Alternatives to Valer
Compare Valer alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to Valer in 2026. Compare features, ratings, user reviews, pricing, and more from Valer competitors and alternatives in order to make an informed decision for your business.
-
1
Veradigm AccelRx
Veradigm
Veradigm AccelRx delivers a free, automated, comprehensive solution to help you streamline specialty medication fulfillment for your patients. With faster time to therapy comes better odds for medication adherence and positive outcomes, as well as fewer phone calls and faxes for your staff. Combining electronic enrollment, consent, prior authorization, and script into an all-in-one system, AccelRx can help your practice significantly cut time-to-fulfillment for all specialty drugs, with any payer. Automatically populate patient data on enrollment and other forms with the click of a button. A single user-friendly platform to help you transform specialty medication management. Enhance your management of most specialty drugs all in one place, including electronic prior authorization (ePA). Access your enhanced specialty medication management as part of your existing electronic health record (EHR) workflow. -
2
Myndshft
Myndshft
Experience a seamless workflow by having real-time transactions driven within existing technology platforms. Providers and Payers reduce time and effort by up to 90% for benefits and utilization management. Eliminate the current benefits and utilization management black box – eliminating confusion for patients, providers and payers. Self-learning automation and fewer clicks mean more time for patients, providers and payers to focus on care. Myndshft eliminates the quagmire of point solutions by providing a unified, end-to-end platform for in the moment payer-provider-patient interactions. Myndshft dynamically updates automated workflow and rules engines based on the actual responses and results from provider-payer interactions. Our technology continuously adapts to the rules in use by payers. The more you use it, the smarter it gets. A library of continuously-updated thousands of rules for national, state and regional payers. -
3
Rhyme
Rhyme
Rhyme connects payers and providers intelligently inside the prior authorization workflow, reclaiming the time lost on back-and-forth efforts and returning it to the patient. Automating manual tasks is critical (that’s why we do it), but it isn’t enough. When the nuances of clinical decision-making require collaboration between payers and providers, Rhyme keeps your workflow clear, agile, and fluid. We created the largest integrated prior authorization network, to leave a disjointed system behind and replace it with intelligent collaboration. Deep relationships and connections to EHRs, payers, and benefits managers, all on one platform. No scrambling, no screen-scraping, no secondhand info. We meet providers and payers right where you are, in your existing systems and workflows. Connections are easy so we can adjust to you, not the other way around. Prior authorizations aren’t an add-on to our platform, they’re all we do. -
4
Infinx
Infinx Healthcare
Leverage automation and intelligence to overcome patient access and revenue cycle challenges and increase reimbursements for patient care delivered. Despite the progress AI and automation is making in automating patient access and revenue cycle processes, there still remains a need for staff with RCM, clinical and compliance expertise to ensure patients seen were financially cleared and services rendered are accurately billed and reimbursed. We provide our clients with complete technology plus team coverage with deep knowledge of the complicated reimbursement landscape. Our technology and team learn from billions of transactions processed for leading healthcare providers and 1400 payers across the United States. Get quicker financial clearance for patients before care with our patient access plus a platform that provides complete coverage for obtaining eligibility verifications, benefit checks, patient pay estimates, and prior authorization approvals, all in one system. -
5
ProviderSoft
ProviderSoft
Specialty Software for your Early Childhood Program. We Focus on Function so you Focus on Families. Manage data for clients, providers, referral sources, and staff. Generate custom, dynamic reports and flags. Easily access schedules, prescriptions, and insurance authorizations. Create and submit electronic, paper, or custom claim files. Generate invoices and statements for families. Upload and track electronic or manual responses from Payers. -
6
AuthParency
Oncospark
Prior Authorization with AuthParency Prior authorization is a growing administrative burden for healthcare providers. Our automated prior authorization solution, AuthParency™, is powered by AI and machine learning (ML). This advanced system can cut your team’s prior authorization time in half. It is also compatible with all EHR and practice management systems AuthParency helps: Analyze payers’ tendencies Reduce patients’ days to care Improve patient outcomes Stop losses from non-reimbursable services Identify financial toxicity burdens Analyze population health data Track disparities Pharmaceutical companies -
7
Paradigm
Paradigm
Paradigm Senior Services offers a full-service, AI-powered revenue cycle management platform specifically tailored to home-care agencies that bill third-party payers such as the U.S. Department of Veterans Affairs (VA), Medicaid, and other managed-care payers. It automates and streamlines every step of the billing and claims process: from eligibility/authorization verification, state- or payer-specific enrollment and credentialing, to submission of clean claims, denial handling, and payment reconciliation. It integrates with common agency management software and electronic visit verification tools to scrub shifts, verify authorizations weekly, and reconcile payments, reducing denials and minimizing administrative burden. Paradigm also supports “back-office as a service” for providers; even if they already have internal billing staff or scheduling software, Paradigm can take over claims processing as a specialized, expert billing department. -
8
HexIQ
HexIQ
