Alternatives to ediLive!
Compare ediLive! alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to ediLive! in 2026. Compare features, ratings, user reviews, pricing, and more from ediLive! competitors and alternatives in order to make an informed decision for your business.
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1
XpertCoding
XpertDox
XpertCoding is an AI-powered medical coding software by XpertDox that uses advanced AI, natural language processing (NLP), and machine learning to code medical claims automatically within 24 hours. It automates the coding process, enabling faster and more accurate claims submissions to maximize financial gains for healthcare organizations. Features include minimal human supervision, easy EHR connectivity, flexible cost structure, a significant reduction in denials and coding costs, a HIPAA-compliant business intelligence platform, risk-free implementation with no initial fee and a free first month, and higher coding accuracy. XpertCoding's autonomous coding solution helps healthcare providers and organizations get paid faster, accelerating the revenue cycle and allowing them to focus on patient care. Opt for XpertCoding for a reliable and accurate medical coding software solution for your practice. -
2
Healthicity Audit Manager
Healthicity
For medical auditing, Audit Manager streamlines the way you manage audits by merging audit workflow, management, education, and reporting into one easy-to-use, web-based solution. Audit Manager brings simplicity by helping you: Identify Revenue Evaluate financial impact. Minimize denials and identify up to 10%, per provider, in missed revenue with extensive reporting and analytics tools. Increase Efficiency Improve your auditing efficiency by up to 40%. Reduce the amount of time you spend completing audits with our user-friendly interface. Improve Accuracy Customize your audit templates. Include your own standards, MAC carrier guidelines, and claim scrubber tech for ideal results. Audit Manager features: Built-in Tableau integration for in-depth analytics and reporting. Flexible Audit Management: View the status, and each associated status, of every audit, by any auditor. E/M Calculator Automatically calculate E/M codes with a built-in calculator.Starting Price: $670/mo for 3 users -
3
expEDIum Medical Billing
iTech Workshop
A secure, SaaS-based Medical Billing, RCM software that helps doctors to increase the collection, and receive faster payment with improved automation. Features like Seamless Insurance Eligibility Verification (IEV), Appointment scheduling, Claims scrubbing, Claim Status Inquiry (CSI),Auto Posting, and Public health clinic make the software efficient and easy to use. expEDIum SDK is available with several APIs to integrate EMR software seamlessly with expEDIum Medical Billing / RCM software. -
4
Virtual Examiner
PCG Software
Virtual Examiner®, PCG Software’s flagship product, monitors the internal claims process of an organization to trend provider data for fraudulent and abusive billing patterns, and maximizes financial recoveries. PCG Software’s Virtual Examiner® allows healthcare organizations to enhance their current claims adjudication system with more than 31 million edits per claim. The software solution monitors an organization’s internal claims process to identify unclean claims and reduce payment for improper or erroneous coding to conserve premium dollars. Virtual Examiner® is more than a claims review solution with a focus on code combinations. It is a cost containment solution that evaluates the claim not only for abusive billing patterns but also identifies those claims that may involve third-party liability/coordination of benefits, case management opportunities, physician billing education and many other cost recovery reports. -
5
AltuMED PracticeFit
AltuMED
Conducting thorough checks on the financial eligibility of the patients, running their insurance’s analysis and monitoring discrepancies, the eligibility checker covers all. If however any error does creeps in the data submitted, our scrubber working on deep AI&ML algorithms is capable of scrubbing errors be it coding errors, incomplete or wrong patient financial information. The software, at present, has 3.5 Million edits pre-loaded in its memory. To further streamline the process, automatic updates are issued by the clearing house to inform about the status of in-process claims. Covering the entire billing spectrum from verifying the patient financials to working on denied or lost claims and also has a through follow-up feature for appeals. Our intuitive systems warns if a claim could be denied, taking corrective actions to prevent it but also is capable of tracking and appealing for lost or denied claims. -
6
E-COMB
KBTS Technologies
EDI Compatible Medical Billing (E-COMB) is a web based solution for generating medical claims complying with the HIPAA transaction and code set standards, regulated by the US Government following the recommendations of American National Standards Institute (ANSI). The application is designed to generate, submit and reconcile the claims to the insurance carriers, guarantors and/or patients. This is one of the most important tools for doctors in realizing their revenue by reducing the turnaround time in the claims reimbursement. All the information related to environment of the Doctor’s Office/Hospital is grouped together as Master Data. This information is frequently used for claims processing and is less likely to change quite often. Master Data contains details of the Procedures, Diagnoses, Doctors, Payers, and Billing Providers etc. This data is created as part of the initial set up and can be updated easily at any time. -
