Top Garner Alternatives

To support the health of both patients and healthcare providers, independent practices need all-encompassing solutions. Tebra's product lineup is meticulously crafted to improve and simplify the overall experience for both patients and practices, functioning as a cohesive operating system when brought together on a single platform that serves the interests of both parties. Through the use of this interconnected system, practices can successfully draw in new patients while also keeping their current clientele engaged by boosting their online presence. Additionally, patients are supported at every interaction, creating a fluid experience that builds trust and fosters a more robust practice environment. Included in this comprehensive suite is an advanced, certified EHR solution specifically designed to address the needs of modern healthcare providers, offering critical functionalities like sophisticated charting, streamlined documentation, a complete overview of patient records, electronic prescriptions, laboratory integrations, telehealth options, and more, allowing providers to maintain oversight of their care delivery practices. With these cutting-edge resources available, practices are positioned to flourish in an increasingly challenging healthcare environment, ensuring they can adapt and meet evolving patient needs. As a result, the combination of technology and patient-centered care can lead to improved outcomes and operational efficiency.

Genius Avenue energizes the insurance sector by providing cutting-edge platform solutions and tailored features that link products directly to consumers, enhancing profitability. Insurance Carriers Partner with a dedicated team of insurance experts to transcend traditional software solutions. Voluntary Benefits Utilize fully customizable features that enhance operational efficiency and boost sales performance. Brokers Access payroll benefits while simplifying both enrollment processes and administration tasks. Captives Carriers Replace obsolete systems and improve the enrollment experience for all stakeholders. We support our partners in broadening their market reach, streamlining enrollment processes, refining administrative functions, and realizing the complete capabilities of customer-focused, digital platforms. Additionally, our commitment to innovation ensures that our solutions remain adaptable to the evolving needs of the insurance landscape.

Benefitexpress, established by a team of benefits specialists, provides top-tier cloud-based software, solutions, and services for employers, brokers, and various partners. The My Benefit Express™ solution streamlines the complexities of benefits administration, allowing employees to navigate their options more effectively, which in turn fosters greater engagement and satisfaction in the workplace. Our offerings encompass a comprehensive phone support center, seamless ACA administration, reimbursement account management, dependent eligibility audits, and detailed total compensation statements. We prioritize our clients' success through our dedication to innovative problem-solving and adaptable systems, ensuring that their unique needs are met efficiently. Additionally, our commitment to excellence positions us as a trusted partner in the benefits management landscape.

Insurance Discovery improves financial results by identifying previously overlooked billable coverage that healthcare providers might not know about, which reduces both underpayments and uncompensated care. Utilizing sophisticated search capabilities, this tool can uncover situations where patients have multiple active insurance payers, thereby enhancing the potential for better reimbursement. Moreover, it aids in avoiding reimbursement delays and speeds up revenue collection by ensuring that claims are accurately directed to the correct payers on the first submission, attributed to more precise coverage information. When combined with verified demographic data, Insurance Discovery offers dependable insights into coverage and eligibility. This innovative method replaces conventional manual insurance discovery processes with a rapid and exhaustive search that accesses numerous databases within seconds, providing comprehensive and precise coverage details. Additionally, it improves the overall experience for patients and residents by allowing for accurate assessments of out-of-pocket costs, leading to a more positive financial journey. By simplifying these procedures, healthcare providers can devote more attention to patient care rather than getting bogged down by administrative duties, ultimately enriching the quality of service delivered.

eHealthApp empowers brokers and consultants to differentiate themselves by seamlessly gathering health information. This collected data enables brokers to secure health underwritten quotes and assess it to identify the most suitable options for their group clients. In addition, TPAs, GAs, and carriers can support eHealthApp brokers in a manner that fosters collaboration rather than competition, enhances the precision of underwriting, and broadens product availability. Reach out to us now to schedule a demonstration and discover more about the capabilities of eHealthApp. We look forward to helping you enhance your services.

