Product Listings
Aptarro helps healthcare providers get paid accurately and on time by simplifying revenue cycle management. Our intelligent solutions reduce denials, ensure compliance, and streamline billing workflows, allowing providers to focus on patient care.
With 40+ years of experience, we’ve developed a powerful rules engine and comprehensive content database to help providers navigate complex regulations with confidence. Our SaaS solutions integrate with EHRs, practice management, and hospital information systems to improve revenue integrity and operational efficiency.
Formed from the combined expertise of Alpha II and RCxRules, Aptarro enables healthcare organizations to manage revenue with greater accuracy and control. By automating corrections and optimizing reimbursements, we help providers strengthen financial performance while reducing administrative burdens.
At Aptarro, we’re committed to making revenue cycle management more accurate and reliable for healthcare organizations.
Zelis is a company that has set out to modernize healthcare by establishing a connected platform that addresses gaps in the financial system and aligns the needs of healthcare insurance providers, healthcare providers, and consumers. The platform is revolutionizing the monetary aspect for numerous payers including national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers and many providers and consumers. It oversees the financial experience to pinpoint, enhance, and tackle issues in a holistic manner with technology created by healthcare experts, thereby generating tangible, quantifiable results for the clients.
Aptarro helps healthcare providers get paid accurately and on time by simplifying revenue cycle management. Our intelligent solutions reduce denials, ensure compliance, and streamline billing workflows, allowing providers to focus on patient care.
With 40+ years of experience, we’ve developed a powerful rules engine and comprehensive content database to help providers navigate complex regulations with confidence. Our SaaS solutions integrate with EHRs, practice management, and hospital information systems to improve revenue integrity and operational efficiency.
Formed from the combined expertise of Alpha II and RCxRules, Aptarro enables healthcare organizations to manage revenue with greater accuracy and control. By automating corrections and optimizing reimbursements, we help providers strengthen financial performance while reducing administrative burdens.
At Aptarro, we’re committed to making revenue cycle management more accurate and reliable for healthcare organizations.
BeaconLBS is a company concentrating on laboratory benefit solutions. The primary business issue it addresses is improving the quality and cost-effectiveness of lab testing for health plans. The company's model is designed to integrate smoothly into the range of care management solutions a health plan offers. BeaconLBS provides solutions such as Prior Authorization and Advance Notification Integration. This component can merge into existing physician workflows, giving physicians quick and easy access to updated, evidence-based clinical guidelines to aid test ordering and selection of cost-effective, quality labs. It offers Policy Management by leveraging claims data, clinical knowledge, actuarial expertise, and business savvy. The team advises policies that can aid the health plan in managing their laboratory test strategy. Claim Editing is another service provided, in which health plans can tailor claim edits using the company's library. This allows for lowered costs and a significant cutback in fraud, waste, and abuse. Responses to different types of edits can also be configured for efficient workflows.
EmblemHealth is a non-profit health insurer that caters to over three million people in the New York tristate area. The company's history traces back to the 1930s, with the merger of Group Health Incorporated (GHI) and Health Insurance Plan of Greater New York (HIP), set up to protect people from financial strain resulting from medical emergencies. Today, after eight decades, its goal remains to provide cost-effective health insurance to New Yorkers. The EmblemHealth conglomerate provides insurance packages, primary and specialty care, and wellness solutions. It encompasses ConnectiCare, AdvantageCare Physicians, BronxDocs, EmblemHealth Health@Work, EmblemHealth Family Dental, and WellSpark Health for diverse health needs. Additionally, to enhance community health, EmblemHealth Neighborhood Care and ConnectiCare Centers provide complimentary wellness and community resources. The conglomerate embodies an 80-year-old start-up's qualities, balancing the stability of a major corporation with a strong dedication towards innovation, collaboration, and adaptability.
Cotiviti operates in the realm of healthcare, using up-to-date technology and detailed data analytics to enable healthcare providers to deliver efficient care at reduced costs. The organization's strategies serve as a vital base for healthcare payers, assisting them in their objective to minimize healthcare expenses and enhance quality by improving payment accuracy, risk adjustment, consumer engagement, and network performance management programs. In addition, Cotiviti works within the retail sector, providing data management and recovery audit services to boost business performance.
Optum, a subsidiary of UnitedHealth Group, concentrates on improving healthcare system effectiveness and promoting healthier lives. Operating globally across 150 countries, its main function is to connect and engage all aspects of healthcare. Advanced technology, extensive healthcare data, and expertise are utilized by Optum to boost the quality, efficiency, and delivery of healthcare services. The broad array of services offered, including healthcare delivery, healthcare operations, pharmacy care services, population health management, and advisory services, are angled towards refining health plan simplicity and improving experiences to promote healthier lives. Integrity, compassion, relationship building, innovation, and performance are integral to the company's operations.
ClarisHealth concentrates on improving healthcare claims payments with a special focus on payment integrity, utilizing its artificial intelligence (AI)-powered platform, Pareo®. The platform is equipped to boost payment accuracy and efficiency, significantly decreasing overspending issues. This is achieved through a combination of tools including claims overpayment inventory management, third-party services vendor management, auditor workflow and analytics, fraud case management, prepay cost avoidance, reporting and business intelligence, and provider engagement. On average, the application of Pareo® results in faster recoveries, increased claim overpayments recoveries, and substantial cost savings resulting from automation. The primary aim is to optimize costs for health plans and enhance overall financial efficiency.
PLEXIS Healthcare Systems is a technology establishment focusing on payer solutions. It offers essential administration and claims management solutions for healthcare payers and delivery systems globally. Serving over 100 organizations, PLEXIS' solutions oversee the management of more than 55 million lives across every state in the United States and other parts of the world. Its solutions are crucial, driving efficiencies and linking evolving business ecosystems with a wide array of payer organizations.
HealthEdge has an objective to foster a digital revolution in the healthcare sector. The company uses connecting business models between health plans, care providers, and patients with inclusive digital technology solutions. These efforts are aimed at supporting new operational models, reducing management costs and enhancing health outcomes. HealthEdge has an expanding range of products, like HealthRules Payer, Source, GuidingCare, and Wellframe, all aimed at transforming healthcare. Empowered by a global team of over 2,000 professionals, the focus is on introducing an innovative environment where the primary focus of healthcare is people.