Alternatives to CLAIMSplus

Service Center by Office Ally is trusted by more than 80,000 healthcare providers and health services organizations to help them take complete control of their revenue cycle. Service Center can verify patient eligibility and benefits, submit, correct, and check claims status online, and receive remittance advice. Accepting standard ANSI formats, data entry, and pipe-delimited formats, Service Center helps streamline administrative tasks and create more efficient workflows for providers.

APP Tech pioneered the incident-based approach to claims and risk management. Since 2003, we’ve delivered integrated technology solutions to hundreds of customers across North America — to improve claims-management efficiency and scalability, increase visibility, shorten response times, lower premiums, and prevent risk events. Cloud Claims by APP Tech is a top-rated risk management and claims software solution. IMS is a purpose-built software solution for self-insureds, TPAs, and companies who want to track their claims and losses. It helps users manage the entire claim lifecycle, from the initial incident report to issuing payments and collections. It offers a variety of features that allow users to have complete control over their claims, as well as risk information. These include incident management and claims management, workgroup tools as well as reporting, insurance tracking, and many other features. We’re proud of our 100 percent implementation-success rate and excellent customer-retention rate, a result of our commitment to understanding our clients’ needs and rolling out solutions that work for them.

Duck Creek Claims offers a robust solution for managing the claims process, aimed at optimizing each stage of the lifecycle for insurance providers. It automates workflows from the first report through to the final settlement, while also simplifying data analysis via integrated analytics and ensuring compatibility with current systems. Notable features encompass advanced first notice of loss (FNOL) capabilities, automated assignments that consider adjuster expertise and current workloads, immediate access to policy and coverage information, and streamlined workflows for adjusters. This innovative platform significantly boosts operational efficiency and minimizes manual tasks, thus facilitating quicker claims resolutions and enhancing customer satisfaction, all while adhering to the latest regulatory standards. With its comprehensive tools and features, Duck Creek Claims positions insurers to effectively respond to the evolving demands of the insurance landscape.

Guidewire ClaimCenter stands out as a premier claims management platform aimed at optimizing the complete claims lifecycle for property and casualty (P&C) insurers. It encompasses a wide array of functionalities, spanning from the initial claim intake phase to final resolution, which empowers insurers to handle claims both swiftly and with precision. Among its notable features are automated workflows, integrated analytics, real-time performance tracking, and fraud detection capabilities, all of which work together to enhance operational effectiveness while boosting customer satisfaction levels. ClaimCenter caters to multiple insurance sectors, such as personal, commercial, and workers' compensation, and can be utilized independently or as a component of the Guidewire InsuranceSuite. By utilizing ClaimCenter, insurers not only expedite the claims process but also gain insights for informed decision-making and remain agile in response to shifting market conditions. Its implementation can lead to significant improvements in both efficiency and overall service delivery for insurers.

If your team is squandering valuable time and resources by updating claims manually on web portals and spending long hours on the phone with payors, then myClaimStatus is the solution you need. Gain access to real-time, actionable information regarding the status of all your claims and eliminate inefficiencies. With myClaimStatus’s comprehensive suite of data tools, you can expedite the reconciliation of claims. Regardless of your organization's size, you’ll save more on each claim when utilizing myClaimStatus. Are you truly maximizing your efficiency? MedX medical claim services incorporate robotic process automation to enhance your workflow productivity. Seamlessly reconcile reimbursement rates against your contracted amounts, ensuring that you receive the payments you are entitled to. With the ability to access real-time data for every healthcare claim across all payors, irrespective of the claim value, you can make informed decisions. This software goes beyond standard healthcare claims processing tools. By optimizing accounts receivable follow-up efforts to focus on exceptions, you can accomplish more in less time and improve your overall operational efficiency.

The process of filing claims is intricate and essential. Over 60% of individuals refrain from submitting complex claims due to the involved procedures and the time they require. Artivatic offers a specialized claims platform tailored to various insurance sectors, empowering companies to facilitate digital claims experiences, enable self-processing, automate evaluations, and implement risk and fraud intelligence alongside claims payouts. A SINGLE PLATFORM TO ADDRESS ALL YOUR CLAIMS REQUIREMENTS. Comprehensive Automation and Assessment for Claims. AUTO CLAIMS – HEALTH CLAIMS – TRAVEL CLAIMS – ACCIDENTAL CLAIMS – DEATH CLAIMS – FIRE CLAIMS – SME CLAIMS – BUSINESS CLAIMS – COMMERCIAL CLAIMS – EVERY CLAIM MATTERS.