7
Claim Agent
EMCsoft
EMCsoft’s Claims Management Ecosystem assures that healthcare providers and billing companies deliver clean claims to insurance payers for proper claim adjudication. It is the integration of our versatile claims processing software Claim Agent and comprehensive fitting process called the Four Step Methodology into your claim adjudication process. This approach enables, supports, and automates your work process to maximize claim reimbursement. Request our free online demo for a great introduction into the functionality/features of Claim Agent and how it fits into your claim adjudication process. Claim Agent scrubs and processes your claims from the provider system to the insurance payers in a efficient, cost effective, and timely manner. The software is compatible with any system making implementation process quick and simple. We provide custom edits, bridge routines, payer lists, and work flow settings that are unique to each user. -
8
Pro Health Billing
Pro Health Billing
Pro Health Billing's Medical Billing Software has simple tools that help with data entry, automated task that take only minutes to setup and very easy to use. You can print your first claim in 20 minutes! With tools like Auto-Codes, Repeat Last Claim and Auto Co-Pays. Pro Health Billing is a wrist saver! Small Medical Practice Companies love Pro Health Billing's Claim and Patient Scheduling Modules. Together they become a powerful tool that cuts your workload almost in half! With tools like Non Payment and Non Billed Alerts your revenue will increase as your workload shrinks! 'Pro Health Billing' is the best medical billing software to help you bring in more income and quickly! With our Claim Catcher Dashboard and our industry leading 'Revenue Cycle Manager' to fix those alerts, claims never go unnoticed! Know the status of all your claims with just a glance. -
9
Artsyl ClaimAction
Artsyl Technologies
Processing high volumes of medical claims through intelligent automation helps businesses deliver higher levels of efficiency that does more than reduce costs. For organizations that rely on manual processes, managing medical claims documents and data is labor-intensive and error-prone, injecting unnecessary risk into the process. With ClaimAction medical claims processing software from Artsyl, your organization can improve margins, minimize touch points and eliminate processing bottlenecks. Capture medical claims data without the need for custom software coding. Route claims data and documents automatically to the right claim examiner, based on your business rules. Configure complex benefits and reimbursement rules to streamline processing and reduce payment delays. Respond quickly to changing government regulations and support data, document and process compliance. -
10
Iridium Suite
Medical Business Systems
Iridium Suite was developed with a focus on seamless processing of electronic claims and electronic remittances through its fully-integrated, web-based program. Shavara is an innovator in the field of medical billing software. Shavara's differentiator is the cumulative experience of 100+ years of laser focus in solving gaps and vulnerabilities in billing, coding and connectivity. Iridium Suite is purpose-built for Oncology. Built-in capability to enable Record & Verify integration; OncoChart integration; CureMD integration are powerful features matched to the requirements for Medical Oncology and Urology Billing Software. Shavara's Iridium Suite features leading-edge technology such as a built-in scheduler, a customizeable automatic medical claim scrubber, seamless electronic billing, and premium reporting. Iridium Suite is platform-agnostic, allowing you to use it as Medical Billing Software for Mac, PC, and even Linux systems.Starting Price: $425 per month -
11
CureAR
TechMatter
CureAR is an AI-powered medical billing and revenue cycle management software designed for in-house billers, billing companies managed-service providers and DME companies. The software consolidates eligibility verification, charge capture, AI-assisted coding suggestions, claim scrubbing, electronic claim submission, ERA ingestion, and automated payment posting into a single cloud-hosted system. It is configurable for specialty billing rules and supports multi-tenant operations for practices that handle multiple client accounts. Key Features: AI-assisted coding and claim scrubbing: Machine learning highlights likely coding errors and applies payer-specific validation rules before submission. Real-time claim status and alerts: Tracks claims from submission to adjudication and surfaces exceptions for prioritized follow-up. ERA ingestion and automated posting: Electronic remittance advice handling with configurable reconciliation workflows reduces manual posting effort.Starting Price: $129/month/user -
12
ZOLL Billing
ZOLL Data Systems
Progressive revenue cycle management is, in many ways, the backbone of a thriving medical services operation. Controlling costs, increasing productivity, and accelerating reimbursements are essential activities that keep EMS agencies rolling. Yet efficiently progressing a claim through its lifecycle has traditionally been labor-intensive and prone to delays caused by documentation and coding inaccuracies. ZOLL® Billing is a cloud-based solution that enables revenue cycle professionals to turbo-charge billing performance and deliver more revenue. By automating workflows and eliminating billing errors, ZOLL Billing helps you process more claims with fewer resources and address compliance risk at the same time. Increase productivity and revenue with automated workflows that enable you to process more claims. -
