Alternatives to eAdjudication

Virtual Examiner®, PCG Software’s flagship product, monitors an organization's internal claims process to track provider data for fraudulent or abusive billing patterns and maximizes financial recovery. The Virtual Examiner®, a PCG Software product, allows healthcare organizations to improve their claims adjudication system by allowing for more than 31,000,000 edits per claim. The software monitors an organization's internal claim process to identify and reduce payments for incorrect or erroneous code to save premium dollars. Virtual Examiner®, is more than a claims management solution that focuses on code combinations. It is a cost containment solution that evaluates the claim not only for abusive billing patterns but also identifies those claims that may involve third-party liability/coordination of benefits, case management opportunities, physician billing education and many other cost recovery reports.

Improve Your Hiring Process Checkr's AI-powered technology reduces time, human error, bias, and manual review time. Our award-winning adjudication tools make hiring more efficient. Our analytics can help identify potential opportunities to expand your talent pool. Legacy background checks required manual data collection from different sources, sorting through inconsistent terminology, and managing ever-changing local compliance laws. We have redesigned the background check to standardize charge data. Forecast accurately the time it takes to complete a report and comply with local laws. Unlock talent. Unlock Opportunity.

eDeviation provides comprehensive tools for assessing and managing Protocol Deviations. It streamlines processes from software design and validation to gathering necessary documentation and exporting information for the Trial Master File (TMF), thereby alleviating the burden on clinical teams who may face risks from improperly assessed or overlooked protocol deviations, whether they occur once or multiple times. As a component of Ethical's eClinical Software Platforms, eDeviation® enhances the efficiency and accuracy of clinical trial management. Whether evaluations are conducted by a dedicated independent committee or by your own research team, our software can be tailored to meet your specific requirements. The integration of forms, workflows, and export functions ensures adherence to GxP standards and fosters effective study management. Additionally, this platform allows study teams, investigators’ sites, and committee members to collaborate online in real-time, facilitating quicker decision-making, reaching consensus, and ensuring the prompt handling of protocol deviation assessments and management. Ultimately, eDeviation® enhances the overall integrity and efficiency of clinical trial processes, contributing to better outcomes in research.

Through the use of the eAdjudication® software managed service, trial leaders can effectively oversee timelines, adapt to fluctuating circumstances and results, and track trends in provider performance and adherence to protocols throughout the extended duration of trials. This innovative, comprehensive managed software service helps prevent unforeseen expenses and timeline violations in Endpoint Adjudication Studies. The eAdjudication® Managed Software Service stands out as the most effective solution for managing Endpoint Adjudication (CEC). By collaborating with the eAdjudication® platform and Ethical's staff, study teams, committee members, and clinical organizations can engage seamlessly in real-time within a user-friendly and GxP-compliant framework, eliminating the inefficiencies, costs, and errors associated with manual processes. Furthermore, the all-inclusive nature of eAdjudication® services facilitates the smooth integration and adoption of EA software across eClinical organizations, enhancing overall operational efficiency. In doing so, it empowers research teams to focus on delivering quality results without being hindered by logistical challenges.

EMCsoft's Claims Management Ecosystem guarantees that healthcare providers and billing companies submit accurate claims to insurance payers for effective claim processing. This system combines our adaptable claims processing software, Claim Agent, with a comprehensive methodology known as the Four Step Methodology, seamlessly integrating into your claim adjudication workflow. By implementing this strategy, we enhance, facilitate, and automate your processes to optimize claim reimbursements. For an insightful overview of Claim Agent's features and its integration into your claims process, you can request our complimentary online demonstration. Claim Agent efficiently manages the scrubbing and processing of claims, ensuring a smooth transition from provider systems to insurance payers in a timely and cost-effective manner. The software is designed to be compatible with any existing system, ensuring a swift and straightforward implementation. Furthermore, we offer tailored edits, bridge routines, payer lists, and workflow configurations that cater specifically to each user's requirements, enhancing the overall claims management experience. This personalized approach enables healthcare providers to focus more on patient care while we take care of the complexities of claims processing.

Tyler's Ethics Management solution streamlines the entire ethics management process by automating the creation, assessment, and submission of annual financial disclosure statements and ethics training documentation. This software is designed to comply with the intricate regulations governing ethics management programs and offers a variety of summary reports that users can generate according to their specific roles and access levels. Moreover, organizations can easily tailor additional reports to fit their unique requirements. The system also features an effective audit finding management tool, which simplifies the administration of audit compliance programs. Additionally, the background investigation software is essential in the broader personnel security and suitability framework, which encompasses adjudication, assessment, analytics, and invoicing processes. Furthermore, Tyler’s Criminal Justice Information System application efficiently organizes and tracks data and workflows, providing crucial support to federal law enforcement agencies in handling various cases effectively. This comprehensive suite of tools demonstrates Tyler’s commitment to enhancing compliance and operational efficiency in ethics and law enforcement sectors.

