-featured electronic document storage and retrieval system in a small package. It's the perfect solution for increasing productivity by electronically organizing and managing paper files. ScanNStore lets you and your staff quickly scan, index, store and retrieve your claims, attachments, remittance notices, and other documents. You can search by multiple indexes and display claims and all related information on-screen, as if you are looking at the original paper. Where instant access to the right claim information is critical, ScanNStore is the right solution. Contact us to download and try out a fully functional multi-user version of ScanNStore for 30 days. Volume seat licensing and vendor discounts available. Supports a wide variety of TWAIN scanners and production level scanners including HP, Fujitsu, Ricoh, Bell & Howell and Panasonic. Supports single page or multi-page batch scanning, automated document feeder, page size, contrast adjustment, etc. -
9
ClaimPilot
Quick Internet
A web-based claims management solution paired with unparalleled customer support. For claims management professionals who are looking to scale and manage their business, ClaimPilot offers its web-based claims management solution that provides the ease of use, features and functionality you need to gain visibility of claim and financial information with custom reporting. Address increasing demands of data inputs required with customizable features. Increase claims processing efficiency. Unlike unwieldy, feature-loaded risk management-focused claims software or lighter software packages that focus on document management only, ClaimPilot provides the features you need to manage your claims including Lloyd’s compliance, and workers comp functionality. Plus, you get our legendary customer support. Our team of experts partners with our clients to build custom reports and functionality to support your growing business. The way we see it, if you are successful, you’ll be successful. -
10
Claimable
Claimable
Claimable is claims management software for businesses that removes the headache of managing insurance claims. Increase your claims handling capacity by spending less time on admin. Stop searching shared folders and inboxes. Your claims data is just a few clicks away! Your data is securely stored in the cloud and is accessible from anywhere. No more paper! Be ready for an audit with a complete history of each claim at your fingertips. Keep track of your documents and access them whenever and wherever you need! Filter and report on your claims data, to drive productivity and stay informed. Label your claims to categorize and organize them to suit your workflow. Keep detailed notes on each claim and collaborate and share with your team. Assign tasks to your team and see at a glance which are due or completed. Build and manage your claims contact database, and find contacts in an instant.Starting Price: $79 per month -
11
mobile claims
Symbility Solutions
Virtual diagramming, voice annotation, photo documentation and full pricing capabilities in the palm of your hand. Quickly and accurately capturing claim information onsite eliminates the need for followup visits and provides a great chance to engage policyholders in the settlement process. Adjusters can document, estimate, and close a claim in a few easy steps leading to a faster, efficient and more accurate claim settlement. Mobile Claims ensures that onsite estimates become onsite settlements. Utilizing logic-based questionnaires, our algorithms can be applied to generate custom loss specific estimates in a fraction of the time than the standard estimate construction today. Easy to integrate, train, and use. Virtually eliminating the cost of change, creating enormous benefits for carriers, adjusters, contractors, and policyholders alike. Fully equipped with aerial imagery/measurement, 3D virtual diagramming, geospatial visualization, video collaboration, contents, etc. -
12
ClaimLogik
Claim Central Consolidated
Connect everyone in your property claim. ClaimLogik connects everyone in a property claim from first notice of loss through to completion. Property assess & repair ecosystem. We connect everyone in your property claim from start to finish. Stakeholder Management. ClaimLogik connects EVERY stakeholder in a claim with real time access, to complete tasks and manage activities at the right time, in the right order and with complete transparency. All stakeholders have access to workflow modules that have been customized to enable them to track, manage and complete tasks throughout the claim. Stay connected. All stakeholders connected on one claim. Complete transparency on claim status for all stakeholders. Line of sight for all activities across the entire claim. Digital contracts between Insurer and supply chain. Service level agreements with all suppliers and trades KPI management to measure and compare supplier performance. Automated exception management when tasks fall outside SLAs -
13
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. -
14
QuickCap
MedVision
MedVision Solutions' QuickCap is an administrative and clinical data process management solution that lets users focus on business and not the paperwork. With QuickCap, users have scalable control over their workflow and information to work smarter. QuickCap features a customizable dashboard for ease and gives them automation of their process for speed. QuickCap also streamlines claims work that makes users' work easier. QuickCap also allows users to easily determine profitability for individual providers with analytics. -
15
Polygonal
City Computers
