Top Veradigm Payerpath Alternatives

RXNT has spent over 25 years building cloud-based healthcare software designed for ambulatory practices and medical organizations of all sizes and specialties. Our innovative, AI-powered, and data-backed software solutions help practices grow, improve clinical efficiency, and streamline business operations—whether you're a solo provider, large healthcare organization, or billing services company. With over 60,000 medical professionals across all 50 U.S. states relying on RXNT, our fully-integrated, ONC-certified software system includes Electronic Health Records (EHR), Physician Practice Management (PPMS), Medical Billing and Revenue Cycle Management (RCM), E-Prescribing (eRx), Scheduling, Patient Portal, mobile applications, and more. Every product works seamlessly as one system or can be used standalone, giving you flexibility to choose what works best for your practice. Our SaaS-based Full Suite software solution integrates every area of RXNT through a secure, centralized database, enabling real-time data flow across clinical and administrative functions. Whether you're modernizing your medical practice or scaling your healthcare business, RXNT delivers all-in-one technology to help you succeed. So far, users have transmitted over 125 million prescriptions and processed more than $7 billion in insurance claims. Built for usability and accessibility, RXNT’s cloud-based software is available 24/7 from any device and includes mobile apps for iOS and Android. Simple, transparent pricing means no hidden fees, and every plan includes free implementation & training periods, data migration, storage, software updates, and U.S.-based customer service.

Office Ally's Service Center is relied upon by over 80,000 healthcare practitioners and service organizations to effectively manage their revenue cycles. The platform offers functionality for verifying patient eligibility and benefits, as well as the ability to submit, amend, and monitor claims statuses online while also facilitating the reception of remittance advice. By supporting standard ANSI formats, data entry, and pipe-delimited formats, Service Center significantly enhances administrative efficiency and optimizes workflows for healthcare providers. Furthermore, this comprehensive tool empowers organizations to focus more on patient care by reducing the time spent on administrative duties.

Accelerate payment procedures while reducing administrative burdens. With a network of over 8,000 payer connections and partnerships with more than 650 practice management providers, our claims management solutions significantly decrease the number of pending claims and lessen the reliance on manual processes. Claims for a wide range of services, such as professional, institutional, dental, and workers' compensation, can be sent efficiently and accurately, ensuring timely reimbursements. Address the changing landscape of healthcare consumerism by providing a seamless and transparent financial experience for patients. Our tools for patient engagement help facilitate informed conversations about eligibility and financial responsibilities, while also minimizing barriers that could negatively impact patient outcomes, ultimately enhancing the overall healthcare experience. By improving transparency and communication, we contribute to a more patient-centered approach in the healthcare industry.

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.

Elevate your claims management approach while minimizing denials through exceptional edits and an outstanding clean claim rate. Healthcare providers must leverage cutting-edge technology to guarantee accurate claim submissions and prompt payments. Claims Director, the innovative claims management platform offered by SSI, streamlines billing processes and enhances transparency by guiding users through the entire electronic claim submission and reconciliation experience. As reimbursement standards from payers evolve, the system diligently monitors these adjustments and modifies its operations accordingly. Additionally, with a wide range of edits at industry, payer, and provider levels, this solution enables organizations to optimize their reimbursement strategies efficiently. By embracing such a robust tool, healthcare systems can witness a remarkable improvement in their financial performance, ensuring sustainability and growth in an increasingly competitive landscape.

Introducing a groundbreaking intelligent medical billing software tailored for various specialties, this innovative tool streamlines the billing process while boosting patient collections for over 75,000 healthcare providers across the country. By eliminating the need for repetitive data entry through its global data capabilities, it simplifies operations significantly. Capable of managing substantial data volumes and complexities, the software's adaptable data structure caters to the unique requirements of different practices and specialties, ensuring faster payment processing. Users can enter payments manually or take advantage of electronic remittance options, while claims undergo automatic error checks to guarantee accuracy. Additionally, the software can refile insurance claims automatically, based on pre-set conditions, enhancing efficiency. Its rapid review functionality enables quick assessment and approval of charges, and users can perform audits based on various metrics such as modality, procedure, insurance type, user, or date of service. An intuitive reporting system offers valuable insights into the financial health of both front-end and back-end billing operations, ensuring that no charge is overlooked. Moreover, the software integrates effortlessly with preferred clearinghouses or statement vendors, making it an adaptable solution for healthcare billing needs. The user-friendly interface, combined with its extensive features, positions this software to revolutionize medical billing practices significantly, promoting efficiency and accuracy in every transaction.