Claims adjudication services cover a range of areas including medical, dental, vision, and prescription claims, as well as short and long-term disability cases. These services can be accessed either on-site with a license or through a hosted application model (ASP). Utilizing Microsoft technology, the system is powered by an SQLServer database paired with a Windows front end. Our customer service is highly regarded, staffed by healthcare claims professionals who boast a minimum of 12 years of industry experience. All support inquiries are recorded, and their statuses can be monitored online. The system features a plan copy and modification tool that facilitates rapid plan implementation. Auto-adjudication is achieved through benefit codes that are constructed using business rules derived from over 25 variables connected to both the claims and the claimants, which are then processed by the adjudication engine. Claims can be submitted in various formats, including scanned images, EDI, or paper submissions. The system is compliant with HIPAA EDI 5010 transaction sets, ensuring secure and efficient processing. Additionally, re-pricing fees and UCR schedules can be pre-loaded into the system prior to their effective dates, while the date-driven logic ensures that re-pricing occurs based on the service date, optimizing the claims processing workflow. The comprehensive nature of this system allows for a more streamlined and efficient claims management experience.

When compared to other Electronic Data Capture (EDC) solutions available from companies like MediData, DataTrack, and Omnicomm, TrialStat stands out as the most comprehensive suite of study management tools that can effortlessly integrate with various external data sources, including electronic medical records (EMR), wearable devices, and both clinical and non-clinical information systems. TrialStat presents a cohesive platform that caters to all phases and categories of clinical trials. Our EDC suite is designed with a single sign-on feature and supports multiple tenants, incorporating modules for Randomization, Adjudication, Coding, Safety, Patient Diaries/ePRO, a Vendor Neutral Imaging Archive, an extensive Reporting and Analytics Portal, and tailored Machine Learning applications. With an emphasis on data analysis, TrialStat provides real-time reporting capabilities, on-demand data extracts, and analytics that span a single study, a program, or the entirety of your research portfolio, ensuring that all stakeholders receive pertinent, customized, and timely insights into every facet of study data while pinpointing areas of risk or potential delays. Additionally, the platform’s integration capabilities allow for improved collaboration among research teams, fostering a more efficient and effective trial management experience.

Optimize Your Entire Healthcare Data Process. Smart Data Solutions possesses the expertise and tools necessary to enhance both your paper-based and electronic workflows. Our suite of integrated tools for validation, matching, and normalization guarantees the highest quality data, which enhances auto-adjudication and minimizes the need for manual processing. Regardless of whether you're a newcomer to Smart Data Solutions or a long-standing collaborator, our development process is designed to support you throughout your projects to maximize your chances of success. Our dedicated team will take the time to grasp your unique needs and the implications of your workflows, addressing both straightforward and intricate requirements. We prioritize your objectives, focusing on what you aim to achieve and then determining the most effective strategies to reach those goals. Smart Data Solutions delivers comprehensive front-end pre-adjudication services for numerous Payers across the country, ensuring flexibility in our offerings. Whether your requirements are minimal or you demand a fully tailored workflow, Smart Data Solutions is equipped with a diverse range of solutions to meet your needs. Our commitment to excellence sets us apart in the industry.

Judi is an innovative cloud-based platform designed for clinical trial collaboration, aimed at enhancing, securing, and streamlining intricate workflows among sponsors, CROs, trial sites, and various partners. This platform encompasses a comprehensive array of trial functions, including endpoint and event adjudication, central eligibility assessments, data safety monitoring, remote oversight, medical imaging, site/user qualification, and personalized workflows through Judi Flex. By replacing outdated manual processes, spreadsheets, unmonitored emails, and isolated file-sharing methods, Judi creates a cohesive and compliant workspace where every document, communication, image, query, and decision flows through secure and traceable channels. Among its robust features are role-based access controls, audit trails, real-time messaging, efficient query management, customizable dashboards, worklists, flexible document submission and review processes, eCRFs with edit checks, and advanced reporting tools, which collectively enhance the efficiency and accuracy of trial data collection, review, and reporting. Furthermore, this platform’s comprehensive approach ensures that all stakeholders can collaborate seamlessly, leading to improved outcomes and faster trial timelines.