Polygonal builds upon the strength and rich functionality of earlier versions and combines it with the latest Microsoft VB.Net and Business Intelligence technology to provide a comprehensive solution able to respond efficiently and quickly in the dynamic market of today. Polygonal, a modular, multi-currency, underwriting, policy/claims administration software solution integrated with transactions, reinsurance, accounting, messaging, data warehouse reporting, document management, and workflow modules to provide a full end-to-end business process with tangible results. Polygonal, designed from a business prospective using City Computers specialist team. We have many years' experience working in the insurance market as practitioners as well as solution providers. -
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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. -
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IMPACT
Managed Care Systems
IMPACT is the core to our suite of Healthcare administration software that supports all facets of health care related data transactions. Our customers use Impact to manage enrollment, provider contracts and re-pricing, benefit plans, authorizations/referrals, claims payment and the various complications that surround these functions. IMPACT has tremendous flexibility and provides a wide offering of industry-specific features. Nothing makes us happier than gratitude and accolades from our customers. We enjoy our client interactions and the delivery of software that makes their work lives easier. Technology is meant to serve the customer. MCSI focuses on the development of solutions that fit well within a client's enterprise allowing them to grow and change with their market. We have experience in all aspects of healthcare data management and solutions deployment. We pride ourselves in creating software that focuses on automation, accuracy and reliability. -
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TherapyNotes
TherapyNotes
TherapyNotes is an easy-to-use and feature-rich practice management software for behavioral health practitioners. It combines robust scheduling tools, patient notes, electronic billing, and a custom patient portal. The software is also certified HIPAA- and PCI-Compliant, which helps to ensure that all practice and patient records are secure and encrypted. Managing a practice comes with plenty of paperwork that can keep you out of session. With features like simple electronic claim submission and assisted ERA payment posting, you'll have fewer data entry errors and less tedious paperwork. TherapyNotes™ integrates all aspects of your practice to help you improve patient care. Person‑centered documentation, searchable diagnoses, and more time in‑session help you provide your clients with the care they deserve.Starting Price: $59 per user per month -
19
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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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 -
21
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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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. -
23
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. -
24
Claim Leader
ClaimLeader
Claim Leader develops and provides technology solutions to automate the communications and workflow processes across the business enterprises of insurance claims organizations. Our software solutions allow to simplify your operations, while providing superior productivity through an advanced, and integrated web platform. Feature-rich modules within Claim Leader systems create a simplified workflow for internal administrators and on the field users. Management tools allow internal users to dispatch assignments to field staff, sort workload, pinpoint files for review, and streamline workflow. -
25
FileHandler Enterprise
JW Software
Built with insurance claims and risk management in mind, our software features live dashboards, detailed reporting functionality, business intelligence tools, and the latest security technology. FileHandler Enterprise™ has become the benchmark for claims administration and risk management information systems (RMIS) in the industry. Our intuitive claims management software is great for third party administrators (TPA's), insurance carriers, risk pools, risk management companies, and a variety of other business professionals looking to make better and faster claims management decisions. No matter your size, our software is scalable from one employee to thousands. FileHandler Enterprise™ software will help you manage and close claims quickly, process payments to parties or vendors, and provide advanced reporting necessary to manage your business. -
26
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. -
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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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Simsol Software
Simultaneous Solutions
Discover why thousands of insurance adjusters and contractors chose our affordable, easiest-to-use Estimating Software for Property Repair and Claims Processing Solutions. Generate estimates, sketches, digital images, reports, and insurance forms with minimal training. Never pay for a technical support call again. Our friendly and knowledgeable support reps are ready to assist you. Simsol provides the most competitive rates in the industry, especially when you sign up for a year. ClaimsWire is a web-based solution for the electronic assignment, tracking, and exchange of property claim data designed for insurance companies. It integrates seamlessly with Simsol, and supports all property estimating platforms. It offers powerful management and review tools, built-in accounting, and much more. -
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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. -
