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Best Core Administrative Processing Systems Software

Emma Stein
ES
Researched and written by Emma Stein

Healthcare Payer’s Core Administrative Processing Solutions support and simplify the solutions that healthcare payers use for administrative management and transactions processing.

To qualify for inclusion in the Healthcare Payer’s Core Administrative Processing Solutions category, a product must:

Evolve and accommodate regulatory changes and innovation in the payment sector
Extend the capabilities and functionalities of existing processing and provider-facing systems
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Best Core Administrative Processing Systems Software At A Glance

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Easiest to Use:
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G2 takes pride in showing unbiased reviews on user satisfaction in our ratings and reports. We do not allow paid placements in any of our ratings, rankings, or reports. Learn about our scoring methodologies.

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42 Listings in Healthcare Payers' Core Administrative Processing Solutions Available
(17)3.9 out of 5
1st Easiest To Use in Healthcare Payers' Core Administrative Processing Solutions software
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  • Overview
    Expand/Collapse Overview
  • Product Description
    How are these determined?Information
    This description is provided by the seller.

    Zelis is modernizing the business of healthcare by building something remarkable: a connected platform that bridges gaps in the financial system and aligns interests across healthcare insurers, provid

    Users
    No information available
    Industries
    • Hospital & Health Care
    Market Segment
    • 41% Mid-Market
    • 35% Small-Business
  • Pros and Cons
    Expand/Collapse Pros and Cons
  • Zelis Pros and Cons
    How are these determined?Information
    Pros and Cons are compiled from review feedback and grouped into themes to provide an easy-to-understand summary of user reviews.
    Pros
    Response Speed
    2
    Staff Professionalism
    2
    Customization
    1
    Ease of Use
    1
    Helpful
    1
    Cons
    Billing Issues
    1
    Payment Issues
    1
    Scheduling Issues
    1
  • Seller Details
    Expand/Collapse Seller Details
  • Seller Details
    Seller
    Zelis
    Year Founded
    2016
    HQ Location
    Bedminister, NJ
    Twitter
    @ZelisHealthcare
    449 Twitter followers
    LinkedIn® Page
    www.linkedin.com
    2,772 employees on LinkedIn®
Product Description
How are these determined?Information
This description is provided by the seller.

Zelis is modernizing the business of healthcare by building something remarkable: a connected platform that bridges gaps in the financial system and aligns interests across healthcare insurers, provid

Users
No information available
Industries
  • Hospital & Health Care
Market Segment
  • 41% Mid-Market
  • 35% Small-Business
Zelis Pros and Cons
How are these determined?Information
Pros and Cons are compiled from review feedback and grouped into themes to provide an easy-to-understand summary of user reviews.
Pros
Response Speed
2
Staff Professionalism
2
Customization
1
Ease of Use
1
Helpful
1
Cons
Billing Issues
1
Payment Issues
1
Scheduling Issues
1
Seller Details
Seller
Zelis
Year Founded
2016
HQ Location
Bedminister, NJ
Twitter
@ZelisHealthcare
449 Twitter followers
LinkedIn® Page
www.linkedin.com
2,772 employees on LinkedIn®
  • Overview
    Expand/Collapse Overview
  • Product Description
    How are these determined?Information
    This description is provided by the seller.

    Clinical Decision Support (CDS) system is a next-generation decision-support solution available to providers today.

    Users
    No information available
    Industries
    • Hospital & Health Care
    Market Segment
    • 50% Small-Business
    • 40% Enterprise
  • Seller Details
    Expand/Collapse Seller Details
  • Seller Details
    Seller
    eviCore
    Year Founded
    1992
    HQ Location
    Bluffton, US
    Twitter
    @evicorehc
    882 Twitter followers
    LinkedIn® Page
    www.linkedin.com
    2,598 employees on LinkedIn®
Product Description
How are these determined?Information
This description is provided by the seller.

Clinical Decision Support (CDS) system is a next-generation decision-support solution available to providers today.