The HexIQ software provides fast and easy access to negotiated rate data and tools that help users search, download, and analyze complex healthcare reimbursement rates for any code, payer, provider (NPI), or tax identification number (TIN) of interest so they can leverage transparency in coverage requirements to inform business decisions and negotiations. It ingests hundreds of machine readable files (MRFs) from payers every month, cleans and enhances the data with provider names, addresses, and network relationships, and updates it regularly so users can benchmark their negotiated rates against peers in the same specialty and region without manual Excel manipulation. Advanced search features let users filter by code, specialty, state, place of service, payer, NPI, or TIN and download results in CSV format for further analysis, while built-in analytics and visualization tools show rate distributions, average and mode rates, and contracted provider networks to reveal market insights.Starting Price: $25 per month per code -
9
Free Market Health
Free Market Health
Free Market Health is a healthcare technology company dedicated to improving the specialty pharmacy ecosystem with a care-driven marketplace platform. Free Market Health partners with forward-thinking payers and specialty pharmacies of all sizes to streamline the complex and opaque specialty medication fulfillment process, ensuring patients have prompt access to life-saving and life-altering medications. The platform addresses inherent challenges by automating submission pack creation and validation, facilitating transparent and equitable access to specialty drug prescriptions, and enabling real-time decision-making. This dynamic marketplace empowers stakeholders to optimize resources, maximize opportunities, and balance the cost of care with the value it provides. Free Market Health has managed over 200,000 specialty drug claims annually, representing nearly a 400% increase year over year. -
10
Turquoise Health
Turquoise Health
Turquoise Health delivers a comprehensive suite of solutions built around healthcare price-transparency and contracting workflows, offering modules such as Clear Rates Data (which aggregates over a trillion provider, payer, professional, drug, and device rate records covering institutional and professional services) and Clear Contracts (a centralized cloud application that supports contract creation, negotiation, and storage for payers and providers). It also includes Compliance+ to help organizations remain compliant with machine-readable file requirements and Good Faith Estimate rules, Analytics tools to benchmark and query market-level rate data, Custom Rates extracts tailored for specialty healthcare segments, Standard Service Packages (pre-built bundles of common procedures), Search and Care Search dashboards for rate discovery and comparison, and a Turquoise Verified program enabling providers and payers to publish and manage price transparency data. -
11
ABN Assistant
Vālenz
For providers, medical necessity denials cost thousands to millions of dollars every year in write-offs, plus costly staff time researching and appealing denials and responding to patient concerns. For payers, the same is true on the other end of the claim management spectrum: Paying for medically unnecessary procedures and treatments – and time spent working on denial appeals – raises costs without improving outcomes. And of course, for the patient, there can be unnecessary copays and other out-of-pocket costs, not to mention a poor patient experience involving costs and moments of care they did not need. ABN Assistant™ from Vālenz® Assurance delivers the prior authorization tools providers need to validate medical necessity, print Medicare-compliant ABNs with estimated cost, and stop over 90 percent of medical necessity denials by verifying necessity before care is delivered to the patient.Starting Price: $1039.00/one-time/user -
12
Veradigm Payerpath
Veradigm
Veradigm Payerpath is an end-to-end revenue cycle management suite of solutions built to assist organizations to improve revenue, streamlining communications with payers and patients, and boosting practice profitability for practices of all sizes and specialties. Eliminate missing information, incorrect coding, and data entry error to ensure clean claim submission. Ensure claims pre-submission are correctly coded, have no missing information, and are error-free. Compare performance against peers at the state, national, and specialty levels to optimize productivity and improve financial performance with advanced analytical reporting. Remind patients of their appointments and confirm their insurance coverage and benefits information. Automate the billing and collection of patient responsibility. Veradigm Payerpath’s integrated solutions are practice management (PM) agnostic, interfacing seamlessly with all major PM systems. -
13
ScriptMed Specialty
Inovalon
The ScriptMed Specialty pharmacy management software is an industry leader, serving seven of the top ten U.S. specialty pharmacy companies. Access the largest dataset in the industry to pre-populate critical, patient-specific data elements, accelerating time to fill and improving quality of care. Delivers streamlined, automated processing across the specialty and infusion pharmacy continuum, decreasing the cost to serve by up to 17%. Reduce time and cost to fill with real-time healthcare connectivity, advanced analytics, and automated processing. Support interventions, outreaches, or internal processes with real-time insights about the patient, prescriber, payer, medication, and more. Synchronized medical claims processing allows many of the steps to be handled concurrently, dramatically decreasing the time and expense of medical billing. Experience unmatched connectivity, functionality, and financial benefits in the specialty pharmacy marketplace. -
14
Inovalon Eligibility Verification
Inovalon