HEALTHsuite provides a comprehensive benefit management system and claims processing software solution for health plans that administer Medicare Advantage and Medicaid benefits. HEALTHsuite, a rules-based auto adjudication solution, automates all aspects of enrollment / eligibility and benefit administration, provider contracting / reimburse, premium billing, care management, claim adjudication, customer support, reporting, and more.

This solution provides a comprehensive claims management system from start to finish. Its main capabilities include processing claim adjudications, managing claim workflows, and facilitating payment distributions. With a versatile architecture, it allows for the integration of adjudication modules tailored to specific lines of business, ensuring that each new addition capitalizes on the system's core functionalities. The user-friendly interface, designed for Windows, leverages a relational database for efficient information storage. Built on the Powerbuilder software platform, it utilizes SQL databases like Oracle or Sybase, making it well-suited for a client-server environment that can handle significant claim volumes. Additionally, both installation and training services are offered, and the licensing package includes the source code. Furthermore, a team of experienced professionals is available to customize and adapt the system according to any unique client needs. All changes come with thorough design documentation and support for the acceptance testing process, guaranteeing a seamless integration experience. This ensures that clients receive a tailored solution that effectively addresses their specific requirements.

inSight offers an all-encompassing suite of applications tailored to equip researchers with precise and prompt information. The wound assessment and documentation process is enhanced through single image capture, which is securely synchronized in an environment that complies with HIPAA, GDPR, and 21 CFR Part 11 regulations. This platform aims to create a cohesive integrated research experience. By utilizing emerging data and clinical evidence, researchers can formulate study protocols, imaging charters, and adjudication manuals effectively. The system allows for effortless building and configuration of databases, while also enabling customization of clinical workflows that integrate smoothly with your EDC. A dedicated project manager is assigned to guarantee a timely project kickoff and ongoing maintenance. Elevate the reliability of your clinical study by adhering to the highest quality standards and implementing robust quality assurance and control procedures. Users can analyze data and extract insights in real-time, facilitating the curation of data sets and enhancing clinical studies with real-world evidence. Our advanced wound imaging solution is CE-marked and registered with the FDA, having undergone clinical validation to ensure its effectiveness and compliance. With such rigorous standards, inSight stands out as a trusted partner in clinical research.

PlanXpand™ is the specialized transaction processing engine developed by Acero, which serves as the backbone for all products aimed at health benefits administrators. With this innovative engine, clients have the flexibility to implement Acero’s offerings either all at once or gradually over time. Beyond simply selecting from our standard range of products, administrators have the option to harness PlanXpand™ to create tailored solutions that enhance their current system functionalities. Acero’s distinctive, integrated solutions utilize a Service-Oriented Architecture, enabling health benefits administrators and insurers to augment their existing adjudication platforms with new features and capabilities. Furthermore, our advanced design and engineering facilitate real-time adjudication for all claim types, directly interacting with the core claims system, which leads to improved processing accuracy, increased customer satisfaction, and a reduced necessity for claims adjustments. This adaptability and precision in processing claims ultimately positions Acero as a leader in the health benefits administration sector.

Utilize a cloud-based healthcare delivery system to effectively manage your members' healthcare and networks. This system streamlines the claims processing for managed care organizations by automating various tasks such as eligibility verification, referral and authorization handling, provider contracting, benefit management, auto adjudication of claims, capitation for primary care and specialty services, EOB/EFT check processing, as well as EDI transfers and reporting. It can be implemented as a cloud solution or operated in-house, making it suitable for a range of entities including managed care organizations (MCOs), independent physician associations (IPAs), third-party administrators (TPAs), preferred provider organizations (PPOs), and self-insured groups. By simplifying the intricate processes involved in managing eligibility, referral authorizations, and claims, this system enhances operational efficiency. Its features are designed to optimize data integrity while minimizing the need for manual data entry, thus improving overall accuracy and productivity. Additionally, the flexibility of deployment options ensures that organizations can choose the best fit for their operational needs.

Our platform equips you with everything needed to streamline your recruitment, applications, auditions, adjudication, and communication more efficiently than ever before. You can easily accept video auditions online, gather applications, collaborate on adjudication using tailored rubrics, arrange in-person auditions, communicate directly with applicants, process payments effortlessly, and much more. Acceptd stands as a robust and secure ally for your team. We offer customizable applications, access for multiple reviewers, intuitive navigation, and tools for viewing and organizing your data effectively. This comprehensive approach enables us to assist organizations and programs of various sizes throughout the entire audition process. From the very beginning, our dedicated team partners with yours to establish a customized account, shares valuable insights drawn from our extensive experience with thousands of programs, and supports you in simplifying your processes. In essence, we are committed to ensuring your success every step of the way. With our expertise, you can focus on what truly matters: finding the right candidates for your needs.

