Best Core Administrative Processing Systems Software

NaviNet Open Foundation consists of a series of layers: a platform, a set of network services, a suite of reimbursement-related and clinical applications, and a set of tools that customers can use to

Clinical Decision Support (CDS) system is a next-generation decision-support solution available to providers today.

Zelis is modernizing the business of healthcare by building something remarkable: a connected platform that bridges gaps in the financial system and aligns interests across healthcare insurers, provid

TriZetto offers consulting, IT, and business process solutions to streamline the deployment and adoption of technologies and improve operations for payers and providers in the health care industry. Tr

Claims and benefits administration solution for health plans managing & processing. Provides the patented configuration feature.

Veradigm Payerpath® is an Internet-based suite of solutions that addresses every step in the reimbursement cycle.​

Custom robotic process automation (RPA) solutions specializing in healthcare, finance, retail and professional services. Since our solutions are custom scripted, they are flexible, less fragile and m

Founded in 1996 and headquartered in Oregon, PLEXIS serves healthcare payer administrative organizations serving over 50 million people in all 50 states and 15 countries. PLEXIS provides enterprise co

Strategic Healthcare Management Systems (SHMS) enables health plans of all sizes reduce administrative overhead. SHMS has segment-specific products for healthcare payer organizations (claims/contracti

End-to-end efficiency accelerates customer acquisition, boosts retention and promotes long-term growth prospects for health payer organisations.

An analytics-driven claims and remittance management solution for healthcare providers who want to automate workflows, improve resource utilization, and accelerate cash flow.

CAQH, a non-profit alliance, is the leader in creating shared initiatives to streamline the business of healthcare.

Veradigm founded in 1986, is an integrated data systems and services company that combines data-driven clinical insights with actionable tools to help healthcare stakeholders improve the quality, effi

A single platform designed to enable cleaner claims, improve communication and speed up reimbursement

A clinically-based claims payment solution for payers that want to create and deploy flexible, automated rules to help improve payment accuracy, reduce appeals, and realize medical and administrative

E-HAS is an Online / Offline Hospital Administration and Management Information System for Health Care organizations . E-HAS has a capability of data warehousing and business intelligence for consiste

ezCAC is an NLP-based HIPPA compliant computer-assisted coding software. It is designed to bring hospital clinical data and all patient related data together in one intuitive Enterprise Computer-Assis

Post Discharge Software is a patient follow up care management solution that helps you connect with recently discharged patients.

Empower your organization to adapt with a user-friendly solution, identifying and mitigating risk. While profitability improves, so will your patients experiences and outcomes.

HealthWare Systems' proven workflow and integration platform, Facilitator, is built to meet the demands of the healthcare marketplace. Facilitator streamlines pre-arrival workflow, prior authorization

Health Portal Solutions is a provider of custom, integrated web portals that saves Employers and Payers time and money by consolidating insurance data, products, and business processes into a single p

Health iPASS is redefining the patient revenue cycle by improving the patient experience from appointment to payment. It helps providers promote price transparency, build trust and increase operating

HxOne is the premiere healthcare payer solutions company that offers customized solutions for commercial and governmental health benefit administrators.

End-to-end visibility from factory to patient

intellicare is a new generation Core Claims System built from the ground up by healthcare payer professionals for healthcare payer professionals. - We Deliver an affordable and quality focused Enterp

Developed in close collaboration with hospitals, the Logibec FMS - Financial Management System is a complete administrative solution that adapts to the structure of each healthcare facility. It is an

MediQuire is a performance management platform designed to leverage data (clinical, claims, demographic and others) to derive powerful insights about operational and clinical performance gaps of indiv

MOMS Medical Billing and Practice Management software is designed to streamline physician billing processes in order to maximize reimbursement.

Orion Health’s Digital Care Record (DCR) provides an integrated platform that consolidates patient data across care settings, enabling enhanced care coordination and population health management.

Payer Compass is dedicated to restoring rationality to the cost of care. We focus squarely on tackling the most elusive problems in today’s healthcare landscape: spiraling costs and associated lack of

PlanXpand is a platform manages real-time, shared benefit accumulators; ACA cost-sharing reduction subsidies; CDH plan designs (HRA) for payors.

Provider1™ (formerly eProviderSync™) enables efficient and accurate provider data and contracts management across a Payer’s back and middle office functions. The Collaboration Portal manages the digit

QuickCap is an advanced healthcare claim processing system built for IPAs, PHOs, MSOs and other management organizations. It is designed to process EDI and manual claims, capitation, eligibility, refe