Eligibility Verification Standard streamlines patient access and billing workflows by enabling staff to assign and prioritize patients/residents, payers, and tasks during eligibility verification. This technology goes beyond basic eligibility needs, providing a dashboard to confirm, manage, and store every inquiry. Speed up eligibility verification processes with automated enrichment of incomplete or incorrectly formatted transactions from the payer. Perform multiple eligibility inquiries at once with batch file uploads that verify Medicaid, Medicare, and commercial coverage quickly and efficiently. Easily assign tasks to team members, apply follow-up flags, and create eligibility documentation for future reference. Manage patients between batches and resolve issues with just a few clicks. Save time and ensure coverage accuracy with one cloud-based, all-payer health insurance eligibility verification software that empowers staff to manage benefit inquiries however, works best for them. -
15
WellSky CareTend
WellSky
WellSky® CareTend® is a comprehensive software platform designed for home infusion and specialty pharmacy providers. It streamlines operations across intake, dispensing, delivery, billing, and clinical documentation. With over 25 years of industry expertise, WellSky CareTend supports HIPAA-compliant workflows, real-time inventory tracking, automated claims submission, and patient engagement tools. The platform integrates with EHRs and courier networks, enabling seamless data exchange and delivery management. Built-in support for compounded IV drugs, TPN, and DME/HME ensures providers can meet payer requirements and deliver high-quality care. -
16
Provider Passport
Provider Passport
Provider Passport is an all-in-one healthcare administration tool that centralizes and automates critical provider management functions including payer enrollment, credentialing, privileging, and provider data management using its TruMation AI automation engine. It aggregates provider data into unified profiles, automatically tracks expiring credentials and licenses, monitors sanction databases in real time, and shares data securely with other systems via APIs or standard messaging protocols while reducing manual data entry and error risk. Provider Passport’s credentialing tools run primary source verifications from hundreds of integrated sources in seconds, enable customizable workflows for different provider types, and help expedite onboarding by automating re-credentialing and approval processes. Its AI-powered payer enrollment engine evaluates criteria across thousands of payer plans, automates application submission and follow-ups, and accelerates enrollment approval. -
17
Anomaly
Anomaly
Anomaly is an AI-powered payer management platform built for healthcare revenue teams to “know your payers as well as they know you.” It surfaces hidden payer behaviors by decoding complex rules and detecting payment patterns across hundreds of millions of healthcare encounters. The core engine, Smart Response, continuously analyzes payer logic, adapts to shifting policies, and embeds learnings directly into existing revenue cycle workflows to provide real-time denial prediction, assisted claims correction, and alerts to revenue risks. By integrating payer-specific insights into existing systems, users can anticipate revenue loss, negotiate payer contracts from a stronger position, and proactively correct or reverse denials before they impact cash flow. The system helps level the playing field between providers and payers by turning opaque billing logic into actionable intelligence and embedding it into day-to-day financial operations. -
18
Inovalon Claims Management Pro
Inovalon
Keep revenue flowing with a powerful tool that speeds up reimbursements with eligibility checks, claims status tracking, audits and appeals, and remittance management for government and commercial claims, all in a single system. Leverage an advanced rules engine that immediately scrubs claims against the most up-to-date CMS and commercial payer rules, allowing you to correct errors before claims go out the door. Verify eligibility across all payers during claim upload and see flagged errors so claims can be edited before submission. Decrease days in A/R with automated workflows for audit responses, appeal submissions, and ADR tracking. Customize staff workflow assignments based on the type of claim and action needed. Automate secondary claims submissions to stop timely filing write-offs. Increase claims revenue with automated workflows for faster, more successful audits and appeals. -
19
CureAR
TechMatter
CureAR is an AI-powered medical billing and revenue cycle management software designed for in-house billers, billing companies managed-service providers and DME companies. The software consolidates eligibility verification, charge capture, AI-assisted coding suggestions, claim scrubbing, electronic claim submission, ERA ingestion, and automated payment posting into a single cloud-hosted system. It is configurable for specialty billing rules and supports multi-tenant operations for practices that handle multiple client accounts. Key Features: AI-assisted coding and claim scrubbing: Machine learning highlights likely coding errors and applies payer-specific validation rules before submission. Real-time claim status and alerts: Tracks claims from submission to adjudication and surfaces exceptions for prioritized follow-up. ERA ingestion and automated posting: Electronic remittance advice handling with configurable reconciliation workflows reduces manual posting effort.Starting Price: $129/month/user -
20
VerifyRX
LexisNexis
VerifyRx is a real-time, compliance-driven prescriber verification solution, designed specifically for pharmacies and PBMs, that seamlessly integrates into existing workflows. VerifyRx processes millions of transactions a day, updating comprehensive prescriber data in real-time, including Drug Enforcement Administration (DEA) and State data (when available) and daily National Technical Information Service (NTIS) data. As part of the pharmacy workflow, VerifyRx processes millions of transactions a day, updating comprehensive prescriber data in real-time, including Drug Enforcement Administration (DEA) and State data (when available) and daily National Technical Information Service (NTIS) data. The highly configurable and responsive tool provides real-time compliance checks on all prescription transactions before they are transmitted to payers, helping retail and specialty pharmacy reduce regulatory risk. It identifies potential claims submission errors prior to dispensation. -