The influence of digital technologies on the insurance sector is profound, with those adapting to these changes set to gain a strong competitive edge. Outdated claim management systems that rely on numerous platforms, physical documents, and labor-intensive procedures are now being supplanted by cloud-based enterprise claim management solutions. The Majesco ClaimVantage Claims Management Software for Life and Health simplifies the entire claims process, encompassing every stage from initial intake to payment calculations, while seamlessly integrating various systems to enhance information flow throughout the organization. By ensuring precise and prompt claim decisions, businesses can elevate customer satisfaction and boost operational efficiency. Additionally, built on the Salesforce Lightning Platform, Majesco ClaimVantage Claims Management Software for L&H empowers insurance firms and third-party administrators to not only modernize their claims handling but also to position themselves for future advancements in the industry. As the landscape evolves, embracing such innovative solutions will be crucial for sustained success.

Enter gets Providers (doctors and practices & hospitals) paid faster that anyone in history. Enter processes insurance claims and pays within 24 hours. It also automatically communicates and collects patient responsibility using a white label collection engine that includes payment plans. Enter is 30x more efficient at getting claims paid, and 45x quicker at getting patients billed at the exact same cost as existing medical billers. In just one year, we processed over $150 million in claims. Providers have access to a $100mm credit facility. United Healthcare Nevada - Revenue Cycle Management Partner Enter supports a wide range of specialties, including ASC, Orthopedics and Neurology, Dermatology. Emergency Rooms, Behavioral Healthcare, Pain Management, and many more. - Enter works with all government and commercial health insurance carriers. - Enter integrates all EMR/practice management systems. No monthly fees No integration fees. Venture backed by Enter

Five Sigma embarked on a quest to empower claims organizations to embrace innovation. Their collection of claims management tools and distinctive platform equips insurers with what is necessary to adapt their claims operations to an ever-evolving environment. By offering a suite of Claims-First Cloud-Native and User-Centric products, Five Sigma enhances the capabilities of adjusters, enabling them to manage claims more effectively and swiftly. Through the automation of routine administrative tasks, adjusters can concentrate on making informed decisions while the system efficiently manages the rest. Introducing Clive™ by Five Sigma, the first AI-driven claims adjuster in the industry, is revolutionizing the claims processing landscape for insurers, MGAs, and TPAs. By harnessing cutting-edge AI and automation, Clive optimizes the entire claims lifecycle, from the First Notice of Loss (FNOL) to the final settlement. This AI agent not only boosts the efficiency of claims handling but also improves accuracy and reduces costs by automating various tasks, ultimately leading to a more streamlined and effective process for all stakeholders involved. In this way, Five Sigma is setting a new standard for the future of claims management.

A data-driven solution for managing claims and remittances specifically designed for healthcare providers looking to streamline their workflows, enhance resource efficiency, minimize denial rates, and expedite cash flow. Boost your initial claim acceptance rate significantly. Our all-inclusive edits package ensures you remain compliant with evolving payer guidelines and regulations. Increase your team's efficiency with user-friendly, exception-based workflows and automated procedures. Your personnel can conveniently utilize our adaptable, cloud-based platform from any device. Effectively manage your secondary claims volume through the automated creation of secondary claims and explanations of benefits (EOB) derived from the primary remittance advice. Leverage predictive artificial intelligence to identify and prioritize claims that require attention, allowing for quicker error resolution and minimizing denials before submission. Achieve a more efficient claims processing experience. Additionally, print and distribute primary paper claims, or compile and send collated claims along with EOBs for secondary submissions. This holistic approach not only enhances operational efficiency but also promotes better financial performance for healthcare providers.

Founded in 2000, DataGenix is dedicated to delivering innovative claims processing solutions to third-party administrators, adjusters, and insurance firms. Recognizing the complexities that can arise in claims processing and health benefits management, our team has developed the sophisticated ClaimScape software designed to streamline the entire adjudication process, ensuring your business remains unaffected by potential losses. Our mission is to tackle the challenges that prevent an exceptional customer experience for your clientele. By aligning our offerings with current trends and demands, we are committed to facilitating your organization's growth through our software solutions. Trusted by leading TPAs nationwide, we are eager to expand our services to a broader audience. As we continue to evolve, we aim to set new standards in the industry.

In the insurance sector, the impact of a claim on long-term business outcomes is unparalleled, serving as a pivotal moment for both insurers and their clients. ClaimsXPress empowers insurers to provide exceptional experiences that yield favorable results. The quality of claims service is a crucial factor that sets insurers apart, regardless of the industry landscape. By improving the claims experience, ClaimsXPress fosters customer loyalty and generates increased business from distribution partners. Agile companies recognize that efficient processes and scalable systems are key to rapid growth. With a focus on the growth trajectory of insurers, ClaimsXPress is tailored to meet this need. The ability to respond swiftly to claims and access crucial data is essential, and ClaimsXPress excels in both aspects, allowing users to fast-track their goals. Ultimately, enhancing the claims process is not just about efficiency; it’s about creating lasting relationships that benefit all stakeholders involved.