Optimize your business processes while putting your team's well-being at the forefront. With Alan, you can remove the burden of paperwork and complications, making it easier to meet your requirements without needing specialized expertise. Discover a health insurance solution that significantly reduces time investment, complete with a clear proposal and a user-friendly benefits table, all accessible online for your employees 24/7. Bid farewell to the cumbersome task of handling physical paperwork and the intricate processes involved in onboarding and offboarding, as everything is managed effortlessly through your smartphone or computer. Additionally, Alan's insurance is fully accredited by the ACPR Banque de France and supported by esteemed reinsurers such as CNP and SwissRe, providing all-encompassing employee protection on a single platform, with no strings attached. Alan Green offers health insurance that provides solid coverage without escalating your expenses, while Alan Blue guarantees excellent reimbursements for any healthcare provider your employees select. Furthermore, Alan Foresight presents provident insurance that protects your employees against unexpected hardships like long-term illness or disability, ensuring they receive essential support during challenging times. With Alan, enhancing your operations and prioritizing employee welfare has never been more straightforward, paving the way for a healthier workplace environment.

Cutting-edge Health Reimbursement Arrangements (HRAs) simplify the process of providing health insurance, giving you both peace of mind and ease of use. Say farewell to the challenges posed by conventional group plans. To get started, just answer a few questions about how you envision your HRA functioning. You can feel confident knowing that our platform will support you throughout the entire process, enabling you to customize your plan to align with your specific requirements. Once your HRA is designed, we will take care of all necessary legal matters and ensure a smooth integration for your employees into our system. After everything is configured, our team will help you effectively manage the claims process. Every day, we dedicate ourselves to creating a healthcare environment that emphasizes your comfort, as we truly believe that a simpler health insurance approach is a right for everyone. By focusing on transparency and simplicity, we strive to significantly improve your overall experience with health benefits while making the process as seamless as possible. Your satisfaction and well-being are at the forefront of our mission, and we are here to support you in navigating the world of healthcare.

Ease, which was previously known as EaseCentral, is a tech-driven platform designed to enhance the services offered by insurance brokers to small and medium-sized business clients. This innovative solution simplifies the process of setting up and managing employee benefits while streamlining the onboarding process for new hires. Furthermore, it helps maintain compliance and provides employees with a centralized location for all their human resources information. Currently, over 70,000 small and medium-sized enterprises utilize Ease for their benefits and HR needs, showcasing its widespread adoption and effectiveness in the industry. Its user-friendly interface and comprehensive features make it a valuable tool for both brokers and their clients.

Healthcare.gov has streamlined the enrollment process for HealthSherpa, allowing for easier access to Affordable Care Act plans. Our collaboration with a diverse range of stakeholders—including employers, insurers, agents, nonprofits, and consumers—aims to maximize enrollment in these comprehensive health plans that qualify for subsidies. We also enhance the functionality of insurance companies' websites, facilitating the enrollment of individuals into Affordable Care Act options. By providing advanced enrollment technology along with a CRM and communication tools, we empower insurance agents to efficiently connect clients with appropriate plans that meet their needs. Currently, over 40,000 agents utilize our platform to enhance their enrollment efforts. In addition, we equip consumers with decision support tools to guide them in selecting the best plan for their healthcare requirements. With more than 5,000,000 consumers successfully enrolled in coverage, HealthSherpa ensures access to the same plans, pricing, and benefits available through HealthCare.gov, reinforcing our commitment to affordable healthcare access for all. This comprehensive approach not only simplifies enrollment but also supports informed decision-making for individuals navigating their healthcare options.

Optimize revenue cycle management, ensure high-quality care oversight, and enhance workforce efficiency through a comprehensive, intuitive portal that offers single sign-on functionality. More than 47,000 provider locations leverage our innovative solutions to simplify the intricacies of the patient care journey. Revolutionize the financial experience for patients while reducing administrative and clinical burdens with the Inovalon Provider Cloud, which integrates various workflows into a cohesive system. Our Software as a Service (SaaS) solutions are tailored to improve both financial outcomes and clinical results throughout the patient's experience, enabling streamlined revenue cycle operations for better reimbursement and maintaining adequate staffing levels for superior care quality. This integrated portal empowers your organization to enhance its overall performance, increasing revenue, employee satisfaction, and standards of care. By improving operational efficiency, productivity, and overall effectiveness, you can realize the maximum potential of your organization. Discover the transformative features of the Provider Cloud today, and watch your organization thrive.