Successful teamwork in patient care relies heavily on ongoing connectivity and access to current information. It is becoming ever more important to facilitate the flow of this information with insurance companies. Availity streamlines the collaboration with payers, assisting providers from the initial step of confirming a patient's eligibility all the way to resolving reimbursements. Healthcare professionals seek quick and easy access to details regarding health plans. With Availity Essentials, a free service supported by health plans, providers can take advantage of real-time data exchanges with many of the payers they regularly interact with. Moreover, Availity offers a premium service called Availity Essentials Pro that is designed to enhance revenue cycle performance, reduce claim denials, and secure patient payments more efficiently. By utilizing Availity as your reliable source for payer information, you can concentrate your efforts on providing high-quality patient care. Their electronic data interchange (EDI) clearinghouse and API solutions allow providers to seamlessly incorporate HIPAA transactions and other vital functions into their practice management systems, leading to improved operational efficiency. This holistic method not only supports healthcare providers in their operational tasks but also reinforces their ultimate goal of prioritizing patient well-being and satisfaction.

Explore a specialized analytics-driven tool crafted for healthcare providers to effectively manage claims and remittances, aiming to refine workflows, optimize resource utilization, decrease denial rates, and improve cash flow. Enhance your initial claim acceptance rates with our comprehensive editing suite that ensures compliance with the latest payer guidelines and regulations. Increase your team's productivity by leveraging intuitive workflows that focus on exceptions while automating repetitive tasks. Your staff can easily access our adaptable, cloud-based platform from any device, promoting uninterrupted operations. Simplify the handling of secondary claims with the automatic generation of secondary claims and explanations of benefits (EOB) derived from primary remittance advice. Utilize predictive artificial intelligence to prioritize claims that need urgent attention, facilitating quicker error resolution and reducing the likelihood of denials before submission. Whether you are processing primary paper claims or organizing claims and EOBs for secondary submissions, you will experience enhanced efficiency in your claims processing. By adopting these innovative features, you can substantially improve your claims management approach and take your practice to the next level. This progressive solution not only streamlines operations but also empowers your team to focus on delivering exceptional patient care.

Silna Health's Care Readiness Platform adeptly handles prior authorizations, benefit verifications, and insurance tracking from the outset, allowing patients to be prepared for care while enabling providers to focus on treatment delivery. Utilizing AI technology, the platform manages the full spectrum of prior authorization workflows, which encompasses tracking upcoming authorizations, dispatching weekly reminders, processing submissions, and performing follow-ups, all while adhering to established industry standards and flagging exceptions that require human oversight. Real-time benefit checks tailored to distinct specialties verify coverage details, accumulation status, authorization requirements, and visit limitations, delivering accurate quotes at the moment of intake. Furthermore, the system continuously monitors insurance to detect lost coverage, identify new plans, and avert eligibility gaps. Engineered to function without the need for additional staffing, Silna seamlessly integrates data from electronic medical records (EMRs) and practice management systems, provides customizable rule sets and strategic frameworks, and includes user-friendly dashboards that reveal insights into incremental revenue opportunities. This all-encompassing methodology not only simplifies various processes but also significantly boosts the financial health of healthcare providers, ultimately leading to improved patient care outcomes. As a result, the platform stands out as a vital tool in modern healthcare management.

By performing thorough evaluations of patients' financial eligibility, reviewing their insurance plans, and detecting any discrepancies, the eligibility checker guarantees a meticulous assessment process. In the event of inaccuracies in the data provided, our sophisticated scrubber employs cutting-edge AI and machine learning technologies to fix problems, such as coding errors and incomplete or erroneous financial information. At present, the software contains an impressive collection of 3.5 million pre-loaded edits to improve its performance. To streamline operations, automatic updates from the clearing house offer real-time insights into the status of outstanding claims. This comprehensive system manages the entire billing cycle, from confirming patient financial information to resolving denied or misplaced claims, and features a strong follow-up system for appeals. Additionally, our intuitive platform proactively notifies users of potential claim denials, allowing for prompt corrective actions, while also efficiently tracking and managing appeals related to any claims that have been lost or rejected. The seamless integration of these capabilities enhances the system's overall efficiency in navigating the complexities of medical billing, leading to improved revenue cycles for healthcare providers. This holistic approach not only maximizes operational effectiveness but also ensures that patients receive timely and accurate billing information.