Curacel's AI-powered platform allows insurers to track fraud and automatically process claims. You can easily collect your claims from your Providers and auto-vet them. Curacel Detection can help you identify and curb fraud, waste, and abuse in the Claims Process. Collect claims from providers to prevent fraud, waste, and abuse in the claims process. To understand where Insurers are losing the most value, we studied the Health Insurance industry. This was the Claims Process. The Claims Process is mostly manual and is prone to fraud, waste, and abuse. Our AI-driven solution helps reduce wastage and makes the Insurer more efficient, unlocking hidden value. Ravel insurance is unique in that it is built upon on-demand policies that only cover a short time. Both the policy holder and the insured want a fast and accurate claim settlement.

ResolvMD is a seasoned full-service medical billing firm that handles all types of health service claims, including AHCIP, for medical practitioners. Our mission is to empower physicians to feel as assured and skilled in their billing practices as they do in their medical expertise by providing data-driven insights and accessible knowledge. We offer the most advanced, affordable, and secure platform available for claims processing in the industry. Our primary audience consists of doctors, particularly specialists like emergency room physicians, urgent care providers, plastic surgeons, anesthesiologists, pediatricians, and general surgeons. These professionals seek a reliable billing partner to manage their health service claims, prioritizing attributes such as time efficiency, trustworthiness, cost-effectiveness, and expertise. Currently, we are focusing on physicians located in Alberta, specifically in cities such as Calgary, Edmonton, Red Deer, Medicine Hat, Lethbridge, Okotoks, and any other area with a population exceeding 25,000, ensuring that we meet the needs of a diverse and growing healthcare community.

Our goal is digitization of data exchange between all claim handling participants: insurers and brokers, their customers and loss adjusters. Our platform allows you to account and share your cases or connect your claims system with our API hub to integrate with your partners. To exchange data with your partners, connect your claims system to the API hub. Direct integration of all claims systems cannot be achieved, so information must be exchanged manually. This slows down the process and increases costs. It also complicates claims process automation. ClaimsControl's purpose is to allow digital data exchange between all participants in the insurance claims handling process. Let's discuss any claims management solutions you may have. We can help you exchange data with other systems, or provide our users with your solution.

FBCS Enterprise serves as a centralized platform that enhances decision-making regarding non-VA Purchased care, ultimately leading to improved management and adjudication of fee basis claims through efficient claims processing. The web-based solution, CTM Plus, optimizes workflows and provides necessary oversight to address challenges related to consults and Return to Clinic (RTC) tracking, ensuring timely patient calls and scheduling. Additionally, purchasing analytics play a crucial role in minimizing costs and waste, fostering greater accountability throughout the system. The automated monitoring of expired and recalled items significantly contributes to patient safety. Moreover, the potential repercussions of delayed or misplaced orders can adversely affect both financial performance and the quality of care provided. Time spent navigating through paper records and digital screens detracts from valuable patient interaction, while the process of verifying every patient's opioid prescriptions can be labor-intensive and complicated. DSS PDMP simplifies this issue by consolidating all necessary checks into a single, straightforward step, ultimately enhancing the efficiency of patient care. This holistic approach to managing care not only streamlines operations but also promotes better health outcomes for patients.

CoreLogic revolutionizes the global property and casualty insurance sector by offering adaptable, collaborative, and secure technologies for claims estimation. We focus on delivering exceptional experiences that enhance business operations and positively impact lives. With Claims Connect™ from CoreLogic®, the claims process is streamlined for all stakeholders through a cohesive digital ecosystem. Transform your workflow to ensure that your customers’ claims are addressed with greater efficiency and precision. All relevant information is securely consolidated within a single platform, making it easily accessible to everyone involved in the claim. Say goodbye to the hassle of toggling between various software applications to modify and review claims data. You can create estimates or implement changes directly in Claims Connect, which immediately updates the information, ensuring that everyone has real-time access to the latest details. By keeping all participants in the claims process informed with timely information, you will facilitate simpler, quicker, and more effective resolutions to claims issues. This innovative approach not only improves operational efficiency but also enhances customer satisfaction throughout the claims experience.