Users
No information available
Industries
  • Hospital & Health Care
Market Segment
  • 50% Small-Business
  • 40% Enterprise
Seller Details
Seller
eviCore
Year Founded
1992
HQ Location
Bluffton, US
Twitter
@evicorehc
882 Twitter followers
LinkedIn® Page
www.linkedin.com
2,598 employees on LinkedIn®

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  • Overview
    Expand/Collapse Overview
  • Seller Details
    Expand/Collapse Seller Details
  • Overview
    Expand/Collapse Overview
  • Product Description
    How are these determined?Information
    This description is provided by the seller.

    TriZetto offers consulting, IT, and business process solutions to streamline the deployment and adoption of technologies and improve operations for payers and providers in the health care industry. Tr

    Users
    No information available
    Industries
    No information available
    Market Segment
    • 46% Enterprise
    • 38% Mid-Market
  • Seller Details
    Expand/Collapse Seller Details
  • Seller Details
    Seller
    Cognizant
    Year Founded
    1994
    HQ Location
    Teaneck, NJ
    Twitter
    @Cognizant
    710,993 Twitter followers
    LinkedIn® Page
    www.linkedin.com
    347,955 employees on LinkedIn®
    Ownership
    NASDAQ:CTSH
Product Description
How are these determined?Information
This description is provided by the seller.

TriZetto offers consulting, IT, and business process solutions to streamline the deployment and adoption of technologies and improve operations for payers and providers in the health care industry. Tr

Users
No information available
Industries
No information available
Market Segment
  • 46% Enterprise
  • 38% Mid-Market
Seller Details
Seller
Cognizant
Year Founded
1994
HQ Location
Teaneck, NJ
Twitter
@Cognizant
710,993 Twitter followers
LinkedIn® Page
www.linkedin.com
347,955 employees on LinkedIn®
Ownership
NASDAQ:CTSH
  • Overview
    Expand/Collapse Overview
  • Product Description
    How are these determined?Information
    This description is provided by the seller.

    Claims and benefits administration solution for health plans managing & processing. Provides the patented configuration feature.

    Users
    No information available
    Industries
    No information available
    Market Segment
    • 114% Mid-Market
  • Seller Details
    Expand/Collapse Seller Details
  • Seller Details
    Year Founded
    2005
    HQ Location
    Burlington, MA
    Twitter
    @HealthEdge
    892 Twitter followers
    LinkedIn® Page
    www.linkedin.com
    2,014 employees on LinkedIn®
Product Description
How are these determined?Information
This description is provided by the seller.

Claims and benefits administration solution for health plans managing & processing. Provides the patented configuration feature.

Users
No information available
Industries
No information available
Market Segment
  • 114% Mid-Market
Seller Details
Year Founded
2005
HQ Location
Burlington, MA
Twitter
@HealthEdge
892 Twitter followers
LinkedIn® Page
www.linkedin.com
2,014 employees on LinkedIn®
  • Overview
    Expand/Collapse Overview
  • Product Description
    How are these determined?Information
    This description is provided by the seller.

    Veradigm Payerpath® is an Internet-based suite of solutions that addresses every step in the reimbursement cycle.​

    Users
    No information available
    Industries
    No information available
    Market Segment
    • 50% Small-Business
    • 25% Mid-Market
  • Seller Details
    Expand/Collapse Seller Details
  • Seller Details
    Seller
    Veradigm
    Year Founded
    1986
    HQ Location
    Chicago, IL
    Twitter
    @Veradigm
    461 Twitter followers
    LinkedIn® Page
    www.linkedin.com
    1,709 employees on LinkedIn®
    Ownership
    NASDAQ
Product Description
How are these determined?Information
This description is provided by the seller.

Veradigm Payerpath® is an Internet-based suite of solutions that addresses every step in the reimbursement cycle.​

Users
No information available
Industries
No information available
Market Segment
  • 50% Small-Business
  • 25% Mid-Market
Seller Details
Seller
Veradigm
Year Founded
1986
HQ Location
Chicago, IL
Twitter
@Veradigm
461 Twitter followers
LinkedIn® Page
www.linkedin.com
1,709 employees on LinkedIn®
Ownership
NASDAQ
  • Overview
    Expand/Collapse Overview
  • Product Description
    How are these determined?Information
    This description is provided by the seller.