13
PatientStudio
PatientStudio
Maximize your appointment calendar with improved visibility into your clinic's schedule and provider availability. View and schedule appointments across many providers, rooms or locations to ensure a steady patient flow. Automatically invite patients to complete patient intake online. Custom digital paperwork can be completed and submitted using a smartphone or personal device. The patient's data will sync directly to their patient chart. Reduce no-shows with perfectly timed patient reminders via email and text message. Patients and staff can communicate, confirm or reschedule with two-way text messaging. Easily generate claims from patient notes and suggested ICD-10 codes. Automatically scrub and submit claims electronically. Services to manage your entire billing process, from submission to payment collection. Quickly create defensible, legible, and comprehensive clinical notes with documentation templates, assessment reports and pre-populated patient data. -
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PowerMed Billing
PowerMed
PowerMed Billing has been built from the ground up to be state-of-the-art. With its powerful feature set, numerous reporting options and electronic claims processing, it will meet the needs of any busy practice. The software can be configured to each individual user's style, including screen appearance, custom navigation commands, and even individual language settings. It contains a full ICD coding library, customizable CPT, HCPCS, super codes, and enterprise-level patient demographics. Because Billing and EMR are essentially one program, all coded visits and claims are automatically pulled for electronic processing or for standard UB92 or CMS1500 printing. Complete with full search and reporting capabilities, practice managers have immediate access to an extensive library of predefined productivity and financial reports broken down by providers, payors and individual patients. -
15
Dr. Bill
Grouse Software Labs
Dr. Bill makes billing on the go easy and pain free. Add a patient in as little as 3 seconds and submit a claim with just a few taps. Remove the pain of manual data entry, paper, index cards and clunky software. Take a picture of a patient label and log your claims in seconds. We alert you in real-time with tips and suggestions to help you maximize your billing. No need to memorize codes. Select from a list of favorites or simply search by keyword. Our easy-to-use app makes billing simple and convenient. As new patients roll in, Dr.Bill keeps up. All it takes is a simple snap of a patient’s label to add their profile information to your account. Find the Right Codes Quickly. When it’s time to find the code you need, Dr.Bill is ready. We make it easy to search and even save the ones you use the most. Get Helpful Tips. It pays to know the ways to maximize your claims. Dr.Bill keeps you up to date with tips and suggestions.Starting Price: $30 per month -
16
RevCycle Engine
Aptarro
RevCycle Engine applies built‑in, customizable rules and AI‑powered automation to correct coding and charge errors at the source, ensuring billing data is accurate before claims are submitted. By integrating seamlessly with EMRs and practice management systems, it ingests claims data in real time, applies industry‑proven rules tailored to each organization’s needs, and fixes errors automatically, reducing preventable denials and costly rework. Streamlined workflows prioritize and route only complex or exception claims for human review, boosting team efficiency and reducing burnout. With AI‑driven charge accuracy, the platform increases clean claim rates, lowers cost‑to‑collect, and stabilizes cash flow, all visible through clear dashboards and real‑time insights. Scalable automation handles high claim volumes without overtime or late‑night efforts, while features such as charge accuracy validation, denial prevention, coding review optimization, payment collection support, and more. -
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Precision Practice Management
Precision Practice Management
Whether you're looking to outsource all of your revenue cycle management functions or just some of them, Precision Practice Management has the experience and expertise to help you stay on top of the constantly changing landscape in this most important area. Precision can successfully address all areas of revenue cycle management, from compliance, credentialing, coding, claims processing, clearinghouse edits and electronic lockbox to claim denial management, reporting, financial analyses and more. Your in-house staff may be doing a tremendous job in managing some or most aspects of your medical billing, but your office staff has many other important clinical functions to perform. Sometimes billing matters receive lower priority and suffer as a result. Precision's medical billing experts are focused entirely on medical billing and nothing else; that's all they do. -
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NeuralRev
NeuralRev
