|
| |
| Company/Charges/Sales |
Hdqtrs/Owner/Employees |
URL/Installations |
Product |
ACES Technologies, LLC
$5 per claim |
Providence, RI
Private |
www.acestechnologies.com |
ACES (Accelerated Case/Claims Evaluation System) Case management and claims
administration is a decision-support software automatically "profiling" and prioritizing
"high loss" claims. |
Active Health Management, Inc.
$5,000,000 |
Reston, VA
e-MEDx
40 |
www.activehealthmanagement.com |
MedAdvice is a case management and utilization review tool designed to handle
administrative functions. It is a fully integrated case management, utilization management and disease
management system that allows the flexibility to meet the needs of all treatment types and managed care
settings. |
ActecSystems, Inc.
$25,000 to $35,000 |
Atlanta, GA
Private |
www.actec.net |
Actec® offers insurance carriers, self-insureds, managed care providers,
TPA’s, and others a central facility for collecting, compiling, and disseminating claims for automobile,
workers’ compensation, general liability, disability, property, personal, as well as for specialized
lines of business. |
ADP, Inc.
$5,400,000,000 |
Roseland, NJ
Automatic Data Processing |
www.adp.com |
Medical cost containment products and services utilizing solutions from efficient
automated processing utilizing the latest in work queuing and technology such as EDI, Windows NT and
ODBC database compatibility, comprehensive medical audit, to PPO/MCO networks. |
| AIG Claim Services, Inc. |
Parsippany, NJ
American International Group, Inc.
85 |
www.aig.com |
Tailor-made health care recovery programs for all segments of the medical claims
industry |
| American Management Systems |
Roseland, NJ |
|
Complete turnkey product for healthcare claims data capture. AMS's QuickStart for
Data Entry (QSDE) is a packaged solution for capturing data from healthcare forms utilizing industry
leading OCR/ICR vendor products. |
| American Medical Software |
Edwardsville, IL |
www.americanmedical.com |
The AMS Medical Office Management System offers complete medical billing and
management solutions |
| American Technical Services, Inc. |
Clearwater, FL
Private |
www.atsrmis.com
150 |
Integrated modules support medical and disability management billing and captive
management programs. "ATS for Windows (includes ATS COMP, ATS PAC, ATS MED, ATS DISABILITY, ATS UR)
" |
Associated Systems, Inc.
$2,000/month |
Wichita, KS |
www.associatedsys.com
450 |
The "complete" health benefits administration software system for TPA's,
self-insured employers, HMO's and others. System is employee focused with flexible plan set-up, multiple
PPO's to a group/plan, triple option PPO, HMO, and POS. Auto adjudication, claims edit interface,
client-server and EDI available. |
Benefit Plan Systems Corp.
$2,000 to $100,000 |
Irvine, CA |
www.bencorp.com |
The CSP Suite is designed for use by Insurance companies, TPAs, Brokers and Client
Service Providers who perform contract administration services for multiple employers. |
| BeneSoft, Inc. |
Bethany, CT |
www.benesoft.com
100 |
FlexibleSoftware is an administrative and management system for flexible benefit,
traditional benefit and flexible spending account programs. FlexibleSoftware performs the administrative,
analytical, and employee communication functions for effective management of benefit programs. |
BISNet, LLC
$157,000,000 |
Walnut Creek, CA
AON Corporation
90 |
www.bisnet.com |
BISNet's Service allows employees to look up their benefits and enroll in the plans of
their choice. Fill administrative reports. Approved information sent to the insurance carriers and HRIS
System for their specific formats. |
| Cambridge Integrated Services Group, Inc. |
Jamesburg, NJ |
www.cambridgeintegrated.com
25 |
Employee benefits, managed care, structured settlements, loss control and integrated
disability management. At the forefront of the industry in reducing loss costs. |
| Celerity Technologies |
Irvine, CA |
www.celeritytech.com |
Provides software and network services allowing claims administrators and employers
to send workers' comp claims electronically. |
| CIMR |
Columbia, SC |
www.cimr.com |
Customized, real-time risk management solutions for healthcare organizations from
integrated delivery systems to large payors. |
| Computer Sciences Corporation |
Jackson, MS
Computer Sciences Corporation
60,000 |
www.csc.com
150 |
Provides PABBLO/PACCASSO: client/server software systems for comprehensive premium
accounting, policy administration, underwriting and automated claims administration. |
Corporate Systems, Inc.
$50,000,000 |
Amarillo, TX
486 |
www.csedge.com |
Risk management products and services. Provides RMIS solutions for 38% of the FORTUNE
500 leading carriers, brokers and claims administrators. |
| Eldorado Computing, Inc. |
Phoenix, AZ |
www.eldocomp.com |
Integrated software solutions for organizations engaged in managed care, adjudicating
health claims, benefits management, repricing PPO claims, case management and billing and administration. |
| Epic Systems Corporation |
Madison, WI |
www.cohortlab.com |
Tapestry is a comprehensive, flexible system designed to help health plans and managed
care organizations better manage operations across all lines of business. It provides the efficiencies
necessary to meet the needs of members, employers, affiliates, and the providers who serve them. |
FACTS Services, Inc.
