Best Medical Insurance Claims Software Solutions

McKesson InterQual is an Evidence-Based Clinical Criteria that provides support covering medical and behavioral health across all levels of care as well as care planning and complex care management. InterQual's comprehensive portfolio includes five content suites: InterQual Level of Care Criteria, InterQual Behavioral Health Criteria, InterQual Care Planning Criteria, Content Powered by InterQual and InterQual Coordinated Care Content. InterQual Criteria connects and aligns payers, providers and other organizations with evidence‐based clinical intelligence that helps care management decisions, support care, manage medical resources.

McKesson ClaimsXten is a solution for clinically-based claims auditing that offers rules creation and firing that enable payers to process each claim under the specific terms and conditions of each benefit plan. ClaimsXten combines with McKesson Total Payment platform, a comprehensive library of McKesson clinical rule content, and a services team of medical claims experts to provide your organization with more medical and administrative savings opportunities. With full-service, technologically advanced ClaimsXten, offers a standard fee-for-service claim code editing

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CureMD Medical Billing Service is an end-to-end revenue cycle management solution geared towards more than 32 specialties.

HEALTHsuite is a comprehensive benefit administration system and claims processing software solution designed for health plans administering Medicaid and / or Medicare Advantage benefits. HEALTHsuite is a rules-based auto adjudication software solution designed to automate all aspects of enrollment / eligibility, benefit administration, provider contracting / reimbursement, premium billing, medical management, care management, claims adjudication, customer service, reporting and more.

iPatientCare PMS is much more than a billing software. It is a complete medical practice management software that allow your Front Office and Back Office staff to work easily and efficiently. It also generates cleaner claims to get you paid faster and receive higher reimbursements.

SS&C Chorus is an intelligent automation platform designed to increase straight-through processing, reduce operational risk, and enhance digital customer journeys. Purpose-built for complex and regulated environments, SS&C Chorus brings machine learning, low-code process automation, system integration, case management, and document capture to transform, manage, and automate critical business processes. 

Alaffia delivers AI-powered payment integrity solutions that optimize your claim reviews and maximize your savings.