An all-encompassing strategy for workforce wellness starts with a Health OS™. This robust health benefits platform empowers organizations to efficiently control expenses, boost utilization rates, and place employee well-being at the forefront. We aim to motivate individuals to pursue healthier and more rewarding lives each day. By fostering exceptional user engagement, we provide valuable insights into workforce health, which supports the development of risk management plans, anticipates healthcare expenses, assesses productivity trends, and designs return-to-work programs. Moreover, our customized concierge services, along with a multifunctional digital wallet, make it easier for employees to discover, understand, and access their health and benefit offerings, including telemedicine and Employee Assistance Programs (EAPs). Our qualified healthcare professionals are available to provide immediate, confidential assistance for both physical and mental health challenges, guaranteeing that support is always within reach. In addition, employees have access to a wealth of virtual resources, such as evidence-based programs and counseling services, to further promote their overall health and well-being, creating a more comprehensive support system. Ultimately, this holistic approach not only benefits individual employees but also strengthens the entire organization's culture of health.

Enter revolutionizes the payment process for healthcare providers, ensuring they receive reimbursements faster than any other company in history. By processing insurance claims and disbursing payments within a mere 24 hours, Enter enhances efficiency and streamlines communication with patients regarding their financial responsibilities through an advanced white-label collection system that accommodates payment plans. This innovative approach makes Enter 30 times more effective at securing claim payments and 45 times faster at billing patients, all while maintaining costs comparable to traditional medical billing services. Over the course of a single year, Enter successfully managed over $150 million in claims, demonstrating its impactful presence in the healthcare financial landscape. Additionally, providers have the advantage of accessing a substantial $100 million credit facility, further supporting their operational needs. Partnered with United Healthcare Nevada for revenue cycle management, Enter caters to a diverse array of specialties, including Ambulatory Surgery Centers (ASC), Orthopedics, Neurology, Dermatology, Emergency Rooms, Behavioral Healthcare, Pain Management, and many others. The company collaborates seamlessly with all government and commercial health insurance carriers and ensures compatibility with all EMR and practice management systems, eliminating both monthly and integration fees. Backed by venture funding, Enter is poised for continued growth and innovation in the healthcare industry.

HealthRules® Payer is a state-of-the-art core administrative processing framework that delivers transformative capabilities for health plans of all shapes and sizes. For more than ten years, health plans that have adopted HealthRules Payer have successfully seized market opportunities and sustained a competitive advantage. What distinguishes HealthRules Payer from other core administrative systems is its unique utilization of the patented HealthRules Language™, which closely resembles English and introduces an innovative approach to configuration, claims management, and transparency of information. This exceptional system empowers health plans to grow, innovate, and excel beyond their competitors more efficiently than any other core solution currently available. Consequently, HealthRules Payer not only enhances operational efficiency but also cultivates a culture of adaptability and responsiveness within health organizations, ultimately leading to improved patient care and satisfaction. By integrating advanced tools and methodologies, HealthRules Payer positions health plans to thrive in an ever-evolving healthcare landscape.

Reimbursify emerges as the first-of-its-kind mobile-driven software platform that revolutionizes the way patients, healthcare professionals, and digital partners manage out-of-network reimbursement claims for medical and mental health services. This cutting-edge application transforms the experience of submitting out-of-network (OON) reimbursement claims to health insurance providers, ensuring a quick and straightforward process that helps users reclaim every dollar owed to them. Featuring a user-friendly registration process tailored for primary insured individuals, spouses, and dependents, the platform includes an intelligent dashboard that organizes claims and tracks expected reimbursements. Moreover, it has an innovative Rejection Resolution Pathway that swiftly deals with any claim denials, alongside a provider search function that automatically populates necessary provider information to enhance user convenience. In addition to streamlining the reimbursement process, Reimbursify significantly improves the overall experience for users, solidifying its position as an essential resource for anyone facing the intricacies of healthcare claims. As a result, it not only saves time but also empowers users to take control of their financial interactions with health insurance providers.