21
EZClaim Medical Billing
EZClaim
EZClaim is a medical billing and scheduling software company that provides a feature-rich practice management system specifically tailored for small to medium-sized provider office and outsourced medical billing firms. It also includes integrations with a number of EMR/EHR vendors. Whether you are a doctor, practice manager, or billing service owner, EZClaim Billing is designed with you in mind, simplifying your claims management from data entry to payment posting, and beyond. EZClaim primarily supports the following specialties, General Practice, Therapy, Vision, Surgical, Medical Specialties, Home Health Care, and Outsourced Medical Billing Services (RCM). However, the software is very adaptable and can be used for many other billing specialties. EZClaim’s billing software allows the creation of insurance payor lists for Medicare, Medicaid, Tricare, Clearinghouse payer IDs, governmental MCO’s, auto insurance, and worker compensation groups. -
22
SSI Claims Director
SSI Group
Elevate your claims management process and decrease denials through unmatched edits and an industry-leading clean claim rate. Health systems require access to technology that facilitates accurate claim submission and rapid reimbursement. Claims Director, SSI’s claims management solution, streamlines billing practices and provides visibility by guiding users through the electronic claim submission and reconciliation process from beginning to end. As payers change or modify reimbursement criteria for services, the system actively monitors and incorporates these changes and requirements. And with a comprehensive mix of edits at the industry, payer and provider levels, the solution aids organizations in making the most of reimbursement efforts. -
23
Optum AI Marketplace
Optum
Optum AI Marketplace is a curated ecosystem of AI-powered solutions designed to transform healthcare by providing payers, providers, and partners with tools to deliver better outcomes efficiently. It offers a diverse range of products and services across categories such as patient & member engagement, eligibility & claims, care operations & management, payment & reimbursement, and analytics & insights. Notable offerings include the prior authorization inquiry API, which enables payers to check a patient's prior authorization status in real-time, and SmartPay Plus, an e-cashiering payment platform that simplifies patient payments and streamlines the collection process. Additionally, Optum Advisory Technology Services provides expert support for digital transformation initiatives, offering system selection, procurement, implementation, and AI tools. It also features partnerships with trusted resellers, such as ServiceNow, to offer cutting-edge healthcare solutions. -
24
Madaket
Madaket Health
Get hours back in your day and millions back in your pocket with our automated solutions. Access the key players—providers, payers, and partners—and the real-time, accurate data you need to never miss a beat in care delivery. We handle all the complex connections across thousands of payers. All you need to know is fast and easy enrollments to any payer starts here. The cloud has never looked this good. Central command to manage, store, and share provider data in real-time—connected everywhere it needs to be. Provider verification made simple. You request it, our platform processes it fast. -
25
HealthRules Payer
HealthEdge Software
HealthRules® Payer is a next-generation core administrative processing system that provides transformational capabilities to health plans of all types and sizes. For more than ten years, health plans implementing HealthRules Payer have been able to quickly address market opportunities and stay in front of their competition. HealthRules Payer is unlike any other core administrative solution because of its use of the patented HealthRules Language™, an English-like vernacular that delivers a revolutionary new approach to configuration, claims processing and transparency of information. HealthRules Payer helps transform health plans looking to grow, innovate and compete beyond any other core system today. -
26
Availity
Availity
Collaborating for patient care requires constant connectivity and up-to-date information. Simplifying how you exchange that information with your payers is more important than ever. Availity makes it easy to work with payers, from the first check of a patient’s eligibility through final resolution of your reimbursement. You want fast, easy access to health plan information. With Availity Essentials, a free, health-plan-sponsored solution, providers can enjoy real-time information exchange with many of the payers they work with every day. Availity also offers providers a premium, all-payer solution called Availity Essentials Pro. Essentials Pro can help enhance revenue cycle performance, reduce claim denials, and capture patient payments. Availity remains your trusted source of payer information, so you can focus on patient care. Our electronic data interchange (EDI) clearinghouse and API products allow providers to integrate HIPAA transactions and other features into their PMS. -
27
Oracle Health Specialty Practice Management is part of the Oracle Health family of clinical and practice management solutions, designed to provide the tools needed to run a profitable medical practice. Oracle Health Specialty Practice Management is customizable and integrates well with user-friendly EHRs offering medical document management, patient appointment scheduling and health record management. With an internet connection, Oracle Health Specialty Practice Management provides near real-time updates on claim status. With most payers, Oracle Health Specialty Practice Management is designed to help your practice have its claims adjudicated, paid and posted weeks sooner than a paper-based system. Other key features include patient scheduling, monitoring and posting payments. Oracle Health Specialty Practice Management includes capabilities to help your practice improve efficiencies during the scheduling, monitoring and payment process.
