Alternatives to Inovalon Insurance Discovery

Streamline revenue cycle management, care quality oversight, and workforce optimization through a unified, user-friendly portal featuring single sign-on capabilities. Over 47,000 provider locations depend on our cutting-edge tools to ease the complexities of the patient care experience. Transform the financial experience for patients while alleviating administrative and clinical challenges with the Inovalon Provider Cloud, eliminating the need for fragmented workflows. Our SaaS offerings are designed to enhance both financial and clinical results throughout the patient journey, facilitating improved revenue cycle processes for enhanced reimbursement and ensuring optimal staffing levels for high-quality care. This all-in-one portal enables your organization to elevate its performance, boosting revenue, staff satisfaction, and care standards. By enhancing operational efficiency, productivity, and overall effectiveness, you can unlock the full potential of your organization. Explore the transformative capabilities of the Provider Cloud today.

Garner offers a comprehensive platform that harnesses extensive data to assist individuals, employers, and health plans in pinpointing the best medical providers, utilizing one of the largest claims databases in the country, which comprises over 60 billion records from more than 320 million patients. This platform employs over 500 metrics specific to various specialties to evaluate provider performance and determine patient outcomes effectively, supported by an AI-enhanced directory that boasts around 92% accuracy for details such as provider contact information and appointment availability. Providers who are designated as “Top Providers” adhere to strict standards, emphasizing evidence-based practices, the reduction of unnecessary medical procedures, and the maintenance of cost efficiency. Additionally, members have access to both a mobile app and a concierge service that facilitate the identification of in-network Top Providers with upcoming appointments, and they may be reimbursed for certain out-of-pocket expenses for services provided by these top-tier professionals. Furthermore, this innovative platform not only streamlines the process of finding quality healthcare but also aims to improve overall patient satisfaction and outcomes through its meticulously curated resources.

Speed up payment processes while minimizing administrative tasks. With over 8,000 payer connections and established collaborations with more than 650 practice management vendors, our claims management solutions lead to a reduction in pending claims and decreased need for manual efforts. Efficiently and accurately send claims for various services, including professional, institutional, dental, and workers' compensation, ensuring prompt reimbursement. Tackle the evolving landscape of healthcare consumerism by delivering a smooth and transparent financial experience. Our patient engagement tools enable you to facilitate informed discussions around eligibility and financial obligations, while also lowering obstacles that could affect patient outcomes, ultimately fostering better healthcare experiences.

Reimbursify stands out as the pioneering mobile-enabled software platform that offers a groundbreaking solution to empower patients, assist healthcare practitioners, and facilitate digital partners in efficiently submitting out-of-network reimbursement claims for both medical and mental health services. This innovative app simplifies the process of filing out-of-network (OON) reimbursement claims with your health insurance provider, providing a swift and hassle-free experience to ensure you receive every dollar you're entitled to. With an intuitive registration process designed for primary insured individuals, spouses, and dependents, the platform boasts a smart dashboard that organizes all your claims and monitors the funds you are set to receive. Additionally, it features a unique Rejection Resolution Pathway that quickly addresses any rejected claims, along with a provider search function that automatically fills in essential provider details to further streamline your experience. Reimbursify not only maximizes the efficiency of the reimbursement process but also enhances the overall user experience, making it an indispensable tool for anyone navigating the complexities of healthcare claims.

Nexus EHR is a cloud-based, ONC-certified EHR and PM system for clinical healthcare providers. Nexus EHR works with your clinical workflow and maximizes the physician-patient encounter. Access anywhere, any time, and with any device (PC, Tablet, Mobile). Breeze through encounters via our intuitive, easy-to-use interface that allows you to practice naturally. Nexus PM helps you practice maximizing your revenue by simplifying billing operations. Physicians can use Nexus telemedicine for e-visits. Nexus patient portal gives patients a better control to fill demographics, insurance details, and histories before the appointment.