I-underwrite provides exceptional auto-underwriting solutions tailored for the insurance industry. Our comprehensive suite of software modules enables a seamless, online insurance sales experience, encompassing everything from needs analysis and quoting to digital signatures, auto-underwriting, and both upselling and cross-selling opportunities, along with offer acceptance, payment processing, and detailed reporting functionalities. At the heart of our digital insurance platform lies our robust auto-underwriting rules engine, which is designed for effortless configuration of underwriting rules. This allows for automatic decision-making on various products, including life, critical illness, disability, income protection, and medical insurance, catering to the specific requirements of any insurer. Furthermore, our rules engine can function as a standalone module for integration into an insurer's existing environment or as part of a Software-as-a-Service (SaaS) setup, ensuring flexibility and ease of use. You can conveniently access the i-underwrite underwriting engine through any electronic distribution channel, making it a versatile choice for modern insurance operations. Ultimately, our goal is to streamline the underwriting process and enhance the overall efficiency of insurance sales.

Collective Health distinguishes itself as the first comprehensive solution that empowers self-funded employers to effectively manage their plans, monitor costs, and prioritize employee wellness, all accessible through a unified platform. We invite you to explore how our customized programs, efficient administration, and smart member interactions enhance the benefits we offer. Catering to a wide range of clients, from scientists and truck drivers to musicians, we take pride in being recognized for having the most satisfied clients and members within the health insurance industry. Discover why numerous top self-funded employers across the country choose Collective Health as their partner. For brokers and consultants looking to elevate their clients' healthcare strategies, Collective Health provides an efficient technological solution that enhances employee healthcare experiences for everyone involved. With nearly 250,000 members and a diverse client roster exceeding 50—including prominent companies such as Driscoll’s, Pinterest, Red Bull, Restoration Hardware (RH), and Zendesk—Collective Health is transforming the healthcare experience for forward-thinking organizations. By emphasizing integration and member contentment, we are committed to redefining the landscape of health insurance for the better. Together, we envision a future where healthcare is seamlessly integrated into the employee experience, creating a healthier workforce overall.

American companies often experience a loss of approximately eight workdays per year for each employee who is a parent, primarily due to childcare gaps. Implementing supportive family policies can greatly reduce employee turnover; studies reveal that 49% of highly skilled women leave the workforce after becoming mothers, while 69% express a desire to stay employed if given additional resources. Mothers tend to handle household responsibilities nearly 1.9 times more than fathers, even in dual-income families, resulting in heightened stress levels and fatigue. Furthermore, both employers and families have the potential to lower childcare expenses by up to 60% compared to traditional methods. We offer complimentary events, support groups, and family-centric activities aimed at cultivating a positive work environment and encouraging employee engagement. Take a look at our selection of free introductory events tailored for your team. By collaborating with us, you gain access to thousands of pre-screened caregivers in major North American cities, ensuring that your employees receive the necessary support to excel both professionally and personally. Utilizing these resources not only aids families but also fosters a more efficient and content workforce, ultimately enhancing overall productivity and morale within the organization. Investing in family-oriented policies lays the groundwork for a thriving workplace where both employees and their families can flourish.

Your workforce can take advantage of various health and wellness perks, including personalized counseling sessions, virtual GP consultations, discounted grocery options, and much more. We aim to assist your business in every possible way. For Sage customers, the Sage Employee Benefits will be complimentary for the initial two months, allowing you and your team to access services like OnDemand GPs, rewards programs, and additional health and wellness resources that are typically reserved for larger organizations. In these challenging times, we believe everyone deserves to gain more from their work experience. Sage Employee Benefits is designed to empower business leaders just like you, providing essential support. This service can seamlessly integrate with any Sage solution or be acquired independently, making it particularly suitable for small and medium enterprises. It serves as a valuable tool for demonstrating appreciation and enhancing employee motivation, ultimately fostering a positive work environment that encourages growth and satisfaction.