-
28
ESO Billing
ESO
Automate your workflow and integrations, and put an end to the repetitive manual work associated with revenue cycle management. ESO Billing frees your team to focus on what they do best. In today’s reimbursement world, efficiency counts. ESO Billing was built to save you time at every possible point in the billing process. Even its interface has been freshly redesigned for the ultimate in speed and ease of use. Customize your workflow based on your business process, task-based workflow moves each claim through its stages with minimal touches. It even alerts you automatically when payments aren’t on time, for the ultimate peace of mind. Our payer-specific proprietary audit process ensures that each claim contains all critical billing information prior to claim submission. The result? The lowest clearinghouse and payer rejection rate in the industry. Pair billing with ESO Health Data Exchange (HDE) and ESO Payer Insights to tap into hospital-generated billing information with one click. -
29
Provider Credentialing
Visualutions
Our Provider Enrollment and Credentialing services enable practice providers to get and remain enrolled for the services they provide by ensuring that payers have the data they need to process claims for the services you provide. New Provider Enrollment. Establish relationships with new or missing payers to optimize revenue opportunities. Re-credentialing. Commercial payers and hospital applications. Annual Maintenance. CAQH Maintenance and Attestation, re-validations for Medicaid and Medicaid, Expirables: DEA, License, Malpractice, etc. Expert Credentialing Services For Healthcare Physicians Trying to manage and understand the required credentialing for your health center can be time-consuming, and take up valuable staff resources. As a full service revenue cycle management company we understand the impact provider credentialing can have on your cash flow. Our provider credentialing service includes options for new and existing providers. -
30
symplr Payer
symplr
Save on costs, eliminate data silos, and deliver better outcomes for your members with a unified, automated provider data solution. symplr Payer provides a single source of truth for provider data that is consistently reconciled and validated against primary sources. It improves data quality, access, and transparency. Further, it eliminates duplicate requests for information, reducing provider frustration. Using symplr Payer as the enterprise-wide hub for provider data, payers can feed timely, accurate information to other downstream systems. Our highly configurable, end-to-end provider data management solution manages all pre-contract and renewal contract negotiations. Standardize and streamline your contracting processes, while capturing contract details such as sentinel events, trigger dates, configuration efforts, process steps, fee schedule info, and more. symplr Payer’s unique design allows your organization to consolidate contracting and credentialing. -
31
MD Clarity
MD Clarity
Boost your bottom line by automating patient cost estimates, payer underpayment detection, and contract optimization in one place. Spot patterns of underpayment by insurance companies. Ensure you are setting your chargemaster optimally. Assign investigations/appeals to staff and see task status, all in one place. Compare performance across payer contracts and renegotiate terms from a position of strength. Project out-of-pocket costs at a high level of accuracy, giving patients the confidence to make up-front deposits. Enable patients to make up-front deposits directly from their online estimate. Hold insurers accountable for the full amount they owe. Get the upper hand in contract negotiations. Reduce bad debt, cost-to-collect, & accounts receivable days. -
32
SKYGEN’s Provider Data Management (PDM) is an on-demand solution that helps healthcare payers strengthen provider network management and provider relationships. PDM also strengthens payers’ ability to effectively build provider networks, improves provider and member satisfaction, and lowers administrative costs. It’s a smart solution that helps payers and providers meet the needs of today’s technology-savvy healthcare constituents. Lower contract acquisition costs via fast, efficient, paperless provider recruitment and supplemental network rental. Lower credentialing costs and improved provider satisfaction through online credentialing. Eliminating expensive outreach by automating provider self-verification and ensuring accurate and verified provider data for online directories. SKYGEN powers dental and vision connectivity solutions that inspire clients to move confidently into the future by employing technology that creates unparalleled efficiencies.