Silna Health's Care Readiness Platform efficiently manages prior authorizations, benefit verifications, and insurance monitoring right from the start, ensuring that patients are ready to receive care while allowing providers to concentrate on delivering treatment. Powered by AI, the platform oversees the entire workflow of prior authorizations, which includes tracking future authorizations, sending weekly reminders, handling submissions, and conducting follow-ups, all while applying established industry rules and highlighting exceptions for human intervention when necessary. Benefit checks specific to various specialties confirm coverage, accumulation, authorization prerequisites, and visit limitations in real time, providing precise quotes at the point of intake. The system also performs continuous insurance monitoring to identify lost coverage, detect new insurance plans, and prevent eligibility gaps. Designed to operate without increasing staff numbers, Silna directly integrates data from EMRs and practice management systems, offers customizable rule sets and strategic frameworks, and features intuitive dashboards that present insights into incremental revenue. Overall, this comprehensive approach not only streamlines processes but also enhances the financial performance of healthcare providers.

Streamline your operations and prioritize your employees’ well-being. With Alan, you can eliminate the hassle of paperwork and confusion, ensuring that fulfilling your responsibilities doesn’t require specialized knowledge. Experience time-saving health insurance with a clear, straightforward offer. Your employees can easily access a simple online table of benefits anytime, without any physical documents to handle. Forget about the complexities of managing arrivals, departures, and portability; everything is conveniently handled through your mobile device or computer. Alan's insurance is fully authorized by the ACPR Banque de France and backed by reputable reinsurers like CNP and SwissRe, consolidating all your employees' protections in one accessible location, free from obligations. Alan green provides health coverage that delivers comprehensive protection without excessive costs. Alan blue offers health coverage that ensures excellent reimbursements regardless of the healthcare provider or optician chosen. Lastly, Alan Foresight features provident insurance, which safeguards your employees against unforeseen challenges such as long-term illness or disability, ensuring that their needs are met during tough times. This innovative approach allows you to focus on growth while providing essential support to your team.

At Enlitic, we believe that the power of artificial intelligence can transform healthcare by enabling effective data management and improving clinical workflows. Our mission at Enlitic is to intelligently manage healthcare data using the power of artificial intelligence to expand capacity and improve clinical workflows and create a foundation for a real-world evidence medical image database for healthcare providers. Through our Enlitic Framework, we aim to reimagine healthcare intelligence, enabling healthcare professionals to make informed decisions and provide personalized care to every patient.

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.

Healthcare.gov has made it easier for HealthSherpa to enroll in Affordable Care Act plans. We work with employers, insurers, agents, nonprofits, and consumers to help them enroll as many people as they can in these comprehensive, subsidy-eligible health plans. We power insurance companies' websites so they can enroll people in Affordable Care Act plans. We offer superior enrollment technology, a CRM and communication tools for insurance agents so they can enroll more clients in plans that are right for them, faster. We have over 40,000 agents using our platform. We offer decision support tools for consumers to help them choose the right plan for their healthcare needs. HealthSherpa has more than 5,000,000 consumers enrolled in coverage. We offer all the same plans, prices and benefits as HealthCare.gov.

Benefitexpress was founded by benefits experts and offers industry-leading cloud-based benefits management software, solutions, and services to employers, brokers, and other partners. My Benefit Express™, our fully outsourced solution, simplifies your benefits administration responsibilities. It helps employees make informed decisions and enhances employee engagement and satisfaction. Software and services include a full-service phone center, integrated ACA administration and reimbursement account administration, dependent eligibility audits and total compensation statements. Our clients' success is assured by our commitment to creative problem solving and scalable systems.

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

The process of patient access serves as the foundation for the entire revenue cycle management in healthcare. By ensuring that patient information is accurate from the outset, healthcare providers can minimize errors that often lead to additional work in administrative departments. A significant portion, between 10 to 20 percent, of a healthcare system's revenue is spent on addressing denied claims, with a staggering 30 to 50 percent of these denials originating from the initial patient access phase. Transitioning to an automated, data-oriented workflow not only mitigates the risk of claim denials but also enhances patient care access, thanks to features such as round-the-clock online scheduling options. Furthermore, patient access can be refined by streamlining billing processes through real-time eligibility checks, which provide patients with precise cost estimates during registration. Additionally, enhancing registration accuracy leads to greater staff efficiency, allowing for immediate rectification of discrepancies and errors, thereby preventing expensive claim denials and the need for further administrative corrections. Ultimately, focusing on these elements not only safeguards revenue but also elevates the overall patient experience.

