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KMR Claims Manager is a fully integrated, customizable state-of-the-art medical claims processing software solution for TPAs, self insured and claims administrators. Features include: comprehensive claims processing-ability to scan, receive via EDI or manual entry; coordination of benefits, co-pays & deductibles; full claims history display; adjuster analysis reporting; actuarial reporting; custom & ad-hoc reports, online portals for members/participants & providers, document imaging integration
Prognos provides a powerful suite of claims management tools to help both employers and service providers efficiently manage workers' compensation and disability claims. Employers using third-party administrators or insurance carriers will find everything they need to manage notes, tasks and return-to-work programs and import and reconcile cost data. Self-administered employers and third-party service providers will find everything they need to administer claims.
FACTS Services is an integrated technology and services provider focused on providing cost effective healthcare payor solutions across the entire claim continuum. The result is a dramatic reduction in cost and improved turnaround time for all facets of the healthcare delivery cycle. FACTS delivers technology within the ASP and turnkey settings and a full administrative services solution that lowers the overall cost of doing business while increasing the value and quality of customer service.
HEALTHsuite is a comprehensive benefit administration system and claims processing software solution designed for health plans and benefit administrators. HEALTHsuite is a rules-based auto adjudication software solution designed to administer complex benefit offerings including Medicare, Medicaid, Indemnity, HMO, Consumer-Driven and Federal Employee products.
Alyce by Brightwork
The Alyce Claims Management System is designed for TPAs, Insurance Carriers and Agencies. It has a very intuitive design, with pages laid out in a logical fashion, which makes it easier for adjusters to get their jobs done faster and more efficiently. Features include multi-tiered infrastructure, duplicate claim alerts, check printing, forms, letters and reports.
ClaimVantage delivers world class claims management software for the life
and health market. The target market includes insurance carriers, Third Party Administrators and self-funded companies who require flexible software solutions that can be customized and enhanced by internal IT resources. Lines of business supported include disability, long-term care, life, AD&D, critical illness and supplemental products.
The solution is a web based secure Claims Processing solution that has a variety of features including provider side web based secure access and high performing backend expEDIum Claims Portal Components. This solution is an optimal way to allow Practices, IPAs, Clearinghouses, Billing Services and Hospitals to connect to one or more Payers or Clearinghouses directly and make the claim life cycle visible across the spectrum and make the claim management more efficient and predictable.
Because every healthcare organization is unique, Plexis healthcare software employs a flexible, rules-based engine. This rules-based architecture allows our business analysts to work with you to create a comprehensive healthcare information system tailored to your organization. Combining flexibility, scalability, and powerful reporting and workflow tools, Plexis healthcare software gives you the data tools you need to keep your operations running smoothly.
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