PharmPix Corp: An Intelligent Approach to Pharmacy Claims Processing

Top 10 Claims Processing Solution Companies - 2020

The innovation in the claims processing industry is soaring as insurers are finding new and creative ways to alleviate pain points in claims and enhance the customer experience. From filing claims to calculating costs, technology-backed solutions are available to expedite the processes and reduce the occurrence of errors, enabling accelerated and accurate results.

The real-time data integration enables insurers to gather information from vital customer touchpoints. Through AI and machine learning, they can analyze historical data to detect frauds and proactively take measures for prevention. This results in faster claims processing and settlements as they have quick access to an accurate data pool. Further, real-time First Notice of Loss (FNOL) apps allow customers to report claims seamlessly. The data integration and image recognition features facilitate auto-filling the fields on the claims form, simplifying the arduous task of answering numerous questions for customers. These apps also convey accurate information directly to the claims dashboards such that the process happens faster.

Similarly, image-recognition technologies tremendously add value to insurers’ efforts in appraisal for claims. Especially in the automotive insurance sector, AI and machine learning are implemented such that computers analyze images and assess vehicle damage. There are also telematics solutions available in the market that collect data, including vehicle location, driver behavior, and engine diagnostics, and provide them to fleet management software systems. This helps insurers access vital data points at the time of an accident and visualize them, thus streamlining the claims process.

With such transformative solutions, insurers can synchronize critical data, simplify claims management and processing, and also prevent accidents. While these solutions were part of a period before the COVID-19 pandemic, the rapid digitization after the pandemic hit has resulted in a surge of new innovative solutions to help insurers cope with the changing work environment and simplify the claims processing and management.

In light of these significant technological advancements today, Financial Tech Review has compiled a list of top 10 claims processing solution providers 2020 to guide enterprise leaderships in harnessing the power of technology to embrace innovation and enhance productivity. With exceptional technological acumen and numerous success stories up their sleeves, many of these companies have consistently proven their expertise in robust claims processing solution landscape. We hope this issue of Financial Tech Review helps you build the partnership you and your firm need to adopt efficient claims processing solutions to streamline operations and enhance customer experience thereby increasing organizational productivity.

We present to you Financial Tech Review’s Top 10 Claims Processing Solution Providers—2020

    Top Claims Processing Solution Companies

  • Acrometis provides the most complete and automated claims processing platform on the market designed particularly for the workers’ compensation industry – including insurance carriers, brokers, self-insureds, Third Party Administrator’s (TPAs), and claims administrators. Since 2002, the company has provided expert claims processing solutions that continue to redefine the workers’ comp industry standards. Acrometis provides the most complete and automated claims processing platform in the market. Its adept, rules-based family of solutions enables meaningful changes to its claims processing environment- leading to maximized efficiency, cost savings, and productivity gains over the lifespan of a claim

  • Artsyl offers intelligent capture and business process automation solutions that eliminate the arduous tasks related to medical claim processing and dozens of other company- or industry-specific processes burdened by high volumes of data and documents. Through its digital transformation platform, docAlpha, Artsyl seamlessly processes healthcare claims documents by extracting data from different CMS forms like HCFAs, UBs, or dental records, organizing, and managing them quickly and easily. Artsyl’s myriad of solutions comprised of InvoiceAction, OrderAction, RemittanceAction, ExpenseAction and ClaimAction benefit customers in the manufacturing, distribution, healthcare, financial services, and government sectors

  • A Tel-Aviv based firm, Five Sigma, is helping insurers deliver on their promise to policyholders through its end-to-end, data-driven claims management solution. By combining advanced innovative technologies like AI and deep learning and leveraging its hands-on experience in handling claims, Five Sigma is assisting insurers with the P&C insurance claims management process. By leveraging its cloud capability, adapting proven AI techniques, and applying them to the traditional structured and unstructured claims data, Five Sigma is helping insurance carriers to better understand claims and claims management on an entirely new level. Furthermore, by enabling easy deployment, the firm allows insurers to embed their preferred claims management workflows in their systems from the get-go

  • With over 250 Benefit Fund Offices and TPA clients in the U.S. and Canada, ISSI is by far the leading provider of Benefits Administration computer systems and services to the Taft-Hartley industry. Headquartered in Maple Shade, NJ, ISSI uses advanced technology for every facet of Benefit Fund Administration, including Contributions, Eligibility, Claims, Pension, Annuity, and more. ISSI’s state-of-the-art solutions and impeccable customer service provide the solid foundation Administrators need to meet the demands of a rapidly changing world

  • A pharmacy benefits information and management provider that offers innovative services for health plans and insurers, medium to large employers and union groups, private and government health programs, including Medicaid and Medicare. At the core of PharmPix’s services is OneArk, an innovative technology platform that allows managed care organizations, employee unions, and self-insured employers to manage their pharmacy benefit costs in ways that were previously inconceivable. Since its inception, PharmPix has established a presence across all 50 U.S. states and territories, serving the dynamic needs of health insurance industry professionals while empowering them to solidify ties with their beneficiaries and providers

  • Crawford


    Crawford & Company (Crawford) is an independent provider of claims management solutions to the risk management and insurance industry, as well as self-insured entities, with a global network serving clients in more than 70 countries. It has four segments: America, which serves the property and casualty insurance company markets in theU.S., Canada, Latin America, and the Caribbean; International Operations, EMEA/AP, which serves the property and casualty insurance company markets in Europe, including the United Kingdom, the Middle East, Africa, and Asia-Pacific; Broadspire, which serves the United States self-insurance marketplace, and Legal Settlement Administration, which serves the securities, bankruptcy and other legal settlements markets, primarily in the United States

  • Decusoft


    Decusoft provides configurable software solutions and professional services to help companies streamline complex business functions. It enables people and organizations, to support business processes, analyze as well as predict, quickly adapt to change, and utilizes competitive advantage. Decusoft empowers organizations and people through more efficient use of software. In business over 10 years, Decusoft has a proven track record of providing reliable, cost-effective software solutions. It has designed, developed, and implemented solutions across a broad array of businesses and technologies based on its clients' unique set of requirements

  • Gallagher Bassett

    Gallagher Bassett

    A global provider of risk and claims management services that blends cutting-edge analytic tools with the human element of claims management to deliver superior outcomes. Organizations in the claims management space have long used data to drive improvement in operations, but Gallagher Bassett is leading the way by enabling its teams to use data to improve their decision-making skills. Gallagher Bassett pioneered remote work in the industry over a decade ago and has spent the time since perfecting the tools, processes and employee engagement elements that are critical in effectively managing a remote workforce

  • Pulpstream


    Pulpstream is an efficient low-code application development and delivery platform. Its cloud-native solutions enable department leaders to align initiatives across borders and adapt to change at digital speed. Pulpstream gives one the power to provide digital business process management solutions, seamlessly dissolve data silos, and continuously improve performance with data. It can streamline operations at the pace of one’s imagination. No coding required. Pulpstream streamlines operations for publicly-traded consumer products manufacturers, broadline organic farms, foodservice distributors, and insurance, construction, as well as human services companies

  • Zywave


    Zywave leads the insurance tech industry with expansive portfolio of sales management and client delivery solutions. Zywave leads the insurance tech industry, boosting business growth for its partners with the most expansive portfolio of cloud-based sales management, content, client delivery, and analytics solutions. By providing an all-on-one platform full of robust data and the most comprehensive content library available, the company empower its partners to make smarter business decisions throughout the entire customer lifecycle in service of greater wellness, health, and safety

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