Samedi is an innovative web-based software designed to enhance patient coordination while simultaneously reducing costs and improving services. This secure networking tool is applicable in various healthcare settings, including medical practices, clinics, and operating rooms. By utilizing effective resource planning, process management, online appointment scheduling, and task assignments, the system streamlines workflows. Additionally, the inclusion of video consultations and online forms allows for a more adaptable process, all while ensuring top-notch data security. Serving as an e-health software solution for physicians, clinics, and health insurers, Samedi connects the healthcare ecosystem and refines medical operations. With a focus on simplicity, efficiency, and security, our 12 years of experience in the e-health sector enables us to cater to your specific needs, providing customizable options for both straightforward and complex workflow demands. Our software integrates seamlessly with nearly all practice and clinic management systems, facilitating a hassle-free operational experience. This adaptability not only enhances productivity but also fosters better patient outcomes.

symplr's provider credentialing software serves as a comprehensive solution for managing provider data, effectively reducing turnaround times and streamlining revenue cycles, all while ensuring that patient safety remains a top priority. This software simplifies the processes of data collection, secure access, reporting, and maintaining ongoing compliance, making it easier for providers, credentialing teams, and internal approval committees to manage their responsibilities. Users have experienced a significant 20% decrease in the time it takes to complete credentialing, with a remarkable 50% drop in the frequency of committee review meetings. By utilizing this automated and intuitive platform, organizations can efficiently collect, verify, store, and share vital provider lifecycle information and documentation in one centralized location, leading to both time savings and cost reductions. Additionally, the software includes a payer enrollment module that facilitates the enrollment of providers with payers, allowing for easy tracking of applications throughout the reimbursement process. With advanced automation capabilities, it gathers data from numerous primary sources and conducts automatic checks for expired or suspended licenses, as well as verifying against databases such as NPDB, DEA, and SAM, thus enhancing the overall efficiency and reliability of the credentialing process. Ultimately, symplr’s software transforms the way healthcare organizations handle provider credentialing, making it a crucial tool in the industry.

Reclaim precious hours in your day and save millions with our innovative automated solutions. Connect effortlessly with essential stakeholders—providers, payers, and partners—while gaining access to real-time, precise data that ensures seamless care delivery. We simplify the intricate web of thousands of payer connections, allowing you to initiate quick and straightforward enrollments with ease. Experience the unparalleled capabilities of the cloud like never before. Our centralized command system enables you to manage, store, and share provider information in real-time, ensuring connectivity wherever necessary. Verification of providers is now a hassle-free process; simply make a request, and our platform will expedite it for you, enhancing your operational efficiency. Let us help you streamline your workflow like never before.

Swiss Re provides an extensive array of reinsurance solutions aimed at assisting insurers in refining risk management and enhancing analytical capabilities throughout the insurance value chain. Their portfolio includes both property & casualty and life & health reinsurance options, delivering customized coverage and cutting-edge tools that address the dynamic requirements of the re/insurance sector. By utilizing state-of-the-art technology and insights driven by data, Swiss Re empowers its clients to manage risks proficiently, boost operational efficiency, and seize emerging market opportunities. The company engages directly with clients and collaborates through brokers, serving a diverse clientele that includes insurance firms, mid-to-large corporations, and public sector entities. Whether offering standard products or bespoke coverage across various business lines, Swiss Re leverages its financial strength, deep expertise, and innovative capabilities to support the risk-taking essential for enterprise growth and societal advancement. This commitment to innovation and client support positions Swiss Re as a leader in the ever-evolving landscape of reinsurance.

HealthRules® Payer represents a cutting-edge core administrative processing system that offers transformative features for health plans across various types and sizes. For over a decade, health plans utilizing HealthRules Payer have effectively capitalized on market opportunities, maintaining a competitive edge. What sets HealthRules Payer apart from other core administrative solutions is its innovative application of the patented HealthRules Language™, which resembles English and introduces a groundbreaking methodology for configuration, claims management, and information transparency. This system empowers health plans by enabling them to expand, innovate, and outperform their peers more effectively than any other core system available today. As a result, HealthRules Payer not only streamlines operations but also fosters a culture of agility and responsiveness within health organizations.