Enhance the management of COBRA and tax-advantaged benefits with our flexible program design and personalized support services. By implementing our solutions, you can cut costs while ensuring that vital benefits remain accessible to employees, whether through a traditional HSA or our cutting-edge HSA On Demand® option. Our COBRA Administration Services guarantee that employees retain their insurance coverage seamlessly, providing them with security and confidence. Promote a consumer-focused healthcare model by offering various options like Health Care FSAs, Limited Purpose FSAs, and Dependent Care FSAs. Boost employee well-being through corporate initiatives that cover Health & Wellness, Adoption, and Education reimbursement. Introduce a Health Reimbursement Arrangement (HRA) to improve oversight of covered expenses while catering to employee needs. Furthermore, our Commuter Benefits program allows employees to use pre-tax funds for eligible transit and parking costs, increasing their financial adaptability. This all-encompassing array of services not only aids employees but also cultivates a culture of wellness and accountability throughout the organization, ultimately enhancing overall employee satisfaction and engagement.

Empower your workforce by providing them with the opportunity to choose benefits that genuinely resonate with their needs. With an intuitive platform that employees love, the burdensome tasks are managed efficiently, offering ease without incurring extra costs. Deliver customized, top-notch benefits that align with the fundamental principles of your organization. This comprehensive platform serves both pre-tax and post-tax spending accounts, while also keeping you updated on budget management, usage metrics, and claims handling. Historically, numerous well-intentioned businesses have complicated their benefits packages, leading to confusion and a lack of appreciation among staff; however, Forma has developed an exceptional alternative. Elevate your benefits offerings to be as attractive as possible, all while optimizing your financial resources. Bid farewell to the hassle of juggling multiple vendors and the extensive time investment it requires. Experience unmatched flexibility, empowering employees to select benefits that personally resonate with them. Cultivate customer loyalty while remaining responsive to shifting best practices. Forma is committed to creating customizable, inclusive, and globally relevant benefits programs tailored to meet the varied requirements of every employee, ultimately transforming the workplace into a more engaging and supportive space. By prioritizing employee choice and satisfaction, organizations can foster a culture of well-being and productivity.

Established in 1981, ASC has been at the forefront of providing innovative and cost-effective retirement plan systems aimed at enhancing your edge in a competitive market. Our offerings are designed with input from experienced professionals in the retirement industry, ensuring they meet your specific needs. By incorporating automated data integration, our solutions not only enhance operational efficiency but also improve profitability. We offer in-house installation services as well as Cloud Platforms to accommodate a variety of client requirements. Utilizing the latest technology, our systems simplify the processes of document creation and management, enabling you to focus on reaching your goals, serving your clientele, and advancing your business. Additionally, ASC provides tailored software, documentation, training, and support aimed at third-party administrators and retirement plan professionals. Our ability to handle unlimited plan sizes makes us an ideal choice for both large enterprises and smaller companies. Impressively, approximately half of all 401(k) participant accounts are managed through ASC systems, highlighting our significant role in the industry. Furthermore, our dedication to continual innovation and exceptional service solidifies our position as a leading provider of retirement plan solutions. We remain committed to adapting our offerings to meet the evolving needs of our clients.

Anagram Prosper allows your practice to return funds to patients at no cost, thus improving your profit margins while fostering patient satisfaction and removing the necessity for courtesy discounts. We have partnered with leading vendors to establish wholesale pricing that serves both your interests and those of your patients. This arrangement enables you to provide rebates on items already in your inventory, which motivates your patients to participate more actively, ultimately resulting in higher revenue. By leveraging Anagram Prosper, you can assist your patients in saving money without affecting your margins or resorting to discounts. Our rebate initiative is crafted to enhance your sales while ensuring patient happiness. Many patients may not realize their out-of-network benefits, but with Anagram Access, you can quickly check real-time eligibility for vision plans, guaranteeing optimal savings for them. Anagram Access empowers you to easily ascertain your patient's financial obligations and the reimbursement they can expect from their vision plan, simplifying the payment process. This groundbreaking strategy not only benefits your practice but also significantly enriches the overall experience for your patients, leading to a stronger relationship between them and your practice. By prioritizing their needs, you can create a loyal patient base that appreciates both the value and service you provide.