Facctum offers an AI-driven solution that transforms the way financial institutions approach compliance, with a focus on adverse media screening, AML, sanctions, and watchlist management. By utilizing advanced AI technology, Facctum automates the extraction and transformation of unstructured data such as press releases and regulatory publications into structured, actionable data profiles. This allows organizations to streamline their compliance workflows, reducing the manual effort required and eliminating common issues such as false positives. With features like real-time data ingestion, anomaly detection, and intelligent data mesh, Facctum empowers teams to make faster, more informed decisions. The platform also integrates seamlessly into existing workflows, providing flexibility and scalability for large organizations. Additionally, its cloud-native architecture ensures rapid deployment, while its robust security measures, including AES-256 encryption and compliance with global standards, ensure data safety and integrity. Facctum’s platform is optimized for modern financial institutions, offering superior screening capabilities and ensuring compliance with evolving regulations.

You can effectively balance the need for regulatory compliance with the adoption of cutting-edge cloud services. With just a few clicks, you can streamline the management of the requirements for your regulated workloads. This approach not only minimizes costs but also reduces risks by simplifying the oversight of necessary controls. The controls associated with the FedRAMP High platform ensure that only first and second-level support personnel, who have undergone thorough background checks and are based in the United States, have access. Similarly, the CJIS platform controls guarantee that access is limited to first and second-level support staff who have passed state-sponsored background checks and are also located in the US. Additionally, escorted session controls are implemented to oversee and track the actions of non-adjudicated personnel, ensuring that all support activities are under strict supervision. This comprehensive framework enables organizations to maintain a secure and compliant environment while leveraging modern cloud solutions.

Our platform fosters consistency, continuity, and scalability throughout our interconnected portfolio, allowing customers to enhance their operational efficiency, make informed decisions, and achieve better patient outcomes while driving innovation in our evolving healthcare system. By leveraging advanced data and analytics alongside patient engagement and collaboration tools, the Change Healthcare platform empowers both providers and payers to streamline workflows, obtain the necessary information precisely when needed, and ensure the delivery of the safest and most appropriate clinical care possible. We facilitate seamless access to data and promote interoperability among various data sources, thereby supporting CMS patient access and interoperability regulations, which ultimately leads to real-time access to clinical documents. This approach is instrumental in managing risk adjustment effectively, boosting HEDIS scores, and ensuring timely and precise payments through quicker adjudication. Furthermore, our commitment to innovation positions us to adapt to the changing landscape of healthcare while continually improving the services we offer.

iA has developed an exclusive software platform tailored for pharmacy operations. At the intersection of individuals, processes, and technology, the NEXiA software delivers an all-encompassing and adaptable approach to managing the entire prescription lifecycle. It effectively oversees inventory by utilizing prioritization and trend analysis, thanks to iA's advanced warehouse management system. This innovation enables pharmacies to provide patients with greater flexibility when it comes to prescription delivery options. With 700 customizable configuration parameters and 70 existing bidirectional interfaces, it can seamlessly integrate with third-party hardware solutions. Furthermore, it offers intelligent production control that spans the entire process from adjudication to distribution. As a result, pharmacies can address their specific operational requirements through tailored configurations and agile routing strategies, enhancing overall efficiency. Ultimately, this software aims to transform the pharmacy experience for both providers and patients alike.

Cohere assists health plans in transforming their processes by integrating clinical intelligence, which facilitates comprehensive automation of prior authorization internally. Health plans can license Cohere's PaaS for intelligent prior authorization directly, allowing their utilization management teams to utilize it seamlessly. Consequently, client health plans experience notable improvements in administrative efficiency, alongside enhanced patient outcomes that are both quicker and more effective. Cohere offers a customized, modular solution suite specifically designed for health plans, streamlining all prior authorization requests into a cohesive, automated workflow. The platform automates decisions regarding prior authorizations based on the policies preferred by the health plans and accelerates the manual review process. It also aids clinical reviewers in handling complex requests with the help of responsible AI/ML and its automated features. By harnessing clinical intelligence through AI/ML and sophisticated analytics, Cohere enhances the performance of utilization management. Furthermore, it contributes to improved patient and population health outcomes through innovative programs tailored to specific specialties. This comprehensive approach positions Cohere as a leader in the health technology space, ensuring that health plans can meet their operational goals effectively.