Simple Interact is a SaaS provider focused on enhancing the operations of medical practices, groups, and hospitals. Our technology accelerates patient workflows while minimizing the need for additional staffing. By automating a variety of repetitive tasks, we alleviate the burden on staff. This includes managing intake processes, capturing images such as insurance cards and selfies, and handling medical histories, screenings, legal documents, informed consents, initials, eSignatures, and educational marketing materials. Additionally, we facilitate the automated filling of canceled appointment slots and streamline appointment and referral request forms along with request management. Our system also offers features like patient self-sign-in with address and insurance verification, a virtual waiting room, and reminders and consent for telehealth services, ensuring a comprehensive solution for modern medical practices. Ultimately, our goal is to create a more efficient and patient-friendly experience in healthcare settings.

Ambulatory practices encounter a myriad of challenges in today's healthcare landscape. Balancing the demands of optimizing appointment schedules with the need to simplify documentation and diagnostic processes can often complicate communication with fellow physicians, insurance providers, and pharmacies, all while adhering to evolving regulatory requirements. Veradigm Professional EHR™, a system originally developed by physicians, stands out as the leading choice for medical practices aiming to enhance patient safety, operational efficiency, and financial performance. This innovative EHR features user-friendly, one-click templates that allow physicians to effectively document patient encounters based on historical data, enabling swift modifications with minimal effort—ultimately boosting provider satisfaction. Additionally, the Physician Desktop feature offers a streamlined approach for healthcare providers to oversee their patient populations, consolidating comprehensive clinical information into a single, accessible screen for better decision-making and care coordination. This integration significantly enhances the overall workflow within practices, making it easier for providers to deliver high-quality care.

Health plans today prioritize population health management (PHM) as a critical focus area. The key issue lies in balancing the overall health of the population while still recognizing and addressing the needs of each individual. ZeOmega emphasizes the significance of the individual member in the context of evolving value-based care initiatives. Our Jiva solution for population health management aggregates extensive data at the population level and incorporates analytical tools that allow for real-time identification of ways to enhance care or modify patient behavior. It is designed around five vital pillars that are crucial for successful population health management. ZeOmega’s robust platform provides strategic, high-value solutions aimed at enhancing both individual health outcomes and provider performance. With our deep expertise in the field, we are well-equipped to tackle the intricate challenges presented by population health dynamics, ensuring that both collective and individual needs are met effectively.

Novo Connection revolutionizes the process of obtaining self-insured health insurance quotes, allowing it to be accomplished in mere minutes rather than enduring a lengthy wait of days. This innovative platform enables advisors to easily explore various self-funding strategies, assess the unique risks of a group, tailor plan designs and elements, and secure competitive stop-loss coverage that aligns with those designs. By removing the uncertainty involved in selecting program components, we streamline the decision-making process. Each vendor featured on our platform has undergone a comprehensive vetting process conducted by industry specialists, guaranteeing you receive top-notch quality and service. Utilizing Novo Connection not only enhances efficiency by saving you precious time but also translates to significant financial savings. Our pre-negotiated vendor rates ensure considerable cost reductions on a range of offerings, from stop-loss coverage to bespoke program solutions. With Novo Connection, you can confidently navigate your health insurance options while enjoying peace of mind and financial benefits.

In critical care, teams must navigate the complexities of treating severely injured patients, where data is constantly shifting and life-saving decisions often hinge on partial information. Under such constraints, emergency and trauma professionals frequently rely on simplified scoring systems, heuristic approaches, and intuitive judgments to make urgent decisions. As they confront the most rapidly changing and intricate cases, the integration of real-time data visualization and evidence-based workflows—facilitated by precise data entry—plays a vital role in guiding decisions and ensuring that all aspects of resuscitation are thoroughly documented and addressed. This synergy between technology and clinical practice not only enhances decision-making but also improves patient outcomes in high-stakes environments.

