Insurance is indeed helpful. However, insurance processes can be complex as you need to meet protocols and insurance policies. That is why you will need a solution, especially in medical claims processing. Luckily, you can use medical claims processing software. This tool enables convenient methods, allowing you to complete your task effectively and efficiently.


13+ Medical Claims Processing Software

1. Apex EDI

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Rating: 4.7/5

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2. PLEXIS Healthcare

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Rating: 5/5

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3. Osplabs

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Rating: 5/5

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4. Exela

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Rating: 4.9/5

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5. Hyland

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Rating: 5/5

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6. Datagenix

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Rating: 5/5

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7. Experian Health

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Rating: 5/5

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8. Change Healthcare

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Rating: 5/5

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9. Comindware

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Rating: 5/5

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10. Nthrive

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Rating: 4.9/5

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11. Abilitynetwork

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Rating: 5/5

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12. CureMD

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Rating: 5/5

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13. Epiccare

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Rating: 5/5

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14. AdvancedMD

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Rating: 4.7/5

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What is Medical Claims Processing Software?

Medical claims processing is not a simple task. It has a complex procedure that both requires accurate operations, cyber, and data security. It is the practice where providers send information to the insurance company regarding the patient to get paid. Given that, of course, it is not a matter you should take lightly. Since manual processes are not enough to ensure flawless transactions, you will need medical claims processing software. Medical claims processing software offers advanced features and functionalities to assist you in every detail of medical claims. It allows comprehensive structures and lucid content helping readers to understand your data smoothly. 

Benefits

As we all know, manual methods nowadays are not enough to ensure accurate data analysis and quick processes. As technology rises, people have higher expectations and impatience. Medical claims processing software has functions that allow you to perform multiple tasks in a single platform, allowing you to solve complexities. This software helps you complete your work in a short time while ensuring faultless transactions. 

Features

Medical claims processing software can have the same and different features. Various platforms have prioritized features that allow them to stand out among others. It also has different compatibilities and advanced levels. Given this reason, it is a wise move to research and read the pros and cons of software that caught your interest. Aside from that, the software is expensive, so you should make sure you choose the best for your company. Several platforms offer free versions and trials, giving you the chance to check them firsthand. Below are recommended features:

Top 10 Medical Claims Processing Software

1. Nthrive

Nthrive includes claims management technology that improves medical billing accuracy and compliance. Nthrive has annual revenue of $952.3 million and 3,527 working employees.

2. Hyland

Hyland includes approval process control, audio file management, audit trail, augmented analytics, content management, and more helpful features. Hyland has annual revenue of $519.8 million and 3,585 employees.

3. Change Healthcare

Change Healthcare includes patient and member management, coverage and financial clearance, care operations, claims lifecycle, and payments. Change Healthcare has annual revenue of $309.7 million and 2,136 employees.

4. Exela

Exela is a market leader in business process automation (BPA), leveraging a global footprint and proprietary technology to provide digital transformation solutions that improve quality, productivity, and end-user experience. Exela Technologies has annual revenue of $263.2 million and 1,815 employees.

5. Experian Health

Experian Health includes appointment scheduling, recurring appointments, reminders, self-service portal, third-party integrations, and more helpful features. Experian has annual revenue of $151.5 million and 1,045 employees.

6. Osplabs

Healthcare Analytics, advanced remote patient monitoring, and medical history records are all available in Osplabs. Ospabs has annual revenue of $94 million and 57 employees.

7. Apex EDI

Apex EDI from Therapy Brands includes email support, payer enrollment assistance, claim status reporting, claim scrubbing, unlimited eligibility, and more advanced features. Therapy Brands has annual revenue of $26 million and 179 employees.

8. PLEXIS Healthcare

PLEXIS Healthcare includes adjustor management, case management, claims tracking, compliance management, and more innovative features. PLEXIs Healthcare Systems has annual revenue of $14.2 million and 98 employees.

9. Comindware

Comindware includes business process automation, calendar management, forms management, task management, and more valuable features. Comindware has annual revenue of $4.5 million and 31 employees.

10. Datagenix

Datagenix includes claims tracking, forms management, health insurance administration, online benefits enrollment, and more valuable features. Datagenix has annual revenue of $0.4 million and three employees.

FAQs

What is a claim in insurance?

The insurance claim is the act of requesting payment to the payor. Such a process requires multiple documents and procedures to ensure that the claim is qualified. The insurance company does not simply process claims. They will request data about the patient to decide if the bills are covered in the insurance.

Why do you need software?

Nowadays, most businesses use software to improve productivity, communication, operations, and security. Insurance companies frequently receive fraudulent claims. With software, you can improve data security and legitimacy evaluation to ensure that claims are legit. The software has multiple advanced features that allow you to multi-task, save more time, secure data, and improve productivity.

What is the purpose of medical claims?

A medical claim is a bill submitted by a healthcare provider to a patient’s insurance provider. This bill includes unique medical codes that detail the care provided during a patient visit, an act of requesting payment assistance from the patient’s insurance company. It involves various procedures to conclude that the patient’s bill is covered.

Medical institutions usually receive multiple patients every day. Most of them have insurance that can cover their bills. Of course, insurance companies do not pay bills without evaluations and assessments. Improve your productivity and ensure accurate data with medical claims processing software. With such a tool, you can process and communicate to your recipients conveniently. 


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