NeuralRev is an AI-powered Revenue Cycle Management (RCM) platform that automates and accelerates end-to-end financial workflows in healthcare, reducing manual effort and errors while improving cash flow and operational efficiency. It automates insurance eligibility verification by connecting to clearinghouse networks in real time so patient intake and coverage checks happen instantly, and it handles prior authorization by assembling clinical and payer requirements, submitting requests electronically, and tracking approvals to reduce denials and delays. It also delivers real-time patient cost estimates by combining eligibility data with payer rules to improve transparency and upfront collections, and it streamlines medical coding, claim submission, claims processing, post-claim follow-up, and recovery, so teams spend less time chasing paperwork. -
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iVEcoder
PCG Software
iVECoder, the decisive code tool with payor intellect, was built on the same intelligence of PCG's Virtual Examiner® claims review engine that healthcare payors worldwide have been using for 25 years. Users can enter multiple codes, and in just a single click, receive multiple answers on a single page. Ramp up coding accuracy and boost your bottom line by using the same billing and coding intelligence platform the payors use. iVECoder is PCG's Virtual Examiner® (VE) claims review engine. This advanced rules based engine —with 45 million edits— is used by healthcare payors throughout the USA and abroad. VE tells payors what to deny or pend for review. -
20
Inovalon Claims Management Pro
Inovalon
Keep revenue flowing with a powerful tool that speeds up reimbursements with eligibility checks, claims status tracking, audits and appeals, and remittance management for government and commercial claims, all in a single system. Leverage an advanced rules engine that immediately scrubs claims against the most up-to-date CMS and commercial payer rules, allowing you to correct errors before claims go out the door. Verify eligibility across all payers during claim upload and see flagged errors so claims can be edited before submission. Decrease days in A/R with automated workflows for audit responses, appeal submissions, and ADR tracking. Customize staff workflow assignments based on the type of claim and action needed. Automate secondary claims submissions to stop timely filing write-offs. Increase claims revenue with automated workflows for faster, more successful audits and appeals. -
21
eClaimStatus
eClaimStatus
eClaimStatus provides simple, practical, efficient and cost effective real time Medical Insurance Eligibility Verification system and Claim Status solutions that power value added healthcare environments. At a time when healthcare insurance companies are reducing reimbursement rates, medical practitioners must monitor their revenue closely and eliminate all possible leakages and payment risks. Inaccurate insurance eligibility verification causes more than 75% of claim rejections and denials by payers. Furthermore, refiling rejected claims cost an organization $50,000 to $250,000 in annual net revenue for every 1% of claims rejected (HFMA.org). To overcome the revenue leakages, you need a no-fuss, affordable and effective Health Insurance Verification and Claim Status software. eClaimStatus was designed to solve these specific challenges. -
22
CMS-1500 Software
Med Claim Software
Our CMS-1500 software is an excellent choice for submitting claims by paper. Download a free trial. We can get you started with the software right away! Order online and our secure shopping cart will guide you through the process to receiving a code which will activate the software any time of the day or night. Type data on the screen as it would be typed on the form itself. Or import from excel (xls or xlsx). Print on pre-printed red Medicare forms or print the entire form in black & white. Align print perfectly with any printer. Save common data for quick completion and to eliminate redundant typing. UB-04 Forms are medical insurance claim forms used by facilities such as hospitals, inpatient and outpatient clinics and ambulatory surgery centers to bill insurance companies for services rendered. The CMS-1500 software functions on any Windows operating system. The software functions on networks or stand-alone personal computers and will work with any printer.Starting Price: $69.95 one-time payment -
23
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. -
24
Paradigm
Paradigm
Paradigm Senior Services offers a full-service, AI-powered revenue cycle management platform specifically tailored to home-care agencies that bill third-party payers such as the U.S. Department of Veterans Affairs (VA), Medicaid, and other managed-care payers. It automates and streamlines every step of the billing and claims process: from eligibility/authorization verification, state- or payer-specific enrollment and credentialing, to submission of clean claims, denial handling, and payment reconciliation. It integrates with common agency management software and electronic visit verification tools to scrub shifts, verify authorizations weekly, and reconcile payments, reducing denials and minimizing administrative burden. Paradigm also supports “back-office as a service” for providers; even if they already have internal billing staff or scheduling software, Paradigm can take over claims processing as a specialized, expert billing department. -
25
Vyne Trellis
Vyne Dental