$6,000,000 |
Coral Gables, FL |
www.factsservices.com |
Provides fully automated and integrated software and hardware solutions for managed
care administration, specializing in claims and encounters processing, risk management, and cost
containment. |
GenSource Corporation
$65,000 to $300,000 |
Valencia, CA
Private
41 |
www.gensourcecorp.com |
Offers fully integrated systems for the management and administration of
insurance-related claims, including workers' compensation, property and casualty, non-occupational
disability, and group medical. |
| @Global, Inc. |
Ft. Lauderdale, FL |
www.atglobal.com |
The Allegro suite of software products provides a complete claims administration, care
management and medical cost management solution for workers' compensation and property and casualty lines
of insurance. |
| HNC Insurance Solutions |
Irvine, CA
HNC Software |
www.hncis.com |
Provides specialty software for workers' compensation, auto, and group health
insurance carriers, employers, TPAs and managed care companies. |
| Human Resources Consulting Group, Inc. |
Provo, UT |
www.hrconsulting.com |
EBS-Benefits Statements: $1,800 to $8,000, $150 to $450 per month, or $3 to $4 per
statement; 15 installations. Enroll-Simple Self Service: $500 to $2,000, or $3 per employee per month;
150 installations. FlexComp 9.0-Windows Employee Self Service: $15,000 to $50,000, $1,500 to $2,500 per
month, or $3 to $6 per inquiry; 252 installations. Web (Internet/Intranet) Employee Self Service:
$15,500 to $40,000, $700 to $1,500, or $1 to $3 per employee per month; 6 installations. |
| JMJ Technologies, Inc. |
Marietta, GA |
www.jmjtech.com |
EncounterPRO is a clinical management system that features an electronic medical
record, a patient tracking system, a health-maintenance alert system, and a dynamic, configurable
office workflow system. |
Logical Claim Solutions, Inc
based on the size of the installation |
Matteson, IL |
www.lcsinc.com |
The LCS system was designed by a TPA owner looking for a product to meet the
requirements of an ever changing industry. The system was developed to operate on a Novell network using
IBM compatible workstations. |
| MCO Advantage |
Cleveland, OH
PBM Corp.
20 |
www.pbmcorp.com |
An ASP claims management system that handles all aspects of illness or injury bill
and claims management for government agencies, insurance companies, TPAs, MCOs, Medicaid, HMOs, and
self-insured and state fund employers and providers. The scalable solution offers real-time
connectivity and unprecedented efficiency in case management workflow. |
| Mednet Connect, Inc. |
Pleasanton, CA |
www.mednetconnect.com |
Insurance companies, managed-care companies, preferred provider organizations and
third-party administrators use Mednet Connect software to audit and reduce medical bills before payment.
Mednet Connect utilizes the Internet and Mednet Connect's state of the art rules engine to directly
connect payers and providers. |
| MicroFour, Inc. |
Amarillo, TX |
www.microfour.com |
PracticeWizard® is a complete, and thorough , Windows98 and Windows NT
accounts receivable billing system that captures information from the initial patient enrollment all
the way through to insurance claim and patient statement processing. |
OAO HealthCare Solutions
$150,000,000 |
Woodland Hills, CA
OAO Technology Solutions
2,300 |
http://www.oaot.com/service/healthcare_solutions.asp |
MC400 manages the day-to-day business operations of HMOs, PPOs, POS', medical groups,
IPAs, TPAs, self-funded organizations, employer groups, Medicare and Medicaid plans. |
OASYS
PerMember PerMonth |
Indianapolis, IN |
www.oasys.com |
Provides administrative processing products and services to HMOs, PPOs, Blue
Cross/Blue Shield plans, and other health insurance administrators via the Application Service Provider
(ASP) and business process outsourcing (BPO) models. |
P & W Software, Inc.
$8,000 to $100,000 |
Westlake Village, CA |
www.pwsoftware.com
340 |
POWERPLUS is the complete solution for administering flexible spending account (FSA)
plans, traditional health and welfare benefit plans, and full-choice cafeteria plans. |
RIMS
$40,700,000 |
Naperville, IL
The TriZetto® Group, Inc |
www.rims.com |
The nation's largest provider of automated claims processing technology for healthcare
benefits administrators. |
| SBPA Systems, Inc. |
Houston, TX |
www.sbpa.com |
Comprehensive solutions for claim administration, eligibility and member services,
and managed care. |
Sedgwick Claims Management Services, Inc.
$120,000.000 |
Memphis, TN |
www.sedgwickcms.com |
The JURIS system is windows-based, client server technology designed to provide our
claims adjusters, a structured, yet flexible, series of screens and routines that simplify the claims
management process. |
| The SSI Group, Inc. |
Clearwater, FL
First American Corp.
220 |
www.thessigroup.com
700 |
Leads the healthcare field in managed care technology, EDI platforms and networking.
SSI offers a wide range of services and technologies in case and document management, utilization
review, EDI commerce, imaging and network services. |
| Systems 2000 |
Santa Barbara, CA |
|
Total Healthcare Integrated System, a full-featured health plan administration
software package on Windows NT, utilizing user-friendly Windows screens. Fully automated on-line claims
adjudication, EOB's, checks, COBRA/HIPAA administration, premium billing Provider Group Pricing,
Utilization Review, EAP and more. |
| Talisman Systems Group, Inc. |
San Francisco, CA |
www.talisys.com |
Talisman Claims System is the first claims management system developed for true
Internet deployment. TalisPoint makes it easy to locate and direct care to PPO members, generating
directories, posting notices, referral letters, maps and driving directions. |
Travelers Property Casualty
$10,420,000,000 |
Hartford, CT
Citigroup |
www.travelerspc.com
1,258 |
"CARMA" features: claims management/loss analysis including adjuster notes;
workers' compensation lost-time analysis; managed care and integrated disability management analysis. |
William M. Mercer, Inc.
$300,000 or $30 to $50 per participant/year
$2,000,000,000 |
New York, NY
Mercer Consulting Group, Inc.
10,911 |
www.mercerhr.com
35 |
Mercer BeneCalc |
|
