U.S. Healthcare Payers’ Core Administrative Processing Solutions (CAPs) Reviews and Ratings

What are U.S. Healthcare Payers’ Core Administrative Processing Solutions?

Core administrative processing solutions (CAPS) are defined as software and services that support healthcare insurance administration and claims processing. These solutions historically reside at the center of payer architecture, serving as the system of record for claims and, in many cases, for member enrollment, premium billing and provider fee schedules....

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Cognizant is focused on engineering modern businesses. The main problem it resolves is helping clients with modernization of their technology, reimagining their processes, and transforming their experiences to adapt to the rapidly changing world. Thus,...
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Cognizant is focused on engineering modern businesses. The main problem it resolves is helping clients with modernization of their technology, reimagining their processes, and transforming their experiences to adapt to the rapidly changing world. Thus,...
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Accenture is a professional services corporation that has global capabilities in cloud, digital, and security domains. With proficiency and dexterity spanning across more than 40 sectors, Accenture provides a range of services such as Strategy...
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HealthAxis is a company specializing in the alteration of healthcare delivery in the United States through advanced technology. It has developed two key technologies known as AxisCore™, a core administrative processing system (CAPS), and AxisConnect™,...
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Burgess is a company that predominantly operates in the domains of healthcare, finance, and technology. The main business problem it works toward solving is Payment Accountability for American health insurers and ACOs. To achieve this,...
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HealthAxis is a company specializing in the alteration of healthcare delivery in the United States through advanced technology. It has developed two key technologies known as AxisCore™, a core administrative processing system (CAPS), and AxisConnect™,...
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enGen is a comprehensive technology platform focused on the health care sector. The firm develops and provides technological solutions for health plans and providers that significantly streamline operations and enhance members' experiences. With an adaptable...
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SS&C is a global entity specializing in mission-critical, cloud-based software and solutions aimed at the financial and healthcare sectors. With operations scaling over 40 countries, SS&C works mainly with financial services and healthcare organizations. Its...
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NASCO focuses on creating products and solutions conducive to healthier outcomes. Rooted in healthcare expertise, the company aligns its strategies and talent to foster innovation. The aim is to provide customers with the tools to...
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Evolent is a company that collaborates with health plans and providers with the aim to improve outcomes for individuals with complex health conditions. Its work spans across various medical specialties and primary care. The main...
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Vee Technologies, established in 2000, is a consulting and professional services organization based in New York City. The firm maintains technology hubs in Bangalore with service centers located in the Philippines, Salem, Hyderabad, and Chennai....
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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...
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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...
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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...
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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...
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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...
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Healthcare Staffing Professionals (HSP) is a team comprised of recruitment specialists. The firm primarily focuses on finding suitable opportunities for individuals from the Clinical, Executive, Sales, and Information Technology sectors. The company operates by providing...
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Features of U.S. Healthcare Payers’ Core Administrative Processing Solutions

Mandatory Features:

  • Enroll and bill purchasers (i.e., employers, individuals and government entities).

  • Comply to industry regulations, such as HIPAA

  • Process and pay claims for nonmedical services such as vision and dental

  • Process and pay claims submitted for products, care and services that are delivered by healthcare providers

  • Support all API-enabled workflows and data formats — including EDI, commonly used for enrollment

  • Support and integrate with reporting and data and analytics software

  • Configure and manage health benefits

  • Integrate business process management and workflow automation

  • Enroll providers and manage fee schedules for claims processing