You have better things to do than sit on the phone. That’s why our real-time eligibility tool allows you to quickly verify your patients’ benefits, regardless of their plan. Gone are the days of paying transaction fees for claims, attachments, and checking eligibility! Our plan includes all features for one monthly fee. Subscribe to Vyne Trellis™ and gain the benefit of our team of industry professionals. With us, you can keep a tab on claims, claims that put money back in your firm’s pocket. Regardless of the size of your practice, our platform can handle any volume of claims. Vyne Trellis™ is integrated with the claims administrators and clearinghouses you need. Our dashboard sends you rejection reasons, status updates, and other smart notifications, so you can keep your claims moving. And if you get a little stuck on a claim, our support team is here to help! No more multiple tabs or windows. You can access virtually all of your data and documents, like ERAs and attachments. -
26
Flash Code
Flash Code Solutions
Flash Code™ is a coding product designed for the healthcare community. Our goal is to provide exceptional, simple to use, cost-effective software which is provided with unsurpassed customer service. We are a division of Practice Management Information Corporation - the leading independent publisher of coding books. Our team can provide a complete solution to meet your coding and compliance needs via our software and print products. Thanks for taking a few moments of your valuable time to explore what Flash Code can do for you. The merger creates an opportunity for MCCS to provide sophisticated electronic coding and compliance solutions to the health care industry. From the physician checking for medical necessity codes at the point of care, to the insurance manager validating diagnosis codes, or the benefits analyst reviewing health insurance claims for correct coding initiative compliance, MCCS provides a solution to facilitate the process. -
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Benchmark PM
Benchmark Solutions
Benchmark PM enhances patient engagement from initial intake through final encounter with features such as patient onboarding, easy appointment scheduling, customizable reminders, robust reporting, and user-friendly dashboards. For billing, Benchmark PM simplifies filing, processing, and follow-up with integrated claims management, an integrated clearinghouse, electronic billing, insurance verification, and a versatile payment portal. Benchmark Solutions operates as healthcare practices’ one-stop management solution, comprising of Benchmark EHR software, Benchmark PM software, and Benchmark RCM services. Benchmark Solutions' offerings come together to form a comprehensive electronic toolset that can streamline daily internal operations and increase revenue earned all while improving the overall patient experience. Each piece of the Benchmark Solutions suite is modular so it can easily integrate with other technologies already in place. -
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PulsePro Practice Management
Pulse Systems
PulsePro practice management system applies automated workflow logic to join financial, clinical and administrative processes into one package. PulsePro is easy to use and implement, offering advanced scheduling, patient registration, medical billing, coding and claims processing. And because implementation is quick and PulsePro is so easy to learn, your team will be up and running in hours — not days or weeks — performing daily tasks using an industry leading practice management system. Pulse is a leading EHR/PM Company that is a part of the Amazing Charts and Harris Healthcare family. We have a long history supporting medical practices with technology and value-added services. -
29
PayorIQ
Compliance PT
Receive notifications when Payors make policy changes. Staying informed makes all the difference. Instead of reading through hundreds of pages of insurance-speak, our software detects policy changes and writes easy-to-digest notes for your billing and coding staff to implement. Quickly find policy specifics for a given claim date. Use our data as evidence to win more cases.Starting Price: $199 per user per month -
30
AdvanceClaims
MP Cloud Technologies
Our seamless ePCR and Clearinghouse integration means no more switching back and forth between different apps to get things done. It doesn't matter which ePCR system your customers use, AdvanceClaim for billing companies handles them all. With Automated Imports from most ePCRs, one-click searches, and auto-population of key claims data, AdvanceClaim for agencies maximizes accuracy and efficiency by reducing redundancy and human error. Say goodbye to downloading massive remittance files, uploading claim files to your clearinghouse, and waiting for validation. AdvanceClaim does automatic submission through our fully integrated clearinghouse so you be confident claims or batches are processed. Quickly get a view of performance across all your clients with our multiple tax ID rollups, or break the reporting down by geography, client size, billing volume, and much more. The entire system is 100% HIPAA, ICD-10, and HITECH compliant; and runs on AWS. -
31
Clinicaid
Clinicaid.ca
ClinicAid helps you efficiently optimize your time by letting our cloud based medical billing software do the heavy lifting for you. Keeping patient care as your priority requires keeping administrative work to a minimum with next generation medical billing and coding software. Automatically add your practice and patient information to claims and avoid complicated workflows. ClinicAid physician billing software keeps your practice on track with powerful report options designed with feedback from our clients. That means you have detailed Remittance, Rejection, Efficiency, and other vital reports available at a click. The reporting within our medical billing software meets your changing practice needs. You can customize and save your own reports with up to 46 individual data points for maximum intelligence in your practice.Starting Price: $19 per month -