AgentSync develops contemporary insurance infrastructure aimed at simplifying complexities and enhancing efficiencies in managing producers and ensuring compliance. By refining your processes for broker onboarding, contracting, licensing, appointing, and compliance, AgentSync’s user-focused design, integrated APIs, automation features, and exceptional customer support help you expand your business, deliver a remarkable experience to producers, and avoid regulatory infractions. The cornerstone of AgentSync’s offerings, Manage, helps to minimize compliance-related expenses and proactively averts regulatory issues. This tool streamlines the often cumbersome administrative tasks involved in confirming that agents possess the necessary appointments and state licenses for selling insurance. Through the automation of these functions, AgentSync significantly alleviates the intricacies associated with the insurance sales process, allowing businesses to operate more smoothly.

Enrollify presents a scalable and intuitive project management platform specifically designed for the employee benefits industry. This innovative tool aims to enhance corporate narratives, increase employee engagement, and deliver impartial decision-making support with remarkable efficiency. It is compatible with all devices, whether desktops, laptops, tablets, or smartphones. Featuring flexible scheduling options, the system adeptly connects appointments with licensed counselors based on their location, language skills, and availability. This comprehensive platform facilitates smooth communication, scheduling, and task execution. By integrating engagement strategies with access to real-time performance metrics, it turns strategic initiatives into quantifiable results. Our goal is to empower our partners with the essential resources to exceed expectations, even in the most complex enrollment situations. Enrollify is distinguished as the leading all-in-one platform committed to providing compassionate and impartial decision support at scale, ensuring that every user receives the guidance they require. Ultimately, our dedication to innovation and user satisfaction sets us apart in the industry.

Samedi is a cutting-edge web-based platform aimed at improving patient coordination while effectively minimizing costs and enhancing service quality. This secure tool is versatile and can be utilized across various healthcare environments, such as medical offices, clinics, and surgical facilities. Through its robust resource planning, efficient process management, online appointment scheduling, and task delegation, the software optimizes workflow efficiency. The incorporation of video consultations and digital forms further streamlines processes, ensuring high standards of data protection are maintained. Acting as a comprehensive e-health software solution for healthcare providers, clinics, and insurers, Samedi effectively connects the healthcare ecosystem and refines operational procedures. With a strong emphasis on user-friendliness, efficiency, and security, our extensive 12 years of experience in the e-health industry allows us to meet a wide range of client needs, offering customizable solutions for both simple and intricate workflow requirements. Additionally, our software is designed to integrate smoothly with almost all practice and clinic management systems, making for a seamless operational experience. This flexibility not only boosts productivity but also ultimately leads to improved outcomes for patients, solidifying Samedi's role as a leader in healthcare technology. With an eye towards continuous improvement, we remain committed to adapting our services to meet the evolving demands of the healthcare landscape.

We capitalize on our keen understanding of potential affinity products along with exceptional digital skills and market execution to aid insurers in rapidly entering new markets. CareVoiceOS is the first healthcare operating system tailored specifically for insurers, creating an ecosystem that improves member experiences and encourages positive behaviors. Our solution offers insurers a cohesive ecosystem that emphasizes the design of personalized digital journeys for their insurance members, thereby allowing insurers to play a vital role in their members' everyday lives. We assist insurers in cutting costs, enhancing member satisfaction, and driving both sales growth and renewal rates. By facilitating the creation of innovative health insurance products aimed at previously untapped market segments, we enable you to engage, inform, and convert customers that were once unreachable. Through thorough market research and validation of product prototypes, we guarantee that our solutions effectively cater to the needs of these new customer segments. This strategic methodology not only boosts operational efficiency but also fosters long-term growth in a landscape that is becoming increasingly competitive. Furthermore, by aligning our strategies with the evolving needs of the market, we ensure that insurers remain at the forefront of industry innovation.