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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. -
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FileTrac Evolve
Evolution Global
FileTrac has a long-standing legacy of being the #1 claims management system in the industry. Building on this reputation, it has now evolved into FileTrac Evolve. This enhanced version is a crucial component of the Evolve Suite, a comprehensive platform designed to revolutionize your claims management process. FileTrac Evolve is a leading web-based claims management system for independent adjusters, third-party administrators (TPAs), managing general agents (MGAs), and insurance companies of all sizes. Comes with a built-in diary system with reminders and provides integrations with Quickbooks, Outlook, Xactanalysis, Symbility, LEDES, NFIP/NFS, and Google Maps, FileTrac Evolve helps businesses manage their adjusters while ensuring accountability to their customers. Other key features include time and expense tracking, invoicing, adjuster timesheets, image and video uploads, accounting reports, quick notes, and more. -
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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. -
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PwC SMART
PwC
PwC SMART (Systematic Monitoring and Review Technology) increases the efficiency and effectiveness of your inpatient and outpatient coding quality evaluation process, and enables a mechanism for quality and compliance review. Coupled with the support provided by PwC Health Information Advisory, SMART bolsters your efforts to monitor coding and data quality. SMART Inpatient includes 1,000+ pre-defined business rules that identify potential coding inaccuracies and documentation improvement opportunities. You can also customize business rules for your specific areas of focus. Reporting and data analysis help you evaluate your staff’s performance and pinpoint education opportunities for Coding, Clinical Documentation Improvement (CDI), Quality and Providers. SMART Outpatient improves the accuracy of claims and identifies charge capture issues and areas for workflow improvements. It also improves regulatory compliance by decreasing the risks caused by inaccurate coding. -
34
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. -
35
EMSmart
EMS Management & Consultants
EMSmart™ claims processing technology raises the bar and your bottom line. At EMS IMC our priorities are clear, to employ a compliant, accurate, and efficient system to manage an increasingly complex billing process while quickly maximizing your revenue. For clients across the country, EMS IMC has done just that with a new solution called EMSmart™ which frees you to focus on the important work of patient care, while having confidence that the maximum amount of revenue is being collected in a compliant manner. EMSmart™ is our new, proprietary claims processing platform that delivers the industry’s best rulesbased process automation while retaining human judgment at the appropriate points in the revenue cycle process. EMSmart™ is our internal processing engine, but we’re excited to share this information with you so you can have confidence that your claims are in the industry’s best hands, both human and automated. -
36
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. -
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Adjustify
Adjustify
Adjustify is a web-based video calling application that allows professionals to connect with their customers to conduct on-site inspections or in-home meetings remotely. Schedule a call with your customer to start connecting digitally through the mobile app. During the video call, users can take digital measurements and access customer phone features including zoom and flash to capture unlimited photos. After the call, users can view a video recording of the meeting and add notes to photos. Innovative video conferencing technology assisting claims management for any industry providing much needed continuity during social distancing. During the time of social distancing and working from home, Adjustify offers a safer and faster way to process claims. Using Advanced Video Calling, users can connect with their customers and conduct on-site inspections efficiently from anywhere.Starting Price: $12 per claim -
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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. -
39
Ebix FACTS
Ebix
The FACTS® family of products supports multiple lines of business within a single information system: Health, Indemnity, TPA, PPO, HMO, PHO, IPA, MSO, Group Administration, COBRA, Section 125-Integrated Flexible Benefits, and Workers' Compensation with Integrated Managed Care for 24-hour coverage. From the inception of HIPAA, the FACTS® system infrastructure has been based on HIPAA-compliant solutions. FACTS® is fully committed to ensuring a clear and easy path to HIPAA readiness - well ahead of the federally mandated compliance deadlines. FACTS® fully integrated, interactive Internet and voice-based systems empower healthcare administrators and professionals with 24 x 7 access to claims and benefit information, and real-time transactions such as EDI claim uploads, through the Internet. Improve your risk and insurance management.Starting Price: $25000 one-time payment -
40
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. -
41
Gallagher Bassett
Gallagher Bassett