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Gentem
Gentem Health
Gentem Health is a platform that transforms the reimbursement experience by not only handling the end-to-end billing and revenue cycle processes, but also advancing payments to private medical practices. Nothing falls through the cracks. Our platform serves as a single source of truth to understand your billing operations and monitor your core metrics so you’re always on top of your revenue. We support the imperative need for cash flow and capital to fuel sustainable growth. Get access to working capital while Gentem submits, scrubs, and pursues your claims. Our specialty-focused experts — empowered by cutting edge technology — are dedicated to maximizing your collections. Technology built to drive results. State-of-the-art analytical tools and A.I. powered automations give you more control over your practice’s revenue than ever before. Gain complete transparency into your claim process with real-time performance analytics and timely alerts to ensure that no claim is left behind. -
33
QuickClaim
Hype Systems
We understand that people don't need their software to do everything. Especially not across specialties, practices, clinics, and hospitals. That is why we have created systems that are modular and will fit what YOU need. The front end (users) offers an intuitive, clutter-free interface; while the back end utilizes cutting-edge technology and database engines to ensure your data is safe and secured. And so you get paid... the first time! Used and loved by over 1,200 Ontario physicians, billing agencies and small to large multi-location clinics and hospitals. QuickClaim’s finesse has the feel of a well-thought-out tool. QuickClaim fulfills many roles. QuickClaim works with other systems like QuickReq, QuickDOCs and third-party systems via HL7 and flat files. Additionally, QuickClaim acts as the offline version of HYPE Medical during rare occasions of Internet failure. As an offline system, it runs independently of the Internet.Starting Price: $1400 one-time payment -
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EmpowerMax Billing
Harris Coordinated Care Solutions
More compensation from payers means more services for your clients, patients, and community. Outsourced billing services through SMART Health Claims or EmpowerMax Billing provide you with all the benefits of our technology while we do most of the work to increase your funds. Designed for behavioral and mental health, EmpowerMax Billing enables your organization to eliminate common issues with in-house billing, like key personnel absence or loss, under- or over-staffing, disorganization in the department, and inadequate billing supervision. EmpowerMax Billing provides a team of billing experts to handle medical claims billing, cash application, corrections, and follow up for you. -
35
eClaims
TELUS Health
Streamline the claims process for your patients with an easy-to-use online service. With eClaims you can Delight your patients by submitting claims on their behalf. You’ll reduce their out-of-pocket expenses and help give your practice an edge on the competition. Reduce clients' out-of-pocket expenses, minimizing the credit card fees associated to your practice. Help attract new clients and retain existing ones with a proven increase in return appointments. When registered, you also benefit from free marketing. Once registered, view patients’ insurance coverage and submit claims electronically. Get instant responses from insurers. Start using it without any specialized hardware or software. Save on credit card fees by charging your clients only the portion not covered by their insurer. View your past transactions to ease payment reconciliation. Select whether payment should be assigned to either the healthcare professional or the patient. -
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DuxWare
Medical Practice Software
DuxWare is a medical practice software built for physicians, practice administrators, billing service, and integration partners. With DuxWare, medical professionals can stay organized and secure and get paid faster. The platform is easy to use and also comes with automated appointment reminders, onhold music and messaging, real-time claim scrubbing, and more.Starting Price: $150.00/month -
37
ESO Billing
ESO
Automate your workflow and integrations, and put an end to the repetitive manual work associated with revenue cycle management. ESO Billing frees your team to focus on what they do best. In today’s reimbursement world, efficiency counts. ESO Billing was built to save you time at every possible point in the billing process. Even its interface has been freshly redesigned for the ultimate in speed and ease of use. Customize your workflow based on your business process, task-based workflow moves each claim through its stages with minimal touches. It even alerts you automatically when payments aren’t on time, for the ultimate peace of mind. Our payer-specific proprietary audit process ensures that each claim contains all critical billing information prior to claim submission. The result? The lowest clearinghouse and payer rejection rate in the industry. Pair billing with ESO Health Data Exchange (HDE) and ESO Payer Insights to tap into hospital-generated billing information with one click. -
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HARMONY