At the heart of PBM Express lies the adjudication program, where claims undergo extensive edits to ensure precise processing outcomes, no matter how complex the plan design may be. The parameter drive program supports a highly adaptable framework that facilitates client-specific customization as required. Laker's cutting-edge software solution equips clients with exceptional performance and top-notch uptime that leads the industry. As a frontrunner in technology, Laker consistently upgrades and improves its systems to address the evolving demands of its clientele. Customers of Laker benefit from having access to the fastest, most versatile, and most resilient system in the market. Furthermore, Laker collaborates closely with its clients to conceive, test, and roll out new products, empowering them to enhance their competitive edge and secure new business opportunities. As client claim volumes increase, Laker evolves alongside them, underscoring the mutual benefit for both parties in implementing prompt and efficient software changes to support this growth. This commitment ensures that Laker remains a valuable partner in its customers' success.

Immediation is an all-encompassing online platform for dispute resolution that aims to make mediation, arbitration, adjudication, and automated negotiation more efficient and straightforward. Specifically designed for legal practitioners such as mediators, arbitrators, and law firms, it provides an array of over 30 specialized tools that promote secure and user-friendly conflict resolution. Noteworthy features include automated intake forms, customizable workflows, management tools for cases and panels, and financial solutions for invoicing and payments, all accessible through a secure client portal. The platform also enables smooth video conferencing, live transcription, the management of exhibits, and document sharing, creating a complete digital ecosystem for all participants. Furthermore, Immediation holds an ISO27001 certification, reflecting its commitment to security and compliance, and it seamlessly integrates with services like Microsoft Teams and Clio, thereby enhancing its overall utility. This integration allows users to maximize their productivity while navigating the complexities of dispute resolution in a modern, digital landscape.

Oracle Health Specialty Practice Management, a component of the Oracle Health suite of clinical and practice management solutions, equips medical practices with essential tools to operate effectively and generate profit. This system is highly customizable and offers seamless integration with user-friendly electronic health records (EHRs), facilitating medical document management, patient appointment scheduling, and health record oversight. With an active internet connection, it enables near real-time tracking of claim statuses. Unlike traditional paper systems, Oracle Health Specialty Practice Management is engineered to expedite the adjudication, payment, and posting of claims, often achieving these processes weeks faster with most insurance providers. Additionally, it boasts features such as patient scheduling, payment tracking, and posting, which collectively enhance overall operational efficiency. By streamlining the scheduling, monitoring, and payment workflows, Oracle Health Specialty Practice Management ultimately supports practices in delivering superior patient care while improving their financial performance.

FormFox provides top-tier tools and technology for workplace health and safety, making them accessible to collectors, laboratories, TPAs, MROs, and employers alike. By utilizing purposeful automation, our web-based software optimizes the entire process from the moment an order is placed to the final reporting and decisions made. This approach not only minimizes errors but also saves valuable time and accelerates data delivery, enhancing quality, accuracy, speed, and efficiency for our partners and their clients. The FormFox MRO solution ensures quicker results adjudication and turnaround times, implementing more streamlined workflows for the review process. Our industry-wide "Common Platform" strategy has been widely accepted, enabling laboratories to significantly cut costs while simultaneously improving the quality and reliability of testing. Furthermore, FormFox stands out as the premier Electronic Custody and Control (ECCF) solution available to all clinics within the employee health and safety sector, reinforcing our commitment to excellence in safety practices. Ultimately, our innovative solutions are designed to adapt to the evolving needs of the industry, ensuring that our clients remain at the forefront of health and safety standards.

PLEXIS offers a comprehensive suite of top-tier applications designed to equip payers with the advanced capabilities required for contemporary core administrative systems. These applications encompass functionalities such as real-time benefit management, adjudication, automated EDI transmission, and self-service customer portals, ensuring that PLEXIS Business Apps meet all your needs. The Passport feature facilitates crucial connections between core administration and claims management systems, PLEXIS business applications, custom applications, and existing internal systems. Its adaptable API layer allows for real-time integration with various portals, automated workflow tools, and business applications, ensuring that connectivity knows no bounds. By employing this centralized, modern core administration and claims management platform, you can enhance workflows effectively. This approach enables the efficient processing of claims while simplifying the complexities associated with benefit administration, resulting in a swift return on investment and the ability to provide exceptional customer service. Ultimately, PLEXIS empowers organizations to thrive in an increasingly complex healthcare landscape.