CureAR is a groundbreaking software solution that utilizes artificial intelligence to optimize medical billing and revenue cycle management for various entities, including in-house billers, billing companies, managed-service providers, and DME firms. This all-encompassing platform merges multiple functionalities such as eligibility checks, charge capture, intelligent coding suggestions, claim scrubbing, electronic claims submission, ERA processing, and automated payment posting into a single cloud-based system. Its flexibility allows for customization based on specific billing regulations across different specialties, and it supports multi-tenant operations, making it particularly suitable for practices that oversee several client accounts. Key Features: AI-enhanced coding support and claim scrubbing: The advanced machine learning algorithms detect potential errors in coding and apply payer-specific validation rules before claims are submitted for processing. Instantaneous claim tracking and alerts: The platform keeps a real-time watch on claims as they move through the submission and adjudication phases, flagging any discrepancies that need urgent attention. Streamlined ERA ingestion and posting: By automating the management of electronic remittance advice through tailored reconciliation workflows, the software significantly reduces manual posting tasks, resulting in enhanced operational efficiency. Furthermore, its intuitive design ensures that all team members can navigate the system with ease, maximizing the utility of its diverse features. In addition, the system's adaptability allows for continuous updates to meet evolving industry standards and practices.

Axora AI functions as a robust claims management platform that merges AI-driven automation with expertise in billing, handling every stage from eligibility checks to the final payment processing. Beyond simple automation, Axora AI is dedicated to proactively reducing the risk of claim denials, adapting to evolving payer regulations, and prioritizing essential tasks, all of which contribute to improved revenue recovery with less labor involved. 1. Manages the entire claims process from start to finish. 2. Detects possible denial challenges before claims are submitted. 3. Concentrates on strategies aimed at enhancing cash flow. 4. Seamlessly integrates with your current EHR, payer, and financial systems. 5. Eliminates the need for migrations or disruptions—resulting in more efficient payment processing. 6. This approach ensures that your organization functions effortlessly while optimizing financial results. 7. By utilizing these features, you can focus on delivering better patient care, knowing that your revenue cycle management is in capable hands.

PLEXIS provides an extensive array of high-quality applications tailored to equip payers with the sophisticated functions necessary for modern core administrative systems. These applications feature capabilities such as real-time benefit management, adjudication, automated EDI transmission, and self-service customer portals, ensuring that PLEXIS Business Apps can fulfill all your requirements. The Passport feature is essential for establishing vital connections between core administration and claims management systems, PLEXIS business applications, custom software, and existing internal systems. Its versatile API layer permits real-time integration with a variety of portals, automated workflow tools, and business applications, guaranteeing limitless connectivity. By utilizing this centralized and contemporary core administration and claims management platform, organizations can significantly enhance their workflows. This strategy not only streamlines the processing of claims but also alleviates the challenges tied to benefit administration, leading to a quick return on investment and the capacity to deliver outstanding customer service. Ultimately, PLEXIS enables organizations to excel in a healthcare environment that is becoming progressively intricate, ensuring they remain competitive and responsive to client needs.

No matter if you function as a standalone reference laboratory, a pathology clinic, an outreach testing facility, or a public health lab, TELCOR RCM billing software provides vital resources to address intricate billing challenges and improve your bottom line. This all-encompassing revenue cycle management system aids in submitting claims, tracking, processing remittances, managing accounts receivable, and handling billing for both patients and clients while supporting multiple NPIs. By utilizing advanced technology, you can minimize the reliance on a large billing team and significantly enhance your revenue cycle's productivity by automating routine tasks like submitting claims and collecting patient data, in addition to producing in-depth financial reports. Furthermore, you can optimize payment processing by automating the handling of electronic payments from payers through 835 ERAs or bank lockbox files, thus removing tedious manual adjudication processes. Enhancing communication regarding billing with patients can also streamline their experience, making payment methods faster and more user-friendly, which ultimately leads to a more efficient revenue cycle. This comprehensive strategy not only boosts operational efficiency but also significantly improves the overall experience for healthcare providers and their patients alike, making it a crucial element in today’s healthcare environment.