Introducing the first-ever intelligent medical billing software that caters to multiple specialties. It simplifies the billing process and enhances patient collections for over 75,000 healthcare providers nationwide. With its global data capabilities, there's no longer a need for entering information multiple times. Designed to handle large volumes and intricate data, it features a flexible data structure that meets the diverse needs of various practices and specialties. This software ensures that you receive payments more quickly. You can input payments manually or utilize electronic remittance options. Claims are automatically scanned for errors and any missing details, ensuring accuracy. Additionally, the software can automatically resubmit insurance claims based on predetermined criteria. The rapid review feature allows for swift evaluation and approval of charges. You can audit charges by various metrics, including modality, procedure, insurance, user, or date of service. The intuitive reporting system provides insights into the financial well-being of both front-end and back-end billing processes. You’ll never miss a charge again. Furthermore, it seamlessly integrates with your chosen clearinghouse or statement vendor, making it a versatile choice for healthcare billing. With its user-friendly interface and comprehensive features, this software is set to transform the way medical billing is handled in practices.

EbixEnterprise serves as an all-encompassing solution for insurance management, effectively optimizing policy oversight throughout its entire lifecycle. The platform comprises six key elements: Customer Relationship Management (CRM), health insurance exchange, policy administration, claims administration, data analytics, and a consumer web portal. These components are interconnected, facilitating the seamless transfer of data in response to various business requirements. SmartOffice CRM empowers organizations to efficiently handle agent and broker details, commission structures, sales pipelines, and state licensing information. Furthermore, the Online Quoting Portal, HealthConnect, stands out as a premier marketplace for both buyers and sellers of health insurance and employee benefits. In addition, EbixEnterprise Administration functions as a robust policy management system, equipping users with all necessary tools to oversee policies, define insurance plans, and maintain associated rate data. This comprehensive approach not only enhances operational efficiency but also drives improved decision-making across the organization.

In today's fast-paced environment, healthcare professionals face the ongoing challenge of "doing more with less" while striving to "work smarter, cheaper, and more efficiently." This challenge is compounded by the continuous shifts in healthcare regulations, increasing patient demand, escalating costs, and limited resources, making it exceedingly difficult to enhance patient care without the appropriate tools. At Inforia, we understand that the efficiency with which your providers manage their daily tasks is paramount; therefore, we have developed a streamlined approach to implementing EHR systems by tailoring our software to fit YOUR specific workflows and forms. You can conveniently enter all visit information in a single location, resulting in the automatic generation of your customized Office Note! Accurately document a patient's comprehensive history, including medical, family, surgical, social, and mental health aspects, while easily incorporating valid Diagnosis and CPT codes through the visit section or an electronic encounter. With our solution, you'll never overlook a billable service again, ensuring that your practice runs smoothly and efficiently. Embracing this technology can significantly elevate the quality of care provided to your patients.

Leading insurance firms leverage our SaaS solution to create a personalized shopping experience, streamline policy management, and enhance teamwork among clients, brokers, and health plan teams. Supercharge your operations with our top-tier platform, which delivers speed, adaptability, efficiency, and regulatory compliance throughout your organization. Ensure that you never overlook a chance to attract clients by showcasing your array of health plans and insurance offerings effectively. Increase operational efficiency, manage workflows seamlessly to maintain smooth business functions, and enhance client follow-ups. Save valuable time by allowing JET Insure to monitor events, enabling you to concentrate on essential business pursuits. Discover how we can refine your operations to meet both present and future healthcare demands, while also illustrating the ways our solution can accelerate your growth trajectory. By partnering with us, you can stay ahead in a competitive landscape and ensure sustained success.

In today's world, a hospital or clinic cannot operate efficiently without a digital system in place. Centralize patient records, scheduling, billing, and financial documents to ensure quick access and seamless collaboration among staff. By minimizing expenses related to hiring extra personnel and reducing the need for physical office space, you can save significantly on your monthly budget. The improvement in patient workflows and productivity will allow your facility to serve a greater number of patients each day. By keeping your database on-site, you ensure that no external parties can access sensitive information, including financial data and patient records. Transitioning to an automated system for generating medical invoices and claims will help to minimize errors in billing and dispensing. This strategic move not only protects privacy but also enhances the overall efficiency of healthcare delivery in your organization.