PayorLink solutions provide a holistic platform that goes beyond mere management of medical claims for employers, aiming to enhance employee benefits while simultaneously lowering healthcare expenses, encouraging healthy lifestyles, and boosting workforce productivity. The escalating costs of employee health care are a global issue that raises concerns for both payor organizations and healthcare providers. PayorLink™ is specifically crafted to decrease health expenditures for payors, incentivize employee productivity, and improve the quality of provider claims, largely through effective information exchange between payor entities and affiliated healthcare facilities such as clinics, medical centers, or hospitals. Additionally, it is equipped with tools for Employee Health Profiles and Assessments, which contribute to the realization of wellness and productivity among staff. By focusing on these areas, PayorLink not only addresses immediate financial concerns but also fosters a healthier work environment.

Enhancing the claims process from start to finish. Our approach is technology-oriented, focused on people, and grounded in integrity. We offer a comprehensive claims service interaction platform tailored for insurance carriers, managing general agents, captives, and self-insured organizations. With easy access to deployments, claims management, and advanced file organization, efficiency is just a click away. At Beagle, we recognize the specific hurdles that insurance service providers and independent adjusters encounter in claims management. Our foundational software features are crafted to optimize the claims process, minimize expenses, and ensure swift responses to your claims. By integrating our technology, we enhance efficiency and bring professional insight to each phase of the adjustment process. Our services include expedited claims and inspection feedback, which not only mitigate liability but also promote operational efficiency. We address new policy inspections, policy renewals, and daily loss assessments seamlessly. Beagle was designed to manage the routine processes that arise each day, ensuring that claims handling is streamlined through the utilization of cutting-edge technologies for quicker resolutions. In this way, we empower our clients to navigate the complexities of claims with ease and confidence.

The KMR Claims Processing Manager is an advanced, fully integrated, and customizable solution designed for Third Party Administrators (TPAs), Self-Insured entities, and Claims Administrators. This sophisticated system features an all-inclusive Medical and Dental Reimbursement module, supports electronic claim submissions, seamlessly integrates with Document Imaging technologies, offers debit card processing capabilities, and ensures full compliance with HIPAA regulations. Additionally, users can easily tailor the system to meet their specific needs and enhance operational efficiency.

ClaimBook streamlines the insurance claims process by facilitating quicker settlements, enhancing accountability, and reducing the likelihood of rejections. It is equipped with comprehensive features that cater to all aspects of claims management and evidence submission. Furthermore, ClaimBook promotes international patient care through specialized workflows, thereby fostering medical tourism. The platform includes a built-in Rules Engine that prevents incomplete submissions and ensures that all necessary information and documents are provided. This leads to submissions that are accurate, thorough, and pre-authorized. Additionally, ClaimBook incorporates Smart Data Extraction technology, which can interpret uploaded documents to retrieve pertinent information from a connected Hospital's Information System, eliminating the need for manual data entry. Another valuable feature is Integrated Emailing, which creates a virtual inbox directly within your dashboard, allowing users to compose emails with a familiar design similar to that of Microsoft Outlook. This integration not only enhances productivity but also ensures seamless communication throughout the claims process.

ALYCE is tailor-made for self-insured entities, municipalities, and small third-party administrators managing claims related to Workers' Compensation, Auto Liability, Auto Property, General Liability, and Property. Its user-friendly interface prominently features essential data points on the primary claim page, showcasing the financial summary alongside other critical information that can be accessed quickly with a simple scroll or a click. Additionally, it offers a multi-tiered structure for employer reporting obligations that vary by location and department. The system also facilitates recoveries through salvage, subrogation, and payments from excess carriers. Users benefit from automated scheduling for recurring payments, complete with diary alerts to enhance organization. Furthermore, diaries are automatically generated based on significant events, timelines, and financial activities, ensuring nothing is overlooked. The system also creates form letters automatically for claimants, attorneys, and various stakeholders involved in the claims process, streamlining communication and documentation. This comprehensive approach not only improves efficiency but also fosters clearer communication among all parties involved.

The flagship claims processing solution from Acrometis provides exceptional workflow management by utilizing a configurable rules engine to automatically route documents. This system is built around various elements such as claim assessment scoring, matching body parts to claim compensability, adhering to jurisdictional directives, and scoring relatedness, all aimed at minimizing both the duration and costs associated with claims. Notably, CLAIMExpert can autonomously process 65 percent of incoming medical bills and non-medical documents without requiring any user intervention. Documents that need adjuster review are efficiently flagged and organized to facilitate straightforward decision-making, ensuring that the process remains streamlined. With no need for adjuster involvement for the initial processing, clients often experience an improvement ranging from 11 to 23 points in medical loss within the first year. Furthermore, CLAIMExpert is equipped with rules addressing over 190 different document types, enabling it to swiftly manage whitemail and any other documentation that may arrive at an adjuster’s desk. This comprehensive approach not only enhances efficiency but also significantly impacts the overall claims handling process.