Amazing Charts Practice Management delivers a comprehensive solution designed to streamline administrative functions and boost the productivity of independent healthcare facilities. Developed by a physician with practical insights, this platform automates a range of tasks, such as gathering patient data, scheduling appointments, verifying insurance eligibility during pre-registration, and creating in-depth analytical reports. Moreover, it assesses patients' financial responsibilities at the moment of service, maintains an up-to-date roster of insurance providers, and ensures accurate billing to facilitate effective payment collection. Its impressive features include the ability to track unpaid claims for quick resolution, a claims manager that diligently reviews submissions to reduce denials, and a secure integrated clearinghouse that enhances support and allows for rapid adjustments to changes in payer policies. Additionally, the system includes intelligent, interactive dashboards that prioritize tasks for various office roles, enabling all team members to manage their duties efficiently. By optimizing workflows and improving communication, this innovative platform plays a crucial role in enhancing the operational effectiveness of medical practices, ultimately paving the way for better patient care and satisfaction.

Veritable significantly improves the verification of patient insurance eligibility and claim status by providing instant results through an intuitive interface. It supports both real-time and batch processing of patient lists, enabling eligibility checks with over 1,000 payers, including national Medicare and state Medicaid, across different service categories. Additionally, it allows users to track claims status from submission to reimbursement, which helps practices and billing companies quickly identify potential issues that may cause payment delays or denials. Key benefits include the automation of eligibility and claims processes, which cuts down on manual data entry and lowers phone inquiries, thus enhancing the patient experience at check-in by confirming coverage and copay amounts. Moreover, it offers seamless integration for users with varying technical expertise while adhering to strong data security standards. A particularly useful feature is the “Code Explorer,” designed for rapid access to ICD-10-CM, ICD-10-PCS, HCPCS Level II, and CPT codes, simplifying the navigation of coding requirements. By effectively streamlining administrative workflows in healthcare practices, Veritable not only boosts operational efficiency but also elevates patient satisfaction, making it an indispensable tool for modern healthcare management. Furthermore, its ability to adapt to the evolving needs of healthcare providers ensures that they remain competitive in a fast-paced industry.

NeuralRev is a cutting-edge platform for Revenue Cycle Management (RCM) that utilizes artificial intelligence to optimize and improve financial workflows within the healthcare industry, resulting in reduced manual effort and errors while enhancing cash flow and operational efficiency. It connects seamlessly with clearinghouse networks to automate the verification of insurance eligibility, which expedites both patient intake and coverage confirmation. In addition, the platform handles prior authorizations by collecting essential clinical and payer data, electronically submitting requests, and tracking approvals to effectively reduce the chances of denials and delays. It also offers real-time cost estimates to patients by combining eligibility information with payer rules, thereby improving transparency and facilitating upfront collections. Moreover, NeuralRev streamlines the processes of medical coding, claim submission, processing, post-claim follow-up, and recovery, which allows healthcare teams to focus more on patient care instead of administrative duties. This multifaceted solution not only enhances the efficiency of financial management in healthcare but also represents a transformative shift in how financial operations are handled in the industry. By embracing such advancements, healthcare providers can ensure better financial health and improve the overall patient experience.

MDaudit represents a cutting-edge, cloud-based solution that integrates billing compliance, coding audits, and revenue integrity processes tailored for a range of healthcare organizations such as hospitals, surgical centers, and physician networks. The platform supports various types of audits, including scheduled, retrospective, risk-based, and those focused on denials. By automating the collection of data from pre-bill charges, claims, and remittance information, MDaudit effectively triggers audit workflows, detects anomalies and high-risk patterns, and provides real-time dashboards equipped with detailed analytics that help uncover the root causes of billing errors, denials, and revenue deficits. Notably, it features a “Denials Predictor” to validate claims prior to submission, alongside a “Revenue Optimizer” that supports continuous risk monitoring, both of which are crucial for organizations aiming to reduce claim denials, lower recoupments, and enhance revenue capture. Additionally, MDaudit simplifies the management of payer audits by offering a secure and centralized platform that streamlines the handling of external audit requests and facilitates the necessary documentation exchange, thus significantly boosting operational efficiency. The extensive capabilities of MDaudit ensure that healthcare providers are better equipped to uphold stringent standards of compliance and revenue management while adapting to the ever-evolving healthcare landscape. By integrating such advanced tools, MDaudit not only empowers healthcare entities to optimize their financial performance but also fosters a culture of accountability and transparency across operations.