Tyler Technologies offers a Workers' Compensation software solution that streamlines various processes while complying with the intricate rules governing workers' compensation programs. This software empowers agencies to effectively receive, monitor, and manage an array of workers' compensation claims, which encompass work-related injuries and occupational illnesses, thus ensuring that benefits are delivered accurately and in a timely manner. It facilitates the entire claims lifecycle, from the initial intake to adjudication and resolution, and includes features for document management, workflow automation, and comprehensive reporting. Its design aims to boost operational efficiency, lessen administrative burdens, and enhance adherence to regulatory demands. By optimizing case management processes, agencies can prioritize providing high-quality services to claimants while simultaneously upholding the integrity of their programs. Ultimately, this software not only simplifies the management of claims but also contributes to an overall improvement in service delivery and compliance.

An integrated solution that offers a comprehensive perspective on the property and casualty insurance lifecycle. Enhance efficiency and save valuable time with an advanced, rules-driven, multi-state underwriting module that automates the gathering of necessary information as well as the generation of quotes, endorsements, cancellations, audits, and renewals. Improve combined ratios by adopting a contemporary and efficient approach to the claims adjudication process, fostering both ease of use and collaboration. Boost new business opportunities by facilitating seamless information exchange with brokers, ensuring that data intake is streamlined and standardized while granting brokers round-the-clock access to essential information. Maintain control over what submissions your underwriters prioritize. Elevate customer satisfaction and retention rates by offering policyholders self-service capabilities for accessing policy details, submitting and reviewing claims, making online payments, and more. Ultimately, you have the flexibility to determine which portal features will deliver the optimal user experience for your clients, ensuring they receive the support they need.

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.

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.

Oracle's Digital Insurance Platform equips insurance companies with the tools needed to create cutting-edge solutions and outstanding digital experiences for customers. This all-encompassing system simplifies everything from sales channels to back-office functions, allowing for quick introduction of new products and easy adaptation to changes. By leveraging real-time analytics, insurers can acquire critical insights that support better decision-making processes. The platform accommodates both individual and group life insurance, as well as annuities, by integrating underwriting, policy management, billing, and claims handling into one streamlined system. Health insurance providers experience enhancements in enrollment procedures, premium billing, and claims processing, which leads to greater member satisfaction thanks to clear and tailored services. Furthermore, the platform improves the bancassurance process by facilitating immediate connectivity between banks and insurance firms, which guarantees efficiency, uniformity, and trust. This interconnected approach fosters a more dynamic insurance environment, ultimately benefitting both providers and their clients.

Micro Merchants Systems has introduced PrimeRx, a leading-edge pharmacy management software tailored for the demands of modern pharmacies across the country. This robust platform delivers an all-encompassing solution that integrates complete control over customer relationship management, forming the essential foundation for pharmacy operations. PrimeRx includes vital features such as patient and provider intake, prescription processing, workflow oversight, claims management, labeling and dispensing, inventory control, and patient records administration. In addition, it boasts specialized functionalities for long-standing pharmacies, as well as compounding and specialty pharmacies, including provisions for digital and mail-order services. The development of the PrimeRx platform was directly influenced by the input of pharmacists who highlighted the necessity for an intuitive, technology-driven tool aimed at enhancing work efficiency, automating critical tasks, and improving patient care. Ultimately, PrimeRx stands out as a comprehensive solution that not only meets current pharmacy needs but also adapts to future demands in the healthcare landscape.

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.

EncoderPro Spotlight, developed by OptumCoding, is an online medical coding reference tool specifically crafted to assist professionals involved in ambulatory coding, billing, and reimbursement by providing them with timely and precise access to various code sets including CPT, HCPCS Level II, ICD-10-CM/PCS, and ICD-9-CM, as well as relevant regulatory guidance; this software boasts robust search and reference functionalities that integrate numerous procedure, service, supply, and diagnosis codes along with detailed descriptive and cross-coding data, allowing users to swiftly identify the appropriate codes and minimize submission errors. In addition to fundamental code listings, it also offers unique content and tools that enrich users' understanding of compliance issues, addressing topics such as National Correct Coding Initiative (NCCI) edits, Hierarchical Condition Categories (HCCs), and policies regarding coverage determinations, while featuring automated review options for correct unbundling and modifier application, alongside a comprehensive historical content database for adjudication purposes. This makes EncoderPro Spotlight an invaluable resource for coding professionals seeking to enhance their accuracy and efficiency in the complex landscape of medical coding.