AUSIS – Comprehensive Behavioral Underwriting AUSIS equips insurance providers with the ability to perform in-depth underwriting, scoring, and decision-making almost instantaneously. By implementing AUSIS, companies can significantly lower their expenses, time requirements, risk exposure, and instances of fraud, all while enhancing efficiency and decision-making through innovative alternative scoring techniques and added functionalities. Additionally, AUSIS improves the straight-through processing (STP) rate as compared to non-straight-through processing (NSTP) and facilitates non-invasive health data gathering from a multitude of sources, including air quality indexes (AQI), geographic locations, mortality rates, social determinants, multimedia content, health monitoring devices, weather patterns, sanitation conditions, and beyond. As a result of using AUSIS, insurance organizations may see up to a 40% reduction in costs tied to policy issuance. This groundbreaking solution not only optimizes the underwriting workflow but also offers critical insights that can enhance risk assessment and management strategies. The integration of such comprehensive data enhances the overall effectiveness of the insurance process.

Claims adjudication services encompass a variety of sectors such as medical, dental, vision, and prescription claims, along with both short and long-term disability cases. These services can be accessed on-site with a license or through a hosted application model (ASP). Powered by Microsoft technology, the system employs an SQLServer database and a Windows front end for optimal performance. Our customer service team is highly esteemed, comprised of healthcare claims experts with at least 12 years of experience in the industry. Every support request is documented, allowing clients to track their status online. The system includes a plan copy and modification feature that enables quick implementation of changes. Auto-adjudication is facilitated through benefit codes built on business rules that take into account over 25 variables related to both claims and claimants, all processed by the adjudication engine. Submissions can be made in various formats, including scanned images, EDI, or traditional paper submissions. The system adheres to HIPAA EDI 5010 transaction sets, guaranteeing secure and efficient processing. Furthermore, re-pricing fees and UCR schedules can be entered into the system ahead of their effective dates, while the date-driven logic ensures re-pricing is executed based on the service date, enhancing the overall workflow of claims processing. This comprehensive solution not only streamlines claims management but also significantly improves client satisfaction and operational efficiency.

Curacel's innovative platform, powered by artificial intelligence, enables insurance companies to monitor fraudulent activities and streamline claim processing with efficiency. It simplifies the collection of claims from providers while offering automatic verification capabilities. Through Curacel Detection, insurers can effectively pinpoint and mitigate instances of fraud, waste, and abuse throughout the claims process. By gathering claims from providers, the system actively works to prevent any potential losses due to these issues. Our analysis of the Health Insurance sector revealed that significant value loss often occurs during the claims process, which remains largely manual and vulnerable to various forms of exploitation. The implementation of our AI-enhanced solution significantly minimizes waste, enhances efficiency for insurers, and reveals previously obscured value opportunities. Ravel insurance distinguishes itself by offering on-demand policies that provide coverage for short durations, catering to the needs of policyholders and insured parties alike, both of whom seek prompt and precise claim resolutions. By focusing on speed and accuracy, Ravel ensures a smoother experience for all involved.

Filing claims is often a complex yet vital task that many people, more than 60%, choose to avoid due to its convoluted nature and the significant time it demands. Artivatic has developed a tailored claims platform that addresses the needs of various insurance sectors, allowing companies to provide a seamless digital claims experience, facilitate self-processing, automate assessments, and improve the detection of risks and fraud while also managing claims payments. This innovative platform is designed to meet all your claims-related needs, delivering a fully automated and thorough evaluation process. Whether you're dealing with auto, health, travel, accidental, death, fire, SME, business, or commercial claims, this solution ensures comprehensive coverage. By simplifying the claims mechanism, Artivatic seeks to boost operational efficiency and enhance overall customer satisfaction, paving the way for a more user-friendly experience in the insurance landscape. With such advancements, the future of claims processing looks significantly brighter.