Our all-encompassing clinic solution features a unified sign-on system for practice management and electronic health records, significantly improving workflow efficiency, speeding up cash flow, and maximizing reimbursement rates. Through collaboration with our expert medical billing and revenue specialists, healthcare practices often see marked enhancements in their financial health, including notable decreases in fixed expenses. By partnering with our revenue services team, you can redirect your attention to what is most essential: providing outstanding patient care and nurturing patient engagement. Equip your team with our exceptional implementation, training, support, data migration services, and interoperability solutions tailored to your needs. Our dependable tools are designed to assist both patients and providers in managing their health more effectively. We also provide continuous education and training that align with the latest industry standards and regulations, ensuring your practice remains compliant and competitive. Additionally, our integrated tools facilitate prompt and effective communication with patients, specifically tailored for the requirements of medical practices, thereby ensuring a smooth experience. This strategy not only boosts operational efficiency but also enhances the connection between providers and patients, ultimately leading to better health outcomes and increased patient satisfaction. By investing in our solutions, healthcare practices can thrive in an ever-evolving landscape while maintaining a strong focus on patient care.

RevCycle Engine employs a blend of integrated and customizable rules along with AI-driven automation to address coding and charge discrepancies right from their source, ensuring that billing data is accurate before claims are submitted. By seamlessly integrating with EMRs and practice management systems, it processes claims data in real-time, applies specific rules tailored to each organization's distinct needs, and automatically corrects errors, significantly reducing the likelihood of unnecessary denials and costly rework. The platform streamlines workflow efficiency by focusing human oversight only on complex or exceptional claims, which helps lighten the workload for teams and mitigates the risk of burnout. Additionally, its AI-enhanced charge accuracy improves clean claim rates, lowers collection costs, and stabilizes cash flow, all of which can be easily tracked through user-friendly dashboards and instant insights. With scalable automation capable of handling large volumes of claims without the need for overtime or late-night shifts, it also incorporates features like charge accuracy validation, denial prevention tactics, and optimization of coding reviews, alongside offering support for payment collection. This extensive array of functionalities guarantees that healthcare organizations can sustain both operational effectiveness and financial stability while adapting to the dynamic demands of the industry. Ultimately, RevCycle Engine not only serves to enhance accuracy and efficiency but also positions organizations for long-term success in a competitive landscape.

Clinics, regardless of their size or specialization, can focus entirely on patient care while PertexaIQ™ takes care of all ancillary tasks. This benefit extends beyond primary care to encompass a wide range of specialties, such as neurology, obstetrics and gynecology, pediatrics, dermatology, podiatry, endocrinology, and behavioral health. By streamlining processes to improve efficiency, speed, and accuracy, healthcare practices can enhance their overall value and increase patient volume, which in turn leads to higher revenue. For hospitalists, nurses, and related professionals, our platform-agnostic application integrates flawlessly with your devices and your clients' electronic health records (EHR), ensuring that documentation is completed in real-time for every patient interaction, whether it takes place remotely, in nursing homes, rehabilitation centers, or at home. Administrators and advisors involved in accountable care organizations (ACOs), patient-centered medical homes (PSOs), and independent practice associations (IPAs) can expect to see an uptick in the number of patients served and claims processed, while also benefiting from quicker payments and reduced staffing and outsourcing expenses. The feature that automates and ensures precise coding results in nearly 100% approval rates for claims on the initial submission, along with immediate auto-audit capabilities at the Recovery Audit Contractor (RAC) level and comprehensive compliance safeguards. Ultimately, this cohesive method not only maximizes operational efficiency but also significantly enhances the quality of care provided to patients. As a result, healthcare providers can foster stronger patient relationships, leading to improved satisfaction and loyalty.