WLT’s MediClaims system presents an economical, user-friendly, and highly effective solution for managing benefits and claims. Its rules-based framework combined with integrated EDI functionalities ensures that claims are handled swiftly, simply, and with precision. The system is designed to manage a diverse array of benefits and claims, including Medical, Dental, Vision, Prescription Drugs, Consumer-Driven Healthcare, Disability, and Capitation processing. With WLT's MediClaims, you can easily customize the configuration of your groups to accommodate either a single line of coverage or intricate benefit plans with multiple coverage lines. To achieve operational efficiency, a robust information system is essential, and WLT consistently utilizes cutting-edge technologies, delivering you the most advanced and adaptable systems available in the market. In an ever-evolving healthcare landscape, having such a dynamic claims processing system is crucial for maintaining competitive advantage and ensuring customer satisfaction.

Introducing the most effective and precise solution in the market for handling claims, the CyberSource Medical Claims Scanning Solution is a fully integrated system designed for HMO, PPO, TPA, or Self-Funded Organizations. This system is set up at your facility to facilitate automated data entry for various forms including CMS-1500, ADA-2006, UB-04, and enrollment documentation. By leveraging sophisticated "intelligent" features along with your specific business protocols, CyberSource adeptly identifies, verifies, and formats data extracted from medical claim submissions. Its Fuzzy Matching technology smartly searches through your member and provider databases to ensure accurate identification of data matches. Once the data is matched, it is used to confirm and rectify information on the medical claim prior to moving it to the adjudication stage. The synergy of top-tier OCR capabilities, your unique business guidelines, and efficient Fuzzy Matching contributes to outstanding precision in processing data from your medical claims forms, ultimately enhancing operational efficiency. Through this innovative solution, organizations can significantly minimize errors and streamline their claims processing workflow.

FileHandler Enterprise helps TPAs, insurance carriers, public entities and self-insured organizations automate processes and improve efficiency. Our software keeps you on track with automation and customization, creating a standard claims management process for your business. From implementation to continuous, dedicated support through our Quality Assurance and Implementation Team Members, our goal is to deliver our client partners an effective business management tool, empowering them to automate workflows and increase productivity throughout their business cycle. FileHandler Enterprise allows businesses to facilitate integration with several third-party applications. We ensure that our software works well with preexisting systems in an essential part of our goal at JW Software; helping create customized third-party integrations for your preexisting ISOs, state systems, insurance systems, and much more. 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.

The EMSmart™ claims processing technology not only elevates service standards but also enhances your financial performance. At EMS IMC, we are dedicated to maintaining a compliant, precise, and efficient system to navigate the growing intricacies of billing, all while swiftly boosting your revenue. Across the nation, our innovative solution, EMSmart™, has empowered clients to concentrate on what truly matters: delivering exceptional patient care, secure in the knowledge that their revenue is being optimized in a compliant way. Our proprietary claims processing platform, EMSmart™, integrates the best rules-based automation in the industry while ensuring that human judgment is applied at key moments throughout the revenue cycle. Though EMSmart™ serves as our internal processing engine, we are eager to communicate this information to you, confirming that your claims are managed by the finest blend of human expertise and automated efficiency available in the field. Ultimately, EMSmart™ not only streamlines the claims process but also reinforces our commitment to excellence in healthcare revenue management.

With the convenience of virtual diagramming, voice annotation, photo documentation, and comprehensive pricing features, everything you need is at your fingertips. By efficiently and precisely gathering claim information directly at the site, follow-up visits are often rendered unnecessary, allowing for deeper engagement with policyholders during the settlement process. Adjusters can seamlessly document, estimate, and finalize claims in just a few simple steps, resulting in quicker, more efficient, and accurate settlements. The Mobile Claims platform ensures that estimates made on-site can quickly transition into settlements. Utilizing intelligent questionnaires, our technology can create tailored, loss-specific estimates significantly faster than conventional methods. The system is designed for easy integration, training, and usability, drastically reducing the costs associated with change while offering substantial advantages for carriers, adjusters, contractors, and policyholders. Additionally, it comes fully equipped with features such as aerial imagery and measurement, 3D virtual diagramming, geospatial visualization, and video collaboration, making it a comprehensive solution for modern claims processing. Overall, this innovative approach not only enhances productivity but also fosters better communication among all parties involved.