-
33
Payer
Payer Financial Services
Pioneering online B2B payments. Enterprise payments. No matter how big or small the purchase is, Payer can do it. Endless opportunities with Payer. Digitise your business, globally. Whether you have local, regional or global ambitions, Payer is the online B2B payments partner you need because we can easily future-proof how you manage payments online. We are designed for the new era of B2B e-commerce. Automated online B2B payments experiences. Our system is designed to seamlessly integrate with your customers’ journeys. Payer does this by giving you complete UI freedom. Automated online B2B payments result in workflows with little manual work, for you or your customers. Seamless integration with your ecosystem. We are specialized in online B2B payments and know first hand the complexity that comes with having multiple system suppliers in your ecosystem. Payer can easily be integrated into your ERP and bookkeeping systems so you can reduce administrative costsStarting Price: $800 per year -
34
Infosys HELIX
Infosys
Driving AI - first as a business strategy for payers, providers and PBMs with products and platforms which are built on AI and runs on cloud. A “healthcare digital platform” is the integration of applications and emerging technologies to provide a tailored healthcare solution that drives business outcomes—a significant modern and accelerated approach to disintermediate legacy core administration processing systems (CAPS). To better understand the role of digital platforms and emerging technologies in achieving business objectives, the impact of digital platforms on healthcare payer KPIs, and the relative attractiveness of healthcare platforms, Infosys, in partnership with HFS, reached out to 100 C-suite healthcare payer executives in US. -
35
Axora
Axora.AI
Axora AI is an intelligent, end-to-end claims engine that blends AI-powered automation with billing expertise - managing everything from eligibility to payment posting. But it’s more than automation. Axora AI prevents denials before they happen, adapts to payer rule changes, and prioritizes what matters - so you recover more revenue with less effort. 1. Manages your full claims cycle from start to finish 2. Flags denial risks before submission 3. Prioritizes actions that improve cash flow 4. Seamlessly fits into your EHR, payer, and finance systems 5. No migrations. No disruption. Just faster, cleaner paymentsStarting Price: $30/month -
36
SHP for Skilled Nursing
Strategic Healthcare Programs
A better way to improve your care and gain referrals. With Value-Based Purchasing (VBP) and the new PDPM model, it is now more important than ever to have access to actionable, real-time SNF performance data that helps to: Improve readmissions, quality of care and outcomes, Demonstrate value to referral partners and payers, Better manage high-risk residents and resource usage, Successfully navigate PDPM and VBP. SHP for Skilled Nursing is a web-based performance improvement program that enables you to proactively manage your readmissions, functional outcomes, staff resources, and helps you to improve your referral partnerships and payer relationships. Strategic Healthcare Programs improves quality and optimizes performance of home health agencies, hospices, skilled nursing facilities and hospitals by providing real-time actionable analytics, benchmarks and dashboards. -
37
Net Health Occupational Medicine
Net Health
Net Health® Occupational Medicine serves the spectrum of major hospital programs to independent clinics. We are the only certified EHR, and fully integrated practice management software designed to meet the needs of both independent and hospital-owned Occupational Medicine programs. Rely on integrated telehealth technology to provide care in any location conquering protocols, driving workflow and simplifying multi-payer billing. Manage detailed employer-specific protocols and give employees secure self-service access to reports, records and invoices. Easily manage multiple payers' insurance, employer invoice, workers' compensation to gain total confidence in your documentation and hone in on your revenue strategy. -
38
Amazing Charts Practice Management
Amazing Charts
Amazing Charts Practice Management is a comprehensive solution designed to streamline administrative tasks and enhance the efficiency of independent medical practices. Developed by a practicing physician, this system automates processes such as capturing patient demographics, scheduling appointments, pre-registering patients with insurance eligibility checks, and generating analytical reports. It also determines patient financial responsibilities at the point of care, maintains insurance payer lists, and ensures prompt and accurate billing to assist in payment collection efforts. Key features include the ability to view unpaid claims to ensure timely resolution, a claims manager who reviews submissions to reduce denials, and an integrated secure connect clearinghouse for high-level support and quick responses to payer changes. The system offers intelligent, interactive role-based dashboards that automatically prioritize work lists across all office areas.Starting Price: $229 per month -
39
CureMD Dermatology EHR
CureMD