Transforming fragmented health data into meaningful insights is at the heart of what we do. Clarify Health's analytics platform cuts through the confusion, enabling organizations to excel in a post-pandemic landscape. We provide accurate insights into the performance of healthcare providers, the experiences of patients, and the adoption rates of therapies. With our state-of-the-art analytics software, you can confidently enhance physician performance, align patients with suitable care options, and adeptly manage value-based agreements. Harness insights that can expedite product launches and foster growth, while showcasing real-world effectiveness and facilitating outcomes-based contracts. Accurately pinpoint leading physicians and facilities, offer a more tailored experience to members, and optimize value-based interactions. Our timely insights are generated through a multitude of predictive models, organizing data into real-time analyses that drive measurable return on investment. Fueled by extensive data and cutting-edge technology, we are dedicated to transforming health data into tangible results that make a difference in patient care. In this rapidly evolving healthcare environment, our platform empowers stakeholders to make informed decisions that lead to better health outcomes.

RiskAgility Financial Modeller (FM) serves as a dynamic and adaptable actuarial software tool tailored for life and health insurance providers as well as pension firms, facilitating the execution of precise financial models that accurately represent their offerings and organizational structures. Its design prioritizes seamless adaptation to both business workflows and compliance with regulatory reporting standards. Leveraging cutting-edge algorithms and modern software technology, RiskAgility FM significantly boosts user experience and operational efficiency, empowering companies to implement advanced analytical computations grounded in realistic economic frameworks, which in turn enhances their risk and capital management capabilities. The software is characterized by an open modeling environment that ensures precise calculations and effective reconciliations, even amidst shifts in product designs, corporate practices, and regulatory stipulations. Notable attributes include its ability to swiftly adjust to evolving business requirements, high performance and scalability for prompt outcomes, comprehensive integration with other systems to streamline reporting processes, and strong support for governance and automation, making it a versatile choice for organizations navigating a complex financial landscape. Additionally, its user-friendly interface further promotes accessibility for actuarial teams, enabling them to leverage its full potential without extensive training.

A hospital management system offers a modern and automated approach to overseeing hospital operations, moving away from traditional methods. It efficiently handles essential functions such as inpatient and outpatient management, billing, laboratory testing, bed allocation, financial accounts, and human resources. Additionally, it facilitates the easy generation of various reports—daily, weekly, monthly, semi-annual, and annual—covering sales, revenue, patient statistics, laboratory tests, and bed occupancy based on your specifications. Accessing these reports is as simple as clicking a few options within the software. Importantly, administrators have the capability to monitor all activities and personnel through this system. The inclusion of an internal messaging feature fosters seamless communication among staff members. Ultimately, clinic management software not only keeps you aligned with current trends but also empowers you to manage your healthcare business operations digitally and with remarkable efficiency. This comprehensive system enhances overall productivity and collaboration within the hospital environment.

Ease, formerly EaseCentral, is a technology-based platform that allows insurance brokers to provide better service to their SMB clients. Ease makes it easy to set up and manage benefits and onboard new employees. It also allows you to stay compliant and give employees one place for all your human resources information. Ease is used by more than 70,000 small and medium-sized businesses today for benefits and HR.

Sentact offers innovative digital rounding solutions that span across the entire enterprise, enabling healthcare facilities to foster safer settings, enhance patient participation, and elevate the standard of care provided. Our top-tier platform boosts satisfaction levels among both patients and caregivers by offering an extensive array of tools designed to streamline rounding processes, enhance the patient experience, enable real-time feedback, and deliver comprehensive reporting across the organization. By empowering health systems to effectively manage patient engagement, Sentact not only improves patient outcomes but also aids in cutting costs and maximizing reimbursements, thereby creating a more efficient healthcare environment. Ultimately, our solutions ensure that hospitals can thrive in their mission to provide exceptional care while maintaining fiscal responsibility.