Achieve a consistent revenue flow by leveraging a powerful platform designed to expedite reimbursements through eligibility checks, claims status monitoring, audit and appeal processes, and remittance management for both governmental and commercial claims, all within a unified system. Benefit from an advanced rules engine that swiftly corrects claims in alignment with the latest regulations from CMS and commercial payers, enabling you to fix any errors before submission. During the claim upload procedure, verify eligibility with all payers and pinpoint any issues that require attention, allowing for essential modifications prior to dispatching the claims. Decrease the days in accounts receivable by utilizing automated workflows to manage audit responses, submit appeals, and oversee administrative dispute resolutions efficiently. Customize staff workflow tasks according to the type of claim and the actions needed for resolution. Moreover, automate the process of submitting secondary claims to avoid the risk of timely filing write-offs. Ultimately, improve your claims revenue through streamlined workflows that support faster and more effective audits and appeals, ensuring your organization remains financially robust. Additionally, the adaptable nature of this comprehensive system allows it to grow alongside your operations, providing sustained advantages over time. This flexibility not only enhances operational efficiency but also prepares your organization for future changes in the healthcare landscape.

PlanXpand™ is a cutting-edge transaction processing engine crafted by Acero, designed to support all products tailored for health benefits administrators. This innovative system empowers clients to adopt Acero’s solutions either in full or incrementally, providing them with the versatility to fit their unique operational needs. In addition to choosing from a comprehensive selection of standard products, administrators are encouraged to leverage PlanXpand™ to develop customized solutions that enhance their existing system functionalities. Acero stands out with its distinctive, integrated offerings that utilize a Service-Oriented Architecture, allowing health benefits administrators and insurers to seamlessly expand their current adjudication platforms with added features and capabilities. The sophisticated design and engineering behind our solutions enable real-time adjudication for all types of claims, which directly interfaces with the core claims system, enhancing processing accuracy, boosting customer satisfaction, and minimizing the need for claims adjustments. This remarkable adaptability and meticulous precision in claims processing not only enhances operational efficiency but also reinforces Acero’s position as a frontrunner in the health benefits administration industry. Ultimately, our commitment to innovation ensures that clients can navigate the complexities of health benefits management with confidence and ease.

QuickCap, created by MedVision Solutions, serves as a holistic management platform that streamlines both administrative and clinical data tasks, allowing users to focus on their core business activities rather than being overwhelmed by paperwork. This innovative solution provides scalable oversight for workflows and information management, leading to enhanced operational efficiency. With a user-friendly customizable dashboard, QuickCap automates various processes, resulting in increased productivity and speed. Moreover, it simplifies the claims process, which contributes to a more seamless work experience for its users. In addition, QuickCap offers insightful analytics that enable users to evaluate the profitability of individual providers easily. By integrating these diverse features, QuickCap ultimately equips organizations to function more successfully and make well-informed decisions while fostering an environment of continuous improvement. Thus, it stands out as a key resource for healthcare management.

Enhance your practice's capabilities by adopting CareCloud, the leading cloud-based EHR and practice management software available today. CareCloud delivers a comprehensive suite of resources tailored for healthcare professionals and organizations of all sizes, ensuring that every need is met efficiently. Key offerings include Concierge, which serves as a robust revenue cycle management system; Central, an easy-to-use practice management application; Charts, a user-friendly electronic health records system; Community, which provides tools for fostering patient engagement and social connectivity; and Companion, a mobile app designed to assist with both clinical and administrative responsibilities. By leveraging these innovative tools, practices can not only streamline their operations but also significantly improve the quality of care provided to patients. Ultimately, integrating CareCloud into your operations can lead to enhanced efficiency and better health outcomes for those you serve.

Centauri Health Solutions focuses on healthcare technology and services, driven by a strong desire to improve the efficiency of the healthcare system for clients while providing compassionate care to those in need. Our innovative software utilizes advanced analytics to assist hospitals and health plans—including sectors like Medicare, Medicaid, Exchange, and Commercial—in managing their variable revenue through a tailored workflow platform. Additionally, we offer personalized support to patients and members, ensuring they have access to essential benefits that can greatly enhance their quality of life. Our comprehensive solutions include Risk Adjustment services (such as Medical Record Retrieval, Medical Record Coding, Analytics, and RAPS/EDPS Submissions), management of HEDIS® and Stars Quality Programs, Clinical Data Exchange, Eligibility and Enrollment services, Out-of-State Medicaid Account Management, Revenue Cycle Analytics, and both Referral Management & Analytics, while also addressing Social Determinants of Health to improve healthcare outcomes and accessibility even further. Each element is meticulously crafted to function together, ultimately fostering a more effective and compassionate healthcare experience for all stakeholders involved. By integrating these services seamlessly, we aim to create a healthcare environment that not only meets but exceeds the expectations of our clients and the communities we serve.