Electionware is a comprehensive election management software solution designed to assist jurisdictions of varying sizes in efficiently overseeing their electoral processes through an intuitive and user-friendly interface. Comprising five distinct software groups with a total of eleven modules, Electionware empowers election officials to establish a secure database for election information, design ballots, program both voting and ballot-scanning devices, aggregate tabulator results, produce reports for election night, and analyze ballot images. Each module serves as a vital tool that enhances the intuitiveness, auditability, and security of election management, while every group is tailored to satisfy specific equipment and election needs. The cutting-edge electronic adjudication feature adeptly manages the complexities associated with write-in votes, ensuring accuracy and reliability. Furthermore, the interface provides essential ballot details such as precinct, ballot style, poll type, machine serial number, and polling location, along with a color-coded system that highlights undervotes and counted votes, all of which can be exported as separate PDF documents for thorough record-keeping. This functionality not only streamlines the election process but also promotes transparency and confidence among voters and officials alike.

Introducing Roker PLUS – a versatile solution that operates independently of hardware, utilizing proprietary intellectual property to cater to the diverse needs of governments, institutions, businesses, and real estate owners with services such as registrations, listings, space management, and enforcement. Aligned with our vision of discovering smart urban spaces, Roker PLUS revolutionizes curb spaces into smart environments to meet the demands of supply fleets and on-demand drivers. This innovation leads to reduced street congestion and enhances accessibility for short-term parking. It offers a holistic approach to designing, managing, and overseeing nearly all permit categories, significantly empowering organizations to validate users and comply with regulations. The system encompasses the entire parking enforcement process, including ticket issuance, payments, appeals, and adjudication, ensuring a seamless experience. Furthermore, it is built to facilitate secure payments and is integrated with top-tier payment solutions. Additionally, even a single parking space can be optimized for leasing, benefiting those in the surrounding area while contributing to the overall efficiency of urban mobility. This comprehensive, user-friendly platform fosters smarter urban planning and resource management.

CURATE by QReserve serves as a reliable exhibition management tool for your organization, streamlining everything from the collection of submissions to the printing of exhibit labels and the showcasing of galleries online. By gathering submissions right from your website, the details are automatically integrated into your CURATE portal for easy access. You can assign tags to efficiently categorize and differentiate between artists, artworks, and exhibitions. Judges are empowered to evaluate artwork and make decisions directly through our platform, enhancing the review process. If you require specific features that aren't available, QReserve is ready to collaborate with you to create tailored reports, integrations, or functionalities that meet your unique needs. You can generate downloadable reports with versatile filters, ranging from basic submission spreadsheets to intricate custom exhibition data. Additionally, payment for submissions can be collected seamlessly through your submission form, and you have the option to personalize the login page and application with your branding elements such as logos and colors. This comprehensive approach ensures that every aspect of your exhibition management is covered, making your organization more efficient and effective.

The QuantaVerse Financial Crime Investigation Platform leverages RPA, AI, and machine learning to streamline the process of data collection, detect financial crimes, and document results. Our innovative solutions have been shown to enhance the efficiency and effectiveness of AML case adjudication and reporting. With thorough data collection and reliable analytics, we provide the consistent outcomes and standardized reporting necessary for both your organization and regulatory bodies. By reducing false positives by up to 40% and decreasing investigation time by 70% through automated data gathering and analysis, your investigation team can operate with significantly greater efficiency. Our platform fosters uniformity within your AML/BSA program by producing timely, transparent, and thoroughly explainable results that meet regulatory expectations. Additionally, uncover the risks your existing systems may overlook, ultimately driving out criminal activities and terrorist groups from your organization. The future of financial crime investigation lies in embracing technology to improve security and compliance effectively.

Regardless of whether you operate as an independent reference lab, a pathology practice, an outreach lab, or a public health laboratory, TELCOR RCM billing software equips you with essential tools to tackle complex billing obstacles and enhance your profitability. This comprehensive revenue cycle management solution facilitates claim submissions, monitoring, remittance processes, accounts receivable management, and billing for both clients and patients, all while accommodating multiple NPIs. By leveraging the right technology, you can reduce the need for extensive billing staff and significantly boost productivity in your revenue cycle by automating daily tasks such as claims submissions and patient information collection, along with generating detailed financial reports. Additionally, you can streamline the handling of payments by automating the processing of electronic payments received from payers through 835 ERAs or bank lockbox payment files, thereby eliminating cumbersome manual adjudication tasks. Moreover, improving billing communication with patients can simplify their experience, making payment processes quicker and more intuitive, ultimately fostering a smoother revenue cycle. This holistic approach to billing not only enhances efficiency but also contributes to a better overall experience for both healthcare providers and patients.