As patients take on a greater share of their healthcare costs, accurately identifying those who are self-pay and maximizing reimbursement for services can be a daunting and time-consuming task. The ZOLL® AR Boost® solution offers a real-time accounts receivable (AR) platform that streamlines and accelerates the pre-billing process, ensuring that all potential payments are captured. By providing precise, actionable insights that uncover hidden insurance coverage and facilitate conversions for self-pay and high-deductible patients, ZOLL AR Boost supports billing professionals in gathering comprehensive patient data upfront, resulting in an average revenue increase of 12% while reducing returned mail by 60%. Inaccurate or missing patient details can lead to claim denials and reimbursement delays, ultimately frustrating patients. Moreover, the manual process of addressing these data gaps consumes valuable time and often results in incorrectly categorizing insured patients as self-pay, further complicating the billing process. This innovative solution not only enhances efficiency but also fosters a smoother financial experience for both the healthcare providers and their patients.

Medinous is a web-enabled, fully integrated Hospital Management System that can be used by large and mid-sized hospitals and clinics. It was designed for simplified operations, superior patient care, and increased administration & control. Our goal is to integrate and automate your entire hospital's process flow, including clinical areas, support functions, finance, supply chain, administrative, and billing functions. We facilitate quick integrations to PACS, Lab/Medical Equipment, Drug Databases, and Payer Connections for ease of use.

By concentrating on enhancing patient flow, streamlining operations, and attaining excellence in patient progression, you will produce significant outcomes across various key priorities. Achieving Performance Excellence entails ensuring the ongoing safety and quality of patient care, boosting revenue and reimbursements, minimizing unnecessary patient days, while simultaneously enhancing safety and improving patient outcomes. The narrative of Holy Cross Hospital exemplifies how better patient flow has positively impacted both patient and staff experiences. Additionally, learn how Good Samaritan prioritized patients to tackle emergency department backlogs, restoring the joy of caregiving for nurses and doctors alike. Ultimately, at the heart of your mission lies the commitment to facilitating healing for individuals. This pivotal mission is intrinsically linked to the quality of experience established through patient care and interaction. The dedication to improving patient experiences not only transforms lives but also elevates the overall standard of healthcare provided.

An all-encompassing hospital management system designed for mobile platforms. This includes applications tailored for Doctors, Nurses, Administrators, Patients, and Pharmacy staff. With just a tap on their smartphones or tablets, healthcare providers can manage all institutional operations seamlessly. Each day presents a challenge for physicians as they strive to provide their patients with the focused care they need within the restricted time available for each consultation. As visits become more intricate, partly due to simpler cases being diverted to walk-in clinics, the pressure intensifies as appointment schedules tighten further amidst the ongoing difficulties of securing adequate reimbursement. Adopting such technology could significantly ease these burdens and enhance overall patient care.

Boost your organization's cash flow by efficiently handling claims from Medicare, Medicaid, and various commercial payers. With our automated system, you can process all payer claims in real-time from any location, ensuring faster payment for your claims. You have the ability to submit and monitor your claims at any moment, benefiting from real-time updates on their status. A dedicated account manager, who is a certified healthcare claims expert, will be assigned to you, and you will even have their mobile contact number for immediate assistance. Expand your revenue streams and enhance your cash flow through our automated claims processing, which provides complete visibility into all your electronic funds transfers (EFT) and payment forecasts. You can streamline the processing, tracking, and resolution of claims in real-time to maximize revenue and eliminate time-consuming tasks. Additionally, our system automates Medicare eligibility verification alongside claims processing to further enhance efficiency. By adopting this approach, you can significantly reduce administrative burdens and focus on what matters most—providing excellent care to your patients.

CORTEX represents a groundbreaking advancement in utilization management software, delivering a comprehensive 360° solution to navigate the complexities of utilization management and revenue cycle operations. Powered by an advanced machine learning engine and real-time predictive analytics, CORTEX guarantees that cases are addressed promptly and appropriately, whether by the right personnel or through exceptions. By integrating precision medicine with a robust foundation of evidence-based practices, CORTEX enhances the evaluation of patient populations through real-time machine learning models. Our analytics solutions have been successfully implemented in hospitals and health plans nationwide, demonstrating their effectiveness. For straightforward inpatient cases, CORTEX streamlines the process by automating determinations based on your specific criteria, significantly reducing the burden on staff. In contrast, when facing challenging cases, CORTEX equips your team with critical insights to facilitate well-informed decisions. This innovative approach delivers tremendous benefits to both payers and providers, fostering improved healthcare outcomes and operational efficiency. Furthermore, CORTEX's adaptability allows it to evolve with the changing needs of the healthcare landscape, ensuring sustained value over time.

