Alternatives to eReconciliation

Medrio's Electronic Data Capture (EDC) platform and complimenting eClinical solutions such as ePRO, RTSM, eConsent, and Direct Data Capture (DDC) have been trusted by major pharmaceutical, biotech, CRO, animal health, medical device, and diagnostic companies since 2005. We are known for our easy-to-use solutions, delivering speed and simplicity to clinical trials of all phases, sizes, and complexities. Medrio users can build their databases in an average of 2.8 weeks with no programming required, make mid-study changes with just a few clicks of a mouse, and much more. From bolt-on capabilities to full-service offerings, Medrio offers flexible, modular solutions that give our customers exactly what they need – and none of what they don’t. Our innovative software, as well as the robust and flexible training and support resources we provide our customers, have earned us a 98% customer satisfaction rating.

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.

Ethical eAdjudication represents a cutting-edge software solution for endpoint adjudication and e-clinical needs. This cloud-based service is crafted specifically for study leaders, quality assurance personnel, and committee members, providing an exceptionally user-friendly experience. It simplifies the management of event databases, facilitates committee evaluations, and organizes meetings focused on resolving disagreements and achieving consensus within a GxP compliant framework. By utilizing Ethical eAdjudication, users can perform independent reviews and adjudication processes effectively, ensuring timely results while maintaining rigorous quality control standards. This innovative platform not only streamlines operations but also enhances collaborative decision-making among stakeholders.

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.

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.

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.

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.

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.

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.

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.

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.

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.

TrialKit is a cloud-based platform available via both a web and native mobile app, enabling end-to-end clinical trial management for medical device, diagnostics, digital therapeutics, and biopharma companies of all sizes. Design and deploy validated studies in days not weeks using our intuitive study builder that requires no programming. Thousands of global users have leveraged the flexibility of TrialKit to deploy over 8,000 studies across all phases of development.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Experience total oversight and effortless management with LifeSphere CTMS, a user-friendly solution crafted for clinical operations teams to enhance efficiency, maintain organization, and simplify processes. This modern cloud application is designed to shorten study timelines by streamlining management and automating essential tasks throughout the trial life cycle. Tackle the intricacies of clinical studies with an intuitive yet robust trial management tool that ensures comprehensive visibility of all trial activities, keeping study teams synchronized and punctual. Enhance your clinical operations with this all-in-one platform, which encompasses payment processing and monitoring, while also ensuring a smooth integration with LifeSphere eTMF. Additionally, achieve compliance with the TMF Reference Model Exchange Mechanism Standard, facilitating effortless document sharing across various platforms, thus further optimizing your clinical workflows. With LifeSphere CTMS, you can elevate your clinical trial management to new heights of efficiency and collaboration.

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.

Oversee your clinical trial seamlessly through a single platform. Zapclinica offers an eClinical suite tailored to manage and execute every facet of your decentralized clinical trial—whether hybrid or entirely virtual. By automating intricate processes, it helps in spotting anomalies, optimizing resources, and enhancing decision-making alongside collaboration among sponsors, CROs, and study sites. This comprehensive solution significantly cuts down the time and expenses associated with running a successful clinical trial. With Zapclinica, you can handle all study components without the need for additional vendors or third-party services; instead, select the necessary applications within one unified environment, including EDC, ETMF, Payments, Logistics, and much more. Embrace the efficiency of a single platform to streamline your clinical research efforts.

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.

IVR Clinical Concepts is a company that focuses on offering technology for virtual clinical trials and solutions for patient engagement. Their products feature electronic patient-reported outcomes and patient diaries, which are designed to enhance data quality by minimizing errors, thereby shortening timelines and reducing overall costs. Furthermore, they provide comprehensive patient recruitment and outreach services that emphasize outreach, pre-screening, and the collection of real-time data. The solutions for subject screening, registration, and randomization are characterized as modular, tailored, adaptable, and customizable. In addition to these services, IVRCC also delivers clinical trial material management solutions aimed at lightening the workload while ensuring greater control, along with eClinical integration services that work to unify data seamlessly. Their chart review services offer insights based on real-world data and clinical experiences. By prioritizing custom, modular, and adaptable solutions, IVRCC strives to enhance the patient experience and maximize the success rates of clinical trials. This commitment to innovation positions IVRCC as a leader in the industry, dedicated to improving the efficacy of clinical research.