CureMD is an award-winning provider of specialty EHR and billing services to help optimize efficiency, decrease cost, and enhance the patient experience. Our cloud platform enables the seamless exchange of information across multiple platforms, systems, and organizations - driving greater collaboration, productivity, and patient safety. At CureMD, we believe healthcare providers deserve technology that lets them focus on patient care rather than administrative tasks. So, we created it. Designed by dermatologists, our new, streamlined dermatology electronic health record (EHR) helps you document faster, easily meet quality program requirements, and remove distractions that get in the way of care. Integrated Practice Management enhances productivity and ensures the financial stability of practices - connecting thousands of pharmacies, labs, hospitals, radiology, payers, patients and other providers. -
40
Cohere PaaS Intelligent Prior Authorization
Cohere Health
Cohere helps health plans digitize the process and apply clinical intelligence to enable in-house, end-to-end automation of prior authorization. Health plans can directly license Cohere’s PaaS intelligent prior authorization for use by the plan’s internal utilization management staff. As a result, our client health plans achieve both significant administrative efficiencies and faster, better patient outcomes. Cohere delivers a tailored, modular, and configurable solution suite for health plans. Digitizes all prior authorization requests into a single automated workflow. Automates prior authorization decisions using health plan-preferred policies and accelerates manual review. Helps clinical reviewers adjudicate complex requests, using responsible AI/ML and automated capabilities. Leverages clinical intelligence with AI/ML and advanced analytics to improve utilization management performance. Improves patient and population outcomes with innovative, specialty-specific programs. -
41
MMIT
MMIT
MMIT (Managed Markets Insight & Technology) offers a comprehensive healthcare market access and analytics platform that centralizes high-value coverage, policy, restriction, payer, and real-world data to help life sciences and healthcare organizations understand and act on how therapies are covered, reimbursed, and accessed across the U.S. healthcare system. The MMIT Platform serves as a single point of entry where users can explore integrated solutions, including formulary, medical policy, and restriction intelligence, payer landscape and enrollment data, coverage search tools, API access, and analytics, organized by workflow and strategic priority to support commercialization, competitive analysis, and patient access strategy. It provides detailed insights into drug coverage status, restriction rules, payer behavior, and market segmentation, with features that help evaluate patient access barriers, inform field engagement, predict policy shifts, and integrate coverage data. -
42
Inovalon Insurance Discovery
Inovalon
Insurance Discovery reduces uncompensated care and underpayments by identifying active billable coverage previously unknown to the provider. Using sophisticated search capabilities, this solution identifies if patients have multiple active payers to help boost reimbursement opportunities. Prevent reimbursement delays and increase the speed of revenue capture by sending claims to the right payers on the first submission, enabled by more accurate coverage information. Run Insurance Discovery with verified patient demographic data to get accurate coverage and eligibility information. Replace manual insurance discovery methods with one quick, comprehensive search that inquires numerous databases in seconds to deliver detailed, accurate coverage information. Improve the patient/resident experience and estimate accurate out-of-pocket costs to improve their financial experience. -
43
SE Healthcare Patient Experience Platform
SE Healthcare
The Patient Experience Platform is a specialty-specific survey tool that collects data directly from your patients and provides your practice with credible, reliable insights into the patient experience. These insights, displayed in an easy-to-navigate dashboard, provide a window into the health of your practice, from the patient’s perspective. These insights allow your practice to improve performance, increase patient retention, and generate higher revenue. Five-star reputation tool that provides transparency into the quality of your providers to help convert website visitors into patients. Free text comments that provide greater depth to the feedback you receive from your patients. Real-time, actionable metrics so you can move forward immediately on insights. Location and physician benchmarking. Measurement of physician, office staff, and practice performance. Enhancing your value story to enhance negotiation with payers. -
44
Tax1099.com
Zenwork
Easily create, verify, and file your 1099 MISC forms and more with the Federal & State compliant e-filing platform - Tax1099. Trusted by 100,000+ businesses. Join us today! Access all your payers or companies in one place. File any type of form for any payer from your account. Simply create multiple payer profiles, or import your data to get started. Avoid time-consuming compliance procedures with our guided notice management tool. The in-built notice management dashboard allows you to organize your communications with the IRS and other involved parties. Protect confidential information with our 256-bit bank-grade security features. Disable unauthorized access to your data with two-factor authentication. Add users and assign authority to select users. Restrict or permit users from viewing all the data on your account. -
45
PayerVault
Corplustech