    Custom robotic process automation (RPA) solutions specializing in healthcare, finance, retail and professional services. Since our solutions are custom scripted, they are flexible, less fragile and m

    Users
    No information available
    Industries
    • Hospital & Health Care
    Market Segment
    • 64% Enterprise
    • 29% Mid-Market
  • Pros and Cons
    Expand/Collapse Pros and Cons
  • Simple Fractal Pros and Cons
    How are these determined?Information
    Pros and Cons are compiled from review feedback and grouped into themes to provide an easy-to-understand summary of user reviews.
    Pros
    Business Growth
    2
    Automation
    1
    Automation Ease
    1
    Bot Creation
    1
    Customer Support
    1
    Cons
    Expensive
    2
    Maintenance Issues
    1
    Poor Documentation
    1
  • Seller Details
    Expand/Collapse Seller Details
  • Seller Details
    Year Founded
    2013
    HQ Location
    New York, US
    Twitter
    @FractalSimple
    4 Twitter followers
    LinkedIn® Page
    www.linkedin.com
    22 employees on LinkedIn®
Product Description
How are these determined?Information
This description is provided by the seller.

Custom robotic process automation (RPA) solutions specializing in healthcare, finance, retail and professional services. Since our solutions are custom scripted, they are flexible, less fragile and m

Users
No information available
Industries
  • Hospital & Health Care
Market Segment
  • 64% Enterprise
  • 29% Mid-Market
Simple Fractal Pros and Cons
How are these determined?Information
Pros and Cons are compiled from review feedback and grouped into themes to provide an easy-to-understand summary of user reviews.
Pros
Business Growth
2
Automation
1
Automation Ease
1
Bot Creation
1
Customer Support
1
Cons
Expensive
2
Maintenance Issues
1
Poor Documentation
1
Seller Details
Year Founded
2013
HQ Location
New York, US
Twitter
@FractalSimple
4 Twitter followers
LinkedIn® Page
www.linkedin.com
22 employees on LinkedIn®
  • Overview
    Expand/Collapse Overview
  • Product Description
    How are these determined?Information
    This description is provided by the seller.

    Founded in 1996 and headquartered in Oregon, PLEXIS serves healthcare payer administrative organizations serving over 50 million people in all 50 states and 15 countries. PLEXIS provides enterprise co

    Users
    No information available
    Industries
    No information available
    Market Segment
    • 75% Small-Business
    • 25% Mid-Market
  • Seller Details
    Expand/Collapse Seller Details
  • Seller Details
    Year Founded
    1996
    HQ Location
    Medford, US
    Twitter
    @plexishealth
    178 Twitter followers
    LinkedIn® Page
    www.linkedin.com
    86 employees on LinkedIn®
Product Description
How are these determined?Information
This description is provided by the seller.

Founded in 1996 and headquartered in Oregon, PLEXIS serves healthcare payer administrative organizations serving over 50 million people in all 50 states and 15 countries. PLEXIS provides enterprise co

Users
No information available
Industries
No information available
Market Segment
  • 75% Small-Business
  • 25% Mid-Market
Seller Details
Year Founded
1996
HQ Location
Medford, US
Twitter
@plexishealth
178 Twitter followers
LinkedIn® Page
www.linkedin.com
86 employees on LinkedIn®
  • Overview
    Expand/Collapse Overview
  • Product Description
    How are these determined?Information
    This description is provided by the seller.

    Strategic Healthcare Management Systems (SHMS) enables health plans of all sizes reduce administrative overhead. SHMS has segment-specific products for healthcare payer organizations (claims/contracti

    Users
    No information available
    Industries
    No information available
    Market Segment
    • 50% Enterprise
    • 50% Mid-Market
  • Seller Details
    Expand/Collapse Seller Details
  • Seller Details
    HQ Location
    Sarasota, US
    LinkedIn® Page
    www.linkedin.com
    4 employees on LinkedIn®
Product Description
How are these determined?Information
This description is provided by the seller.