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.

ServiceNetwork™, which unifies and simplifies contract service for Authorizers and Service Providers, is called ServiceNetwork. A program to manage and onboard a provider network. It also allows you to view and track services in progress. An Authorizer will guide you through the process of receiving, servicing, reporting back, and setting up a workflow. A portal that allows consumers to request services, choose locations, schedule appointments, and track service status. Appointment scheduling and consumer engagement. Connection to the Service Provider network. Qualification of the provider and the location. Technician-led workflows. Adjudication and resolution. There are more than 2000+ walk-in service centers in North America and mail-in depots. The majority of these locations are owned by large and medium-sized retail brands. These service providers are already available on our platform and can be quickly onboarded. You can add additional partners through our provider portal, our application, or integrate through our service provider API.

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.

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.

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.

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.

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.

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.

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.

AssisTek stands out as a frontrunner in cutting-edge clinical technology solutions tailored for clinical research, providing specialized software that optimizes and improves the process of gathering patient data. With a legacy of over 25 years, the company has successfully facilitated more than 800 clinical research trials spanning 46 therapeutic areas, which include upwards of 500 multinational Phase I–IV clinical trials. Their electronic Clinical Outcome Assessment (eCOA) solutions boast scalability, customization, and efficiency, backed by a reliable cloud-based technology platform. Among their extensive product offerings are the TEK eCOA Tablet, which accommodates any questionnaire utilized in clinical trials, TEK eDiary, enabling the collection of patient-reported outcomes from home, TEK Configurator for comprehensive project development in clinical trials, and TEK Study Portal, which consolidates eClinical tracking, training, and reporting into one convenient location. AssisTek's innovative systems and services have established them as the preferred partner for data collection and analytics, winning the trust of both patients and healthcare professionals alike. As they continue to evolve, AssisTek remains committed to enhancing the efficiency and accuracy of clinical research methodologies.

Clinical One RTSM is capable of accommodating various randomization strategies, ranging from the most straightforward to highly intricate studies, all without requiring any programming or coding, which consequently reduces the duration of user acceptance testing. You can take charge of your study with self-service configurations, allowing you to develop a study in just a matter of days rather than weeks. Additionally, you can assess the drug inventory status and make real-time adjustments without needing to consult the vendor, thereby avoiding unnecessary costs and change requests. By implementing changes swiftly, you can eliminate expenses associated with change requests and prevent delays, enabling you to launch your studies almost instantaneously. This platform stands out as the only one that genuinely integrates individuals, processes, and data to streamline and expedite the future of clinical trials. Moreover, the inclusion of virtual components in clinical trials enhances patient engagement and significantly elevates the quality of trial data. To keep pace with the rapidly evolving landscape, it is essential to adopt transformative digital strategies that facilitate quicker study initiations, harmonize data from diverse sources, and optimize workflow efficiency. Such advancements are pivotal for the successful execution of modern clinical research initiatives.

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.

ClearForce: Safeguard Your Organization and Foster a Trustworthy Atmosphere. With round-the-clock employee risk management, our approach to risk mitigation focuses on identifying and alleviating employee stress. Traditional pre-employment background checks alone are insufficient. What sets ClearForce apart? The ClearForce Resolve™ platform ensures protection for both organizations and their employees by continuously monitoring and assessing risky behaviors. It provides immediate, event-driven notifications regarding external employee misconduct and behaviors that could pose risks to the organization, its workforce, or its clientele. Furthermore, ClearForce Resolve™ stands out as the sole platform that integrates various departments—HR, Security, and Legal—within a unified framework, making investigative processes more streamlined and effective. Every behavioral alert, incident report, and complaint is systematically recorded, stored, and evaluated within the Resolve system. Consequently, resources that were once consumed by data compilation, research, and correlation can now be reallocated to other essential areas. By utilizing our platform, organizations can enhance their overall security measures and focus on fostering a healthier work environment.