The rise in total loss claims has reached a concerning 20 percent of all collision and liability losses within the auto insurance sector. Unfortunately, many insurance providers still struggle with disjointed total loss operations, which can result in higher expenses, unhappy customers, and limited oversight. Introducing Total Loss Pro™ from Vemark: this innovative solution is designed to turn the cumbersome total loss claims process into a streamlined and efficient system that can adapt to rapid industry changes. With this tool, you can ensure quicker settlements that enhance policyholder satisfaction. Additionally, it boosts employee morale by minimizing frustration associated with cumbersome processes. This platform also offers improved visibility and transparency, enabling data-driven decision-making. Given the complexities involved in total loss auto claims compared to standard repair claims, Total Loss Pro serves as a cloud-based solution that optimizes every stage of the intricate salvage vehicle workflow, ultimately benefiting both insurers and their clients. Moreover, by implementing this comprehensive tool, carriers can foster a more proactive approach to managing claims, ensuring a smoother experience for all parties involved.

Auto insurance companies require effective solutions to streamline the processing of physical damage claims from the initial report of loss to final settlement. Mitchell WorkCenter offers a comprehensive, modular system that can be tailored to meet the specific requirements of your business. By enhancing accuracy and efficiency, this platform helps to reduce overall ownership costs while ensuring better outcomes. You can seamlessly exchange information directly with your claims management system, facilitating a smoother workflow. With a history of successful project implementations in under 90 days, your IT team will find integrating with Mitchell WorkCenter to be an easy task. Each business operates differently, and WorkCenter allows for the customization and management of software according to your distinct operational needs. You can either utilize the full suite of features or choose particular tools that align perfectly with your claims management processes, providing flexibility and control. This adaptability ensures that your unique workflow is supported, optimizing your claims handling efficiency.

Effortlessly incorporate into current claims systems while streamlining automation and minimizing expenses. The dilemma of choosing between cost savings and enhancing customer satisfaction is now a thing of the past. Leverage data-driven insights for superior decision-making and automate tedious tasks to empower your claims staff. Prioritize your customers’ satisfaction by ensuring a smooth connection between incoming claims and your core insurance system. Address inefficiencies in processes through claims automation and witness a remarkable boost in customer contentment. By automating the handling of low to moderate complexity claims, you can significantly lower the incidence of manual intervention. Enhanced triaging and manual assignment of claims have led to a substantial increase in the effectiveness of case teams. The reduction in processing time for the remaining manual claims has enabled real-time settlements in numerous cases. The digital claims journey has been automated through the implementation of FNOL-completeness checks, coverage verifications, and automatic claims file generation, resulting in a more efficient system overall. This transformation not only improves operational efficiency but also cultivates a more robust relationship with clients.

When unexpected events occur, will your claims services provider meet the challenge head-on? At GB, we perceive Claims Management as the ultimate realization of the promises and potential inherent in the insurance sector. It is a pivotal moment when we are called not just to rectify situations but to enhance and improve them. For over five decades, we have consistently responded to that call. Going beyond the norm is ingrained in our culture. Our focus is on the individuals we serve, as well as the exceptional members of our team who drive our success. Our Relationship Managers are amongst the most motivated and empowered professionals in the industry. Each one is committed to achieving outstanding outcomes consistently. They embody a philosophy we refer to as Own the Outcome, which emphasizes taking responsibility for making informed decisions early in the claims process. This approach allows us to identify and provide the necessary resources promptly and effectively, ensuring we are always prepared to exceed expectations. Furthermore, our dedication to evolving and improving our services ensures that we remain at the forefront of the claims management industry.

Safeguard the reliability of your health plan while pinpointing precise pricing with the Context4 Health Plans Suite, our versatile and cloud-centric technological framework. Experience immediate and actionable insights for detecting Fraud, Waste, and Abuse (FWA), developed by our skilled team of certified experts in clinical, dental, and health benefits. By leveraging accurate data and state-of-the-art cloud technology, we deliver a robust and defensible Medicare reference-based pricing (RBP) solution. Our platform comprises over 100 healthcare data sets, complemented by professional guidance to enhance operational efficiency and ensure regulatory compliance. Additionally, our sophisticated medical coding software is tailored to streamline claim submissions and reduce the likelihood of denials. Furthermore, the cloud-based Payment Integrity Platform harnesses our unique analytics engine to uncover coding mistakes, assess medical necessity, address unbundling, detect fraud, waste, and abuse, evaluate audit risks, and identify pricing discrepancies, all of which can significantly influence your organization's performance. This comprehensive approach not only safeguards your financial health but also positions you for sustainable success in the ever-evolving healthcare landscape.

Adjustify is an innovative video calling platform designed for professionals to engage with their clients for remote on-site inspections or in-home consultations. You can easily schedule a call with your client using the mobile app, facilitating a seamless digital connection. Throughout the video session, participants can utilize digital measurement tools and customer phone capabilities, such as zoom and flash, to capture an unlimited number of photos. Following the conversation, users have the ability to review a recorded video of the meeting and annotate the images taken. This cutting-edge video conferencing solution supports claims management across various sectors, ensuring essential continuity even during periods of social distancing. Amidst the challenges of remote work and social distancing, Adjustify provides a secure and efficient method for processing claims. By leveraging Advanced Video Calling technology, users can effectively connect with clients and perform on-site inspections from virtually any location, enhancing both productivity and client satisfaction.