Harmony Medical
Harmony Medical is a trusted leading provider of electronic health record, practice management, and revenue cycle management software solutions. Purpose-built for independent medical practices, Harmony is a fully integrated HIPAA compliant practice management platform that helps streamline your practice in order to improve patient care and enhance your bottom line. The solution features a variety of tools for easy scheduling, robust reporting, comprehensive claims scrubbing, insurance and patient billing, patient history, patient tracking, patient referral tracking, and so much more. -
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StreamCare
StreamCare
Increase script adherence and patient convenience while strengthening your bottom line with our comprehensive solution. Our software provides a full suite of services from medication sourcing through claim reimbursement. Our business model is one of true alignment, guaranteeing that we are only compensated when a claim is successfully reimbursed and ensuring that we protect your reputation and referrals. Our solution is a game-changer for pharmacies. No longer an afterthought, Workers’ Comp prescription claims can now help drive profitability in a meaningful way. Transmit your Workers’ Comp claims directly from your pharmacy software to ours and spend more time focused on patient care. Let our experienced reimbursement team and industry-tailored software handle all the paperwork, phone calls, and headaches of reimbursement. -
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mDOC
Mack Software
Using our claim listing page you can quickly resolve errors and omissions prior to submitting your claims. After all information has been posted, diagnosis and modifier codes applied, you can submit a group of claims to Trizetto Provider Solutions® in one quick step to upload the claims. Trizetto Provider Solutions® will in turn perform additional claim scrubbing and then send your claims on to the payers. Post payments from insurance companies against claims indicating allowed amounts, adjustments and copay, coinsurance and deductible. Payments are entered in batches to ensure accuracy. Statements are prepared at your desired frequency - daily, weekly, monthly. These statements are presented in a simple, clear format that is easy for patients to read and understand. No more confusion!! A credit card authorization area is included on the statement for convenient payment of balances due. -
41
SSI Claims Director
SSI Group
Elevate your claims management process and decrease denials through unmatched edits and an industry-leading clean claim rate. Health systems require access to technology that facilitates accurate claim submission and rapid reimbursement. Claims Director, SSI’s claims management solution, streamlines billing practices and provides visibility by guiding users through the electronic claim submission and reconciliation process from beginning to end. As payers change or modify reimbursement criteria for services, the system actively monitors and incorporates these changes and requirements. And with a comprehensive mix of edits at the industry, payer and provider levels, the solution aids organizations in making the most of reimbursement efforts. -
42
NowMD
Inborne Technology
NowMD is modern, innovative and affordable software designed for use in healthcare practices and medical billing services. NowMD is used for billing insurance carriers and patients for professional health care services. NowMD’s Appointment Scheduler is designed specifically for scheduling patient appointments. Advanced features like appointment templates, recurring appointments and a wait list make the scheduler a great addition to NowMD’s billing features. Employees can clock in and out on any computer running NowMD. Payroll day is a breeze with employee work hour reports. NowMD can create ANSI 5010 compliant electronic claim files for use with a variety of included clearinghouses, for sending claims directly to an insurance carrier, or for use with other clearinghouses. Payments and adjustments can be created automatically through Electronic Remittance Advice auto-posting.Starting Price: $349 per computer -
43
Medical Office One
Biosoftworld Medical Software
Medical Office One. A HIPAA Compliant - NPI Compliant and feature-rich medical billing software package. Fast and easy to use, it allows the creation of the new CMS 1500 02/12 or UB-04 claims. Provides full customization, excellent reporting features and points of integration with popular software packages including Microsoft Word, Excel & Outlook. Data for claims can be entered directly or can be retrieved for the Electronic Medical Records portion of the software. Print the CMS 1500 and UB-04 Form, or send claims electronically to clearinghouses. Medical Office One provides QuickBooks® integration, an advanced SOAP Notes module, and a powerful chart generator. You can create additional databases for unlimited providers - practices! and handle all from the same interface. Start a successful medical billing from home business. Handle with one software package billing and clinical side of your healthcare practice. A powerful CMS 1500 Form Filler or UB-04 Form Filler. -
44
NovoHealth Dental
NovoDynamics