When the unforeseen becomes reality, will your claims services provider rise to the challenge? At GB, we view Claims Management as the absolute fulfillment of all the promises and potential of the entire insurance industry. We see it as the moment when we’re called to do more than making good. We’re called to go beyond and make it better. We’ve been answering that call every day for over 50 years. It’s in our DNA to go beyond the expected. We place people right at the heart of our process. The people we serve and a very special person who makes it all happen. Our RMs are the most engaged and empowered you’ll find anywhere in the business. Each one is dedicated to delivering a demonstrably superior outcome. Time and again. They do it with a spirit we call Own the Outcome. Taking the responsibility to make better decisions earlier in the life of every claim. To identify and deliver the right resources, at the right time and in the right place. -
42
DocuSketch
DocuSketch
Speed up your scoping, estimating, and cycle times. Create detailed 3D, 360° photo tours in under 20s per room. Generate accurate floor plans in up to 5 hours. Get scope of work reports with just a few clicks on your phone. Improve your bottom line with insurance-compliant estimates. Everything you need and more to accurately document, sketch, scope, and estimate. Low upfront cost with maximum time savings and greatest bottom line improvements. Get going within minutes, no complex onboarding or training is needed. Just pick it up and start. A dedicated team of pros is a phone call away, including a 24-hour emergency hotline. Our camera collects more accurate data with a lower margin of error, compared to using a phone. Years of industry insights fuel our products and propel your business forward. DocuSketch transforms restoration businesses with cutting-edge solutions, reducing cycle times, boosting profitability, and expediting claims to drive growth and assistance.Starting Price: $429 per month -
43
POWEReob
Unicomp Corp. of America
Insurance payment posting, like so many other tasks, falls under the proverbial 80/20 rule. The 20% of your payments that are still posted from paper EOBs take 80% of the overall payment posting work, if not more. Not so with POWEReob. POWEReob is a combination of free software and a pay-per-transaction service that will convert the paper EOBs you still receive from some payers into electronic remittances files in the ANSI 835 or NSF format. These files can then be used for automated payment posting to your practice management software, electronic secondary claims billing and denials management. POWEReob can work with any practice management that accepts remittance files from 3rd party sources (not just from their designated clearinghouse). For those that don't, we'll work with your practice management or clearinghouse so you, too, can benefit from the labor savings resulting from 100% electronic remittances. -
44
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. -
45
eobXL
Optiform
Given that remittance advice often contains thousands of detailed transactions, healthcare providers must resort to costly and labor-intensive manual data entry tasks to perform the necessary patient accounting activities. In an effort to automate this process and accelerate billing cycles, healthcare providers have turned to recently available computer-aided recognition technologies designed to extract transaction-based data from paper forms. While this technology has proven effective at extracting accurate data elements, there remain many processing tasks specific to EOBs that must be addressed for successful implementation to occur. The Optiform eobXL™ for Kofax Capture solution provides the necessary features to address these tasks, as well as the data and image integration requirements, all in an intuitive, “point & click” interface. -
46
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. -
47
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. -
48
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. -
49
Curacel
Curacel
Curacel’s AI powered platform enables insurers track fraud and automate claims seamlessly. Collect your claims from your Providers in real-time and easily auto-vet the claims. Curacel Detection helps you detect and curb fraud, waste and abuse in the Claims Process. Collect claims from their providers and prevent fraud, waste and abuse in the claims process. We studied the Health Insurance industry to understand where the most value is lost by Insurers. This was identified to be the Claims Process. The Process is mostly manual and is fraught with a lot of fraud, waste and abuse. Our solution, driven by AI, helps to curb wastage and make the Insurer more efficient, thereby making them unlock hidden value. ravel insurance is peculiar in that it is built on on-demand policies that cover relatively short periods of time. Should a policy holder want to make a Claim, both the insurer and the insured want claim settlement to be as efficient and accurate as possible. -
50
MyClaimStatus
Medical Payment Exchange
If your staff is wasting precious time and resources by manually statusing claims on web portals and sitting on the phone with payors you need myClaimStatus. Get real-time, actionable claim status information on all of your claims and eliminate the waste. myClaimStatus’s suite of data tools helps you reconcile claims faster. It doesn’t matter how big or small you are. Save more with every claim when you use myClaimStatus. Are you working efficiently? MedX medical claim services use robotic process automation to maximize your workflow efficiency. Easily reconcile reimbursement rates with your contracted amount ensuring you’re receiving what you should. Drill down with real-time data for every healthcare claim from every payor, no matter the dollar amount. This is not your standard healthcare claims processing software. Optimize AR follow-up activities to work by exception and get more done in less time.