Strategic Healthcare Management Systems (SHMS) enables health plans of all sizes reduce administrative overhead. SHMS has segment-specific products for healthcare payer organizations (claims/contracti

Users
No information available
Industries
No information available
Market Segment
  • 50% Enterprise
  • 50% Mid-Market
Seller Details
HQ Location
Sarasota, US
LinkedIn® Page
www.linkedin.com
4 employees on LinkedIn®
  • Overview
    Expand/Collapse Overview
  • Product Description
    How are these determined?Information
    This description is provided by the seller.

    End-to-end efficiency accelerates customer acquisition, boosts retention and promotes long-term growth prospects for health payer organisations.

    Users
    No information available
    Industries
    No information available
    Market Segment
    • 100% Mid-Market
  • Seller Details
    Expand/Collapse Seller Details
  • Seller Details
    Seller
    Accenture
    Year Founded
    1989
    HQ Location
    Dublin, Ireland
    Twitter
    @Accenture
    519,275 Twitter followers
    LinkedIn® Page
    www.linkedin.com
    646,829 employees on LinkedIn®
    Ownership
    NYSE:ACN
Product Description
How are these determined?Information
This description is provided by the seller.

End-to-end efficiency accelerates customer acquisition, boosts retention and promotes long-term growth prospects for health payer organisations.

Users
No information available
Industries
No information available
Market Segment
  • 100% Mid-Market
Seller Details
Seller
Accenture
Year Founded
1989
HQ Location
Dublin, Ireland
Twitter
@Accenture
519,275 Twitter followers
LinkedIn® Page
www.linkedin.com
646,829 employees on LinkedIn®
Ownership
NYSE:ACN
  • Overview
    Expand/Collapse Overview
  • Product Description
    How are these determined?Information
    This description is provided by the seller.

    An analytics-driven claims and remittance management solution for healthcare providers who want to automate workflows, improve resource utilization, and accelerate cash flow.

    Users
    No information available
    Industries
    No information available
    Market Segment
    • 100% Enterprise
  • Seller Details
    Expand/Collapse Seller Details
  • Seller Details
    Year Founded
    2007
    HQ Location
    Nashville, US
    Twitter
    @Change_HC
    36,075 Twitter followers
    LinkedIn® Page
    www.linkedin.com
    4,901 employees on LinkedIn®
    Ownership
    NASDAQ: CHNG
Product Description
How are these determined?Information
This description is provided by the seller.

An analytics-driven claims and remittance management solution for healthcare providers who want to automate workflows, improve resource utilization, and accelerate cash flow.

Users
No information available
Industries
No information available
Market Segment
  • 100% Enterprise
Seller Details
Year Founded
2007
HQ Location
Nashville, US
Twitter
@Change_HC
36,075 Twitter followers
LinkedIn® Page
www.linkedin.com
4,901 employees on LinkedIn®
Ownership
NASDAQ: CHNG
  • Overview
    Expand/Collapse Overview
  • Product Description
    How are these determined?Information
    This description is provided by the seller.

    CAQH, a non-profit alliance, is the leader in creating shared initiatives to streamline the business of healthcare.

    Users
    No information available
    Industries
    No information available
    Market Segment
    • 100% Small-Business
  • Seller Details
    Expand/Collapse Seller Details
  • Seller Details
    Seller
    CAQH
    Year Founded
    1998
    HQ Location
    Washington, District of Columbia, United States
    Twitter
    @CAQH
    1,481 Twitter followers
    LinkedIn® Page
    www.linkedin.com
    189 employees on LinkedIn®
Product Description
How are these determined?Information
This description is provided by the seller.

CAQH, a non-profit alliance, is the leader in creating shared initiatives to streamline the business of healthcare.