GenHealth.ai is a specialized generative AI platform designed for the healthcare sector, utilizing a unique Large Medical Model (LMM) developed from the analysis of over 100 million patient records instead of traditional natural language data. This LMM excels in interpreting medical codes and events, allowing it to accurately forecast patient outcomes, estimate costs, and model clinical pathways with significantly fewer errors compared to conventional large language models. The platform features a range of tailored applications such as Intake Automation for managing PDF routing and data extraction, a Prior Authorization Agent that automates the approval process, and G‑Mode analytics that allows users to interact with both historical and predictive population health data using natural language, all without requiring any coding expertise. Notably, this AI co-pilot has achieved an impressive 94% accuracy rate in prior authorization cases, a remarkable 120-fold enhancement in forecasting medical loss ratios, and a 110% improvement in cost predictions when compared to standard Hierarchical Condition Category (HCC) scoring methods. In addition to these advancements, GenHealth.ai is positioned to transform the healthcare landscape by facilitating more efficient and data-driven decision-making.

The latest iteration of The CourtRoom Program is detailed above, while updates regarding The CourtRoom Program can be found here, along with updates for The Parking Program. In light of the ongoing pandemic, it is essential to remain informed about the latest directives issued by the Office of Justice Court Support. Since The CourtRoom Program has now integrated into the Unified Court System, we will adhere to the same Holiday schedule, which is available for review here. We encourage your insights and suggestions for future program improvements, and you can share your ideas by clicking here. The CourtRoom Program serves as an electronic docketing system that meticulously monitors each case from initiation to conclusion. This system enables the Court to promptly refresh case information with the latest adjournment details, thereby preventing cases from being overlooked and ensuring timely adjudication and reporting. It features more than 200 forms and letters, enhancing its utility and efficiency in the judicial process. Moreover, we are committed to continuously improving the program based on user feedback.

Boost the effectiveness, clarity, and responsibility within judicial systems and criminal justice institutions. Guarantee that all individuals in your community have equitable access to legal resources. Optimize workflows in case management to enhance the investigative process, encompassing everything from crime reports to the processing of evidence and analysis of intelligence. Conduct precise investigations in a shorter timeframe and with reduced effort. Maintain oversight of the entire prosecution process, from the pretrial phase to trial proceedings and sentencing outcomes. Concentrate on essential tasks and manage your caseload adeptly while minimizing redundant paperwork and curbing delays in case processing. Unify all court systems under a single technological framework, enabling the management of cases from their inception through to post-disposition stages. Alleviate case backlogs, hasten the resolution of cases, and enhance the adjudication process while ensuring that public services remain accessible. Address potential risks by overseeing all inmate-related data and operations within one cohesive system. Collaborate effectively with prisons, community correctional facilities, courts, and other relevant agencies to bolster public safety initiatives. This comprehensive approach not only improves overall efficiency but also fosters a more integrated justice system for the benefit of society as a whole.

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.

We collaborate with private insurance providers to ensure that your therapy sessions are consistently covered. Dealing with mental health billing and health insurance should not feel like navigating a maze without a light. Nirvana simplifies the entire insurance experience, from determining eligibility to securing reimbursement, allowing you and your therapist to focus on what truly matters—your well-being. Instead of wasting precious time on lengthy phone calls with insurance companies to clarify your benefits, you can effortlessly access a comprehensive overview of your coverage right after you sign up. With Nirvana, you can easily oversee the entire claims process, tracking everything from submission to processing and adjudication. Additionally, you can filter your claims by session and date ranges to gain valuable insights into the reimbursement amounts related to your therapy sessions, ensuring you stay informed every step of the way. This way, you not only save time but also enhance the efficiency of your overall therapy experience.

Origin simplifies the hiring process by providing a comprehensive graded background check service. Unlike conventional methods that merely supply software for checking backgrounds and leave you to figure things out, Origin takes a proactive approach by educating and training clients on the specifics of what a background check entails. This foundational knowledge enables Origin to tailor the screening criteria and employment verification processes to meet the unique needs of your organization. A graded background check allows the researcher at Origin to evaluate reports using a straightforward "Pass" or "Fail" system that aligns with your company's established standards. Furthermore, the OriginONE platform seamlessly integrates with our range of HR, occupational health, and workforce management tools, enhancing the efficiency of your recruitment efforts. Consequently, recruiters can say goodbye to the hassle of navigating between different systems to access applicant tracking, employee onboarding, and background screening reports, streamlining their workflow significantly. This cohesive system not only saves time but also ensures a smoother hiring process, ultimately benefiting both employers and potential employees.