Our state-of the-art system provides instant patient financial and clinical results to private small and medium healthcare providers. This allows for a seamless, seamless integration of technology into daily operations. Docta makes it easy to work with computers, regardless of how big or small your practice is. It has a simplified interface that allows you to browse your patients and find records much faster. It's easy to keep track of your patients, consults, vital signs and prescriptions. Get paid faster! You will get paid faster, regardless of whether you submit claims electronically. Use the right office tools to communicate with patients and potential patients.

Identify patients in need of follow-up care by analyzing their prescriptions, the services they have received, and the elapsed time since their last visit. Act promptly to engage those patients who require follow-up, demonstrating your commitment to their health. Implement automated SMS reminders based on patient analytics to ensure you never miss a crucial follow-up opportunity again. Klinify will take the responsibility of reaching out to these patients on your behalf. Additionally, pinpoint areas of your clinic's operations that may need improvement. Visualize essential metrics and track shifts in trends over time. Tailor a dashboard that provides a comprehensive overview of your clinic's performance. Gain insights into how your clinic stacks up against regional and national standards. Our data analyst is available to assist you in interpreting your data, formulating a strategic plan, and guiding you to enhance vital components of your practice for better patient outcomes. With this support, you can foster a more efficient and effective healthcare environment.

Prioritizing the front end is essential for enhancing the overall patient financial experience and optimizing revenue cycle outcomes. By implementing cohesive front-end solutions, organizations can effectively address deliverability issues, significantly reducing the occurrence of returned mail and unpaid invoices. It is crucial to minimize input errors by accurately verifying patient identity and demographic details. Additionally, confirming insurance eligibility at the point of service plays a vital role in maximizing revenue while ensuring compliance with regulations. To streamline processes, automating prior authorization from start to finish within seconds can lead to improved efficiency. Furthermore, automating notifications guarantees that payers receive timely updates regarding inpatient hospital admissions. Clear and precise communication of patient out-of-pocket expenses also contributes to better financial transparency. By assessing patients' propensity to pay and their eligibility for financial assistance, hospitals can enhance their collections. Once a secondary concern, patient access is now recognized as a pivotal element in healthcare facilities. Our adaptable platform harnesses the power of integrated data from various verification sources, coupled with intelligent guidance, to create a comprehensive solution. This integration not only fosters better patient access but also drives overall organizational effectiveness.

The corporate-grade rooms dashboard allows the front office staff to warmly welcome visitors and doctors, effortlessly directing them to their designated rooms. Additionally, the RMO and PRO can access a comprehensive live summary of the hospital's occupancy on a single screen. With Surge HIMS, your front office team can efficiently and confidently complete the admission process through minimal and one-time data entry, as well as checking room availability. The rooms dashboard not only provides insights into all patient services but also facilitates billing processes. From this centralized dashboard, staff can easily access a patient’s EMR, charts, and billing information, allowing for quick application or collection of charges. Furthermore, the front office can monitor room availability in real-time, manage advance bookings, and transfer patients to preferred rooms, all while Surge HIMS ensures that billing is handled accurately and efficiently. This streamlined approach enhances overall operational efficiency in the hospital setting.

GEMMS ONE integrates seamlessly with EHRs, allowing for seamless workflows throughout the patient care process. GEMMS ONE integrates with clients to allow them to track patient appointments and create charges. They can also process claims, post electronic payment, run PM reports, manage collections, and process claims. GEMMS Patient Portal provides patients 24/7 access to their personal health information. It also enhances patient-provider communication, leading to better outcomes. GEMMS ONE can be integrated with other systems in a flexible and efficient manner. Specific interoperability requirements can be met with the ability to export and import data or text. Multiple ways.

Medbridge’s award-winning suite of online solutions for healthcare organizations and individual practitioners is paving the way for the future of healthcare, allowing organizations to meet the needs of every patient at every stage along the care continuum with exactly the right level of care at the right time. With education and engagement resources for practitioners and patients, reporting tools for organizations, and an integrated, all-in-one online platform to simplify access, Medbridge is uniquely positioned to improve population health on a global scale.