Nextech offers a comprehensive platform for revenue cycle management, encompassing payment processing, claims management, and patient access. Designed specifically for specialty providers, Nextech's technology solutions align with the distinct workflow requirements of these practices. By utilizing a unified platform, healthcare practices can enhance efficiency across clinical, administrative, and financial operations. As the foremost provider of electronic medical records (EMR/EHR) and revenue management software, Nextech supports over 9,000 clients and employs around 50,000 staff members. Additionally, Nextech empowers physicians with advanced healthcare technology while emphasizing the importance of specialty practices' success. Their approach includes providing tailored consultative guidance and implementing customized solutions to effectively address the unique workflows of individual providers, ensuring a more streamlined operation overall.

BHRev is a groundbreaking platform specifically crafted for revenue cycle management and automation, aimed at fulfilling the requirements of behavioral health providers, thereby allowing them to optimize their financial operations from initial claims submission to payment collection through the integration of AI-driven automation and specialized knowledge. By tackling the unique challenges faced by behavioral health organizations—such as complex payer regulations, rigorous documentation requirements, high denial rates, and evolving compliance standards—BHRev can automate up to 80% of revenue cycle management tasks, enabling skilled professionals to handle exceptions, guarantee compliance, and oversee intricate billing processes, which leads to faster reimbursements and fewer administrative errors. This platform effectively combines advanced automation with expert human oversight to address critical operations such as verifying insurance eligibility, processing and scrubbing claims, managing denials, and posting patient payments, consequently reducing the operational burden on clinics and enhancing their cash flow. As a result, BHRev not only simplifies financial workflows but also allows behavioral health practices to devote more attention to patient care, ultimately fostering a healthier and more efficient healthcare environment. Furthermore, the platform's innovative approach ensures that providers can maintain focus on their core mission while relying on BHRev to streamline their financial operations.

How you address challenges within your revenue cycle plays a crucial role in determining your profitability and the overall performance of your organization. A surge in patient demand for your services is of little value if the collection of payments becomes a prolonged endeavor. You shouldn't have to exhaust countless hours pursuing payments that are rightfully owed to you. Thankfully, there are more efficient approaches available to optimize healthcare reimbursement. Let Quadax help you create a comprehensive, sustainable, and well-coordinated strategic plan, while guiding you in selecting the most appropriate technology solutions and services that complement your business model. By collaborating with us, you have the opportunity to achieve not only operational efficiency but also improved financial results and a better patient experience. The ultimate goal for every claim you submit is to minimize denials and ensure swift payment. Moreover, establishing strong processes can greatly enhance operational flow and contribute to the financial health of your organization, fostering a more resilient future. As you refine these processes, you will likely notice a significant improvement in both patient satisfaction and overall revenue performance.

Leverage a cloud-based healthcare delivery system to efficiently oversee the healthcare services and networks for your members. This innovative system enhances claims processing for managed care organizations by automating essential tasks such as verifying eligibility, managing referrals and authorizations, handling provider contracts, overseeing benefit management, automating claims adjudication, administering capitation for both primary and specialty care, processing EOB/EFT checks, and facilitating EDI transfers and reporting. It can be deployed as a cloud solution or maintained on-site, making it an ideal option for various entities, including managed care organizations (MCOs), independent physician associations (IPAs), third-party administrators (TPAs), preferred provider organizations (PPOs), and self-insured groups. By streamlining the complex procedures associated with eligibility management, referral authorizations, and claims processing, this system significantly boosts operational efficiency. Its design prioritizes data integrity while reducing the reliance on manual data entry, leading to enhanced accuracy and productivity. Moreover, the adaptability of deployment options allows organizations to select the solution that best aligns with their specific operational requirements, ensuring they remain agile in a constantly evolving healthcare landscape. Ultimately, this comprehensive system not only improves day-to-day operations but also supports better healthcare outcomes for members.