The FINEOS Platform stands out as the sole comprehensive end-to-end SaaS core product suite for clients, featuring FINEOS AdminSuite for managing everything from quote to claim, alongside add-on products such as FINEOS Engage to enhance digital interaction, and FINEOS Insight for advanced analytics and reporting capabilities. It serves as a cornerstone for your digital insurance approach. By integrating FINEOS AdminSuite, FINEOS Engage, FINEOS Insight, and robust platform capabilities, the FINEOS Platform establishes itself as the most contemporary single core insurance solution tailored for Life, Accident, and Health sectors. In contrast to outdated legacy core systems that relied on a 'one size fits all' technology model, which is no longer suitable for dynamic businesses, modern consumers, employers, and brokers now benefit from sophisticated SaaS solutions and software that elevate expectations for an insurer's digital initiatives. The previous monolithic insurance software systems primarily concentrated on the intricacies of insurance contracts, overlooking the need for flexibility and adaptability in today's fast-paced market. Embracing the FINEOS Platform means adopting a future-ready approach that aligns with current consumer demands and technological advancements.

AGO Insurance Software, Inc. stands out as a prominent provider of software and services tailored for property and casualty insurance companies, delivering reliable and economical business solutions suitable for insurers regardless of their scale. Our offerings encompass a range of solutions, including those for policy administration, claims handling, accounting, bureau reporting, and expert systems. With our software, you can enhance operational efficiency, boost productivity, and increase overall profitability. The modular design of our system allows for installation as either a fully integrated solution or as individual modules that can be licensed separately. This versatility enables seamless integration with current legacy systems or third-party applications, ensuring that our clients can adapt and thrive in a dynamic industry landscape. Ultimately, our commitment to innovation positions us as a valuable partner for insurance firms aiming to optimize their processes.

Polygonal enhances previous versions' robust capabilities by integrating cutting-edge Microsoft VB.Net and Business Intelligence technologies, offering a holistic solution that swiftly adapts to today’s ever-changing market demands. This software is a modular, multi-currency platform for underwriting and policy/claims administration, seamlessly incorporating transactions, reinsurance, accounting, messaging, data warehouse reporting, document management, and workflow modules to deliver a comprehensive end-to-end business process with measurable outcomes. Developed with a focus on business needs by the expert team at City Computers, Polygonal benefits from years of experience in the insurance sector, combining practical insights with innovative solutions. As a result, users can expect not only efficiency but also enhanced decision-making capabilities through integrated analytics.

Snapsheet makes claims simple. We do this through our suite of innovative insurance software solutions which transform insurance companies' ability to seamlessly manage claims, reduce cycle time, increase appraisal accuracy, and deliver payments effortlessly. We started it all with virtual appraisals, and followed that up with our leading claims management system. Today we are driving an industry-wide movement in claims by delivering solutions that enhance customer experiences while our customers create innovative, data-driven claims organizations.

Accelerate your scoping, estimating, and overall cycle times significantly. Produce intricate 3D, 360° photo tours in less than 20 seconds for each room, and create precise floor plans in as little as five hours. Obtain scope of work reports effortlessly with just a few taps on your mobile device. Enhance your financial performance with estimates that comply with insurance standards. Everything you require and even more is at your fingertips to effectively document, sketch, scope, and estimate. Experience low initial costs while enjoying substantial time savings and enhanced profitability. You can get started in no time, as there is no complicated onboarding or extensive training required; simply pick it up and dive right in. A dedicated team of professionals is readily available by phone, including a 24-hour emergency hotline for immediate assistance. Our camera captures data with greater accuracy and a reduced margin of error compared to smartphone usage. Backed by years of industry experience, our products are designed to propel your business to new heights. DocuSketch revolutionizes restoration companies with innovative solutions, dramatically shortening cycle times, increasing profitability, and streamlining claims to foster growth and support. Additionally, the seamless integration of our technology into your workflow will ensure you stay ahead of the competition.

Thoughtful AI presents an all-encompassing, AI-powered approach to managing healthcare revenue cycles (RCM). Featuring advanced AI agents like EVA for verifying eligibility and CAM for handling claims, this platform streamlines even the most intricate and labor-intensive RCM tasks. Aimed at enhancing both efficiency and precision, it lowers operational costs, decreases denial rates, and speeds up the posting of payments. Endorsed by top healthcare organizations, Thoughtful AI ensures smooth integration, promises a return on investment, and effectively cuts down costs associated with collections, all while adhering to HIPAA-compliant security standards and offering performance-based assurances. This innovative solution is transforming the way healthcare providers manage their financial processes.