Our platform automatically flags and prioritizes anomalous claims for review. NovoHealth Dental ensures exceptional claim quality and offers real-time analysis. Our platform provides accurate and consistent dental disease assessment. The future of dental claims processing is here. Our proven AI platform is in use within some of the country's largest dental payer organizations. We offer pilots to demonstrate the value of our solution. NovoHealth Dental saves time and money by making dental insurance claim review faster, easier and more efficient. It helps your analysts uncover anomalies that may indicate errors, omissions or potential fraud. We use AI to quickly verify and assess the quality of submitted claims and their attachments. The platform quickly, accurately, and consistently assesses dental diseases. Our AI fingerprints and analyzes every claim and attachment to detect high-confidence anomalies. -
45
ImagineBilling
ImagineSoftware
The industry’s first intelligent, multi-specialty medical billing software. Streamlining billing and patient collections for over 75,000 physicians across the country. Globalized data eliminates the need for duplicate entry. Visit-driven to allow for large volume and complex information. Flexible data structure accommodates requirements across multiple practices and specialties. Helping you get paid faster. Post payment manually or through electronic remittance. Automatically scrub claims for errors and missing information. Automatically refile insurance claims based on selected criteria. Fast review to evaluate and approve charges. Audit charges by modality, procedure, insurance, user, doctor or date of service. Intuitive reports for tracking the financial health of your front-end and back-end billing. Never lose another charge again. Integrates with your preferred clearinghouse or statement vendor. -
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OptiPayRCM
OptiPayRCM
OptiPayRCM’s platform delivers seamless, “last-mile” revenue cycle management automation by integrating with EHRs, clearing houses, payer portals, and other systems via flexible adapters so your billing workflows can be processed end-to-end. Its unified core engine handles eligibility checks, claim submissions, payment postings, denial management, and full accounts receivable workflows using AI and robotic process automation to reduce manual effort and accelerate cash flow. Real-time dashboards and reports provide visibility into key metrics and enable predictive insights, while customizable automation supports exceptions and unique workflows. It reduces first-pass denials by up to 63%, speeds claim status checks up to 50 times faster than human processing, and reduces payment cycle time by up to 35%. It is compatible with more than 200 healthcare systems and supports direct integrations via EHRs, FHIR, EDI, and HL7. -
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AveaOffice
Avea Solutions
Designed specifically to mirror the typical patient journey from pre-admission to post-discharge, yet flexible enough to adjust to your unique processes, every staff member is guided to push workflows forward effortlessly and capture the information needed to ensure clean claims and maximum reimbursements. From patient intake and benefit verification, across every Utilization Review, marking attendance and getting claims out the door, working denials and collecting payment, we’ve got you covered. It has never been more critical to work smarter and not harder in the industry. We’ve raised the bar when it comes to liberating your teams from the burden of manual processes and workarounds with our automation and powerful claim rules engines. Managing your revenue cycle is like watching dominoes fall in a harmonious pattern. Continuous industry changes, new payer rules, declining reimbursements, tighter margins. -
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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. -
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Casamba Revenue
Casamba
Fewer denials and delays in claim submission + a dedicated team to manage follow-ups. Grow revenue by 4% and net payment per visit by 10%. Improved collection efficiency and consistent follow-up help net collection percentages grow. Reduce your DSO by 10 days or more. Claims that meet exact requirements shorten collection timelines and increase cash flow. Dashboards and metrics allow you to make informed decisions and move your business forward. The integration of Casamba and IKS Health creates a unified solution tailored for physical therapy practices and the challenges you face. By combining technology and services, we bring exponential value. We make your practice more efficient by freeing you and your therapists to focus on the delivery of excellent care. Contact us to find out how our RCM service can help you grow your business. -
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Alaffia
Alaffia Health
Alaffia’s AI-powered system uncovers fraud, waste, and abuse in the most intricate healthcare claims to prevent and recover overpayments for payers and employers. Alaffia detects and corrects errors in misbilled claims before an improper payment is made. Alaffia empowers you to recover and save on overpayments previously made on misbilled claims. Overpayments on error-filled claims could be costing you hundreds of dollars per employee each year. Work with Alaffia to eliminate overpayments and drive more savings to the bottom line. The Alaffia system detects and corrects inaccurately billed claims, preventing overpayments. We work directly with your health plan or TPA for seamless integration and no disruption to your members. Our services are entirely contingency-based, so you only pay when we deliver savings. We ensure that providers aren’t charging your employees for services not rendered.