Users
No information available
Industries
No information available
Market Segment
  • 100% Small-Business
Seller Details
Seller
CAQH
Year Founded
1998
HQ Location
Washington, District of Columbia, United States
Twitter
@CAQH
1,481 Twitter followers
LinkedIn® Page
www.linkedin.com
189 employees on LinkedIn®
  • Overview
    Expand/Collapse Overview
  • Product Description
    How are these determined?Information
    This description is provided by the seller.

    Codoxo's Forensic AI Platform is an advanced artificial intelligence solution designed to help healthcare organizations detect and prevent fraud, waste, and abuse (FWA within their payment systems. By

    Users
    No information available
    Industries
    No information available
    Market Segment
    • 100% Small-Business
  • Seller Details
    Expand/Collapse Seller Details
  • Seller Details
    Seller
    Codoxo
    HQ Location
    Atlanta, US
    LinkedIn® Page
    www.linkedin.com
    82 employees on LinkedIn®
Product Description
How are these determined?Information
This description is provided by the seller.

Codoxo's Forensic AI Platform is an advanced artificial intelligence solution designed to help healthcare organizations detect and prevent fraud, waste, and abuse (FWA within their payment systems. By

Users
No information available
Industries
No information available
Market Segment
  • 100% Small-Business
Seller Details
Seller
Codoxo
HQ Location
Atlanta, US
LinkedIn® Page
www.linkedin.com
82 employees on LinkedIn®
  • Overview
    Expand/Collapse Overview
  • Product Description
    How are these determined?Information
    This description is provided by the seller.

    Veradigm founded in 1986, is an integrated data systems and services company that combines data-driven clinical insights with actionable tools to help healthcare stakeholders improve the quality, effi

    Users
    No information available
    Industries
    • Hospital & Health Care
    Market Segment
    • 44% Small-Business
    • 31% Enterprise
  • Seller Details
    Expand/Collapse Seller Details
  • Seller Details
    Seller
    Veradigm
    Year Founded
    1986
    HQ Location
    Chicago, IL
    Twitter
    @Veradigm
    461 Twitter followers
    LinkedIn® Page
    www.linkedin.com
    1,709 employees on LinkedIn®
    Ownership
    NASDAQ
Product Description
How are these determined?Information
This description is provided by the seller.

Veradigm founded in 1986, is an integrated data systems and services company that combines data-driven clinical insights with actionable tools to help healthcare stakeholders improve the quality, effi

Users
No information available
Industries
  • Hospital & Health Care
Market Segment
  • 44% Small-Business
  • 31% Enterprise
Seller Details
Seller
Veradigm
Year Founded
1986
HQ Location
Chicago, IL
Twitter
@Veradigm
461 Twitter followers
LinkedIn® Page
www.linkedin.com
1,709 employees on LinkedIn®
Ownership
NASDAQ
  • Overview
    Expand/Collapse Overview
  • Product Description
    How are these determined?Information
    This description is provided by the seller.

    AxisCore is a comprehensive core administration platform developed by HealthAxis, designed to streamline and enhance the operational efficiency of healthcare organizations. This robust solution integr

    We don't have enough data from reviews to share who uses this product. Leave a review to contribute, or learn more about review generation.
    Industries
    No information available
    Market Segment
    No information available
  • Seller Details
    Expand/Collapse Seller Details
  • Seller Details
    Year Founded
    1965
    HQ Location
    Tampa, Florida, United States
    Twitter
    @healthaxis
    239 Twitter followers
    LinkedIn® Page
    www.linkedin.com
    201 employees on LinkedIn®
Product Description
How are these determined?Information
This description is provided by the seller.

AxisCore is a comprehensive core administration platform developed by HealthAxis, designed to streamline and enhance the operational efficiency of healthcare organizations. This robust solution integr

We don't have enough data from reviews to share who uses this product. Leave a review to contribute, or learn more about review generation.
Industries
No information available
Market Segment
No information available
Seller Details
Year Founded
1965
HQ Location
Tampa, Florida, United States
Twitter
@healthaxis
239 Twitter followers
LinkedIn® Page
www.linkedin.com
201 employees on LinkedIn®