ClaimPilot delivers an exceptional web-based claims management solution combined with outstanding customer service. Tailored for claims management professionals aiming to expand and efficiently oversee their operations, ClaimPilot ensures a user-friendly experience with essential features and capabilities that enhance visibility into claims and financial data through personalized reporting options. This platform effectively addresses the rising demands for data input with its adaptable functionalities, leading to greater efficiency in claims processing. In contrast to cumbersome, overly complex risk management software or simpler systems that only handle document management, ClaimPilot encompasses all necessary features for comprehensive claims management, including compliance with Lloyd’s standards and workers' compensation functionalities. Furthermore, our esteemed customer service team is dedicated to collaborating with clients to create customized reports and features that cater to their evolving needs. Ultimately, we believe that your success directly influences our success, and we are committed to supporting your growth.

The Whitespace Platform stands out as a fully digital solution tailored for the global (re)insurance industry. Contracts that are generated and managed through Whitespace consist solely of data. By leveraging digital data for risk transfer instead of traditional formats like Word or PDF files, businesses can unlock the true potential of digital transformation. This shift opens up a world of opportunities, including enhancements in speed, precision, availability, and an expansive array of detailed data for risk assessment, all of which significantly benefit both Brokers and Carriers. Moreover, insurers prioritize the needs of their clients, as a digital interface enables immediate access to risk placements, expedited payments, and quicker claim responses. The comprehensive process is thoroughly supported; with Whitespace, brokers and underwriters can seamlessly create risk submissions, collaborate on contractual agreements, communicate through real-time messaging, request and share quotes, and digitally bind, sign, and endorse (re)insurance contracts, enhancing overall efficiency in the marketplace. Ultimately, this innovative approach not only streamlines operations but also fosters stronger relationships between all parties involved.

Streamline the complete claims process by automating steps from the initial loss notification and fraud detection through to adjudication and final settlement. Enjoy the capability to handle various claim types distinctively, such as death claims and maturity claims, while enhancing adherence to regulations and avoiding penalties for non-compliance. Achieve more efficient and precise processing with features for data collection, payment oversight, salvage and recovery management, legal case processing, and comprehensive monitoring. Ensure effective registration, adjudication, tracking, and oversight of all claim submissions. Utilize integrated and detailed business rules that enable claims to be categorized automatically into “fast track” or “non-fast track” categories. Additionally, you have the option to easily add or adjust stakeholders involved in the process, including garages, assessors, loss adjusters, surveyors, investigators, and claims officers, to further enhance operational efficiency. This comprehensive approach not only simplifies workflows but also fosters collaboration among all parties involved in the claims journey.

Introducing a cutting-edge and efficient method for managing and settling insurance claims. This comprehensive, all-in-one solution caters to various types of insurance, including property, liability, and workers’ compensation. ClaimRuler™ is a state-of-the-art cloud-based claims management platform crafted specifically for Independent Adjusters, Third-Party Administrators, CAT Adjusters, Insurance Carriers, Self-Insured entities, and Municipalities. The system facilitates seamless claims processing with integrated guided workflows, extensive reporting features, and an automated diary system that enhances the efficiency of the claims settlement process. Designed with the real-world needs of industry professionals in mind, ClaimRuler™ offers a user-friendly and functional interface, making it easier to manage forms, lists, documents, and images. Whether you are part of an I/A firm, a TPA, an insurance carrier, or a municipality, ClaimRuler™ is flexible and scalable to grow alongside your organization. This adaptability ensures that users can navigate the platform with ease while meeting the evolving demands of the insurance landscape.

Venue ™ Claims Management for Independent Adjusters offers a complete solution for overseeing the entire claims processing workflow. This system is suitable for various entities, including adjustment firms, third-party administrators, insurance carriers, and self-insured organizations. Users can enjoy a highly customizable interface, enabling significant self-modification of the claims management system to meet their specific needs. The platform includes a built-in web service interface, facilitating real-time or batch data imports, updates, and exports to nearly any external data-sharing source concerning all claim-related information. Furthermore, seamless integration with policy and billing systems ensures real-time synchronization of all policy-related details, which may encompass essential policy dates and alerts, such as ongoing fraud investigations and assumed policies. The system provides thorough capabilities for every dimension of claims processing—spanning claim payments, recovery processes, reserves tracking, contact management, trust accounts, forms templates, and extensive reporting functionalities. Overall, Venue ™ empowers organizations to enhance their claims management efficiency and effectiveness.