PayerVault empowers entrepreneurs and businesses of all sizes to launch and scale their online ventures effortlessly. We provide a user-friendly platform with everything you need to thrive in the e-commerce world. Its Features: Effortless Website Builder: No coding skills required! Design and customize your beautiful online store with our drag-and-drop website builder. Integrated Payment Processing: Accept all major payment methods securely with PayerVault. Manage payouts, transactions, and fees efficiently. Simplified Delivery Management: Seamlessly integrate with popular delivery partners or choose self-fulfillment options within PayerVault. Track your packages and keep customers informed. Comprehensive KYC Suite: Verify your customers quickly and securely using PAN Card, Aadhaar Card, Bank Account details, Driving License, and more. Build trust and prevent fraud. Actionable Analytics: Gain valuable insights into your business performance with detailed reports on sales, custoStarting Price: 4.9% per transaction -
46
RCM Cloud
Medsphere Systems Corporation
The RCM Cloud® “software as a service” (SaaS) model strives to replace resource-intensive medical billing processes with digital solutions that reduce manual processes and optimize workflow thru automation. This approach significantly improves operational efficiency and further allows the business to expand service delivery capacity with only minor increases in administrative staff. Leverage your investment in technology to grow and sustain your business as opposed to increasing the headcount necessary to expand. On the administrative side, RCM Cloud® and associated services are delivered via the powerful, proven and secure medsphere cloud services platform. RCM Cloud® modules include patient/resource scheduling, enterprise registration, in-stream payer eligibility checking, contract management, medical records, billing, claims, payer and self-pay collections, POS payment posting and bad debt which enable all types of healthcare entities to truly transform their revenue cycles. -
47
HHAeXchange
HHAeXchange
HHAeXchange connects the dots between payers and providers for improved patient outcomes. Grow your business, streamline workflows, and improve patient outcomes with our enterprise homecare management software. HHAeXchange’s comprehensive homecare provider platform offers an enterprise solution for all of your agency’s needs, from referral and intake management to scheduling, billing, and compliance. Our easy-to-use system is designed specifically for Medicaid Managed Care, Commercial LTC, Consumer Directed, and Private Pay services. We are the industry leader in connecting providers and payers for successful communications, collecting confirmed visits, creating claims, and providing workflow efficiency tools to help providers optimize their operations and grow their business. -
48
Claim Agent
EMCsoft
EMCsoft’s Claims Management Ecosystem assures that healthcare providers and billing companies deliver clean claims to insurance payers for proper claim adjudication. It is the integration of our versatile claims processing software Claim Agent and comprehensive fitting process called the Four Step Methodology into your claim adjudication process. This approach enables, supports, and automates your work process to maximize claim reimbursement. Request our free online demo for a great introduction into the functionality/features of Claim Agent and how it fits into your claim adjudication process. Claim Agent scrubs and processes your claims from the provider system to the insurance payers in a efficient, cost effective, and timely manner. The software is compatible with any system making implementation process quick and simple. We provide custom edits, bridge routines, payer lists, and work flow settings that are unique to each user. -
49
EchoOneApp
HealthStream
EchoOneApp is a legacy platform supported by HealthStream. New customers should check out CredentialStream. As a current customer with EchoOneApp, you can take advantage of additional modules that will further optimize your platform and processes. These are just a few of the additional tools available to you. Contact your sales representative for more information or to discuss a migration to CredentialStream platform! Enrolling providers with payers, networks, and in contracts has never been more important. Meeting deadlines for enrollment applications and providing accurate provider data is critical to ensure that providers will be enrolled with the requested payers to receive reimbursements. Submit paper and online payer applications with validated provider data directly from EchoOneApp Enroll. Automate the enrollment process with the most advanced tools in the industry to reduce enrollment timelines and aging receivables. -
50
Inovalon Payer Cloud
Inovalon
Improve clinical quality metrics, risk score accuracy, patient and provider engagement, patient outcomes, operational transparency, and economic performance, all with one comprehensive suite of software solutions. The Inovalon Payer Cloud transforms traditional workflows into data-driven processes that support your health plan’s key objectives. Backed by industry-leading analytics capabilities, our converged SaaS solutions deliver the member-centric insights and speed, accuracy, and flexibility you need to stay ahead in this diverse, ever-changing marketplace. Inovalon's SaaS suite of healthcare payer solutions delivers member-centric insights and actions to help health plans measure, manage, and improve healthcare outcomes, economics, and quality of care. Payer solutions to improve member care and outcomes while achieving greater operational performance and efficiency with sophisticated analytics and dynamic business intelligence.
