Medical Insurance Claims Software solutions mindshare
As of November 2024, in the Medical Insurance Claims Software category, the mindshare of McKesson ClaimsXten is 36.0%, down
from 40.7% compared to the previous year. The mindshare of Managed Care Systems MCSI Impact is 9.3%, up
from 7.1% compared to the previous year. The mindshare of McKesson Interqual is 41.9%, up
from 40.7% compared to the previous year. It is calculated based on PeerSpot user engagement data.
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 evidenceâbased 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
SS&C Blue Prism excels in automating repetitive tasks with its robust features, enhancing efficiency. Users praise its scalability but find the learning curve steep and documentation lacking. Enhancements in integration capabilities and clearer guidance during setup can improve user experience significantly.
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.
Alaffia Health offers innovative solutions designed to enhance healthcare decision-making by leveraging advanced analytics and data insights. It caters to professionals seeking precise information to optimize health operations.
