Decision Insights Claims Management & Clearinghouse Commentary

Subject Expert
Dustin Cragun
VP of Revenue Cycle Research
KLAS VP of Revenue Cycle Research - Dustin Cragun
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Being Replaced

Manager

Our organization experienced a lot of push from various departments to go toward Epic and away from...

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Director

Availity Essentials Pro isn't part of our long-term plans because it isn't as integrated with our...

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Manager

Our company has entered a partnership with another company, so we will be moving to that company's...

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Decided / Likely Choice

Physician

We are looking to stand Availity Essentials Pro up as a backup once the dust settles with our...

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Manager

We did a demo with Availity, and we liked it. Their system is a strong possibility for our...

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CMO

We looked at Availity. They have an excellent product. However, it is more of a standalone product....

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COO

We looked at Availity's system, but we decided that its technology and price didn't match our needs.

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Director

We were looking for a vendor that was better at communicating about instances of downtime, so we...

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Cognizant ClaimLogic (TriZetto) ClaimLogic (TriZetto)
 

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Manager

Our health system wants to consolidate to just one vendor for claims. The organization is going to...

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Unknown

We decided to go with TriZetto Provider Solutions because their clearinghouse solution plays with...

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CIO

We are considering replacing ClaimSource because we have had some issues on the front end.

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COO

Our decision to choose ClaimSource was very close. What really set ClaimSource apart was that we had...

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Manager

We are switching to Epic's platform, and Experian Health's product is the claims management piece...

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Physician

Our decision to go with Experian Health was largely related to patient access. Experian Health had...

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Manager

We are leaning toward Experian Health's offering because Experian Health has a lot of features that...

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Unknown

ClaimSource has functionalities for preadmissions, revisits, check-ins, insurance eligibility,...

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Manager

The decision to go with Experian Health's system was made by our operational team. They chose it...

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COO

We decided to move to Experian Health's system because of the vendor's technology and prices. We...

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Physician

It didn't take a rocket scientist to figure out that ClaimSource would be a good connection on the...

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Manager

We are leaning toward Experian Health because they offer more in terms of client support with claims...

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Manager

Our organization is switching to Epic, and ClaimSource is the product that Epic is encouraging.

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Analyst/Coordinator

We chose Experian Health's system because we were already using the vendors' systems for some other...

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Analyst/Coordinator

We are moving to ClaimSource because the pricepoint is better and the platform will integrate with...

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Analyst/Coordinator

Experian Health's system looked fine. I don't think there was anything wrong with it, but it didn't...

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CIO

We are thinking of staying with ClaimSource because we haven’t had any issues with Experian Health....

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Director

We were looking around the market for claims management vendors who could do the work more quickly...

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Analyst/Coordinator

We want to move away from FinThrive because of their customer service. We have had some issues, but...

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Manager

We replaced FinThrive's system due to costs.

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Analyst/Coordinator

We are leaving FinThrive's system because we are trying to reduce the number of vendors we work with....

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Unknown

The big thing that made us decide to go with another vendor was that FinThrive told us they could...

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CIO

We are considering moving to FinThrive because they have everything we need and have a contract...

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Analyst/Coordinator

FinThrive didn't win our RFP because their customers service was poor. We needed a person dedicated...

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Manager

We considered FinThrive because we thought they could do some things more efficiently than our...

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Physician

We looked at FinThrive. FinThrive was probably a little better at the back-end stuff compared to the...

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Unknown

When I looked at KLAS' site, I saw FinThrive's system. I wanted to research that system because I...

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Inovalon Claims Management Pro Inovalon Claims Management Pro
 

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Director

We are moving to Inovalon's system because we are having issues with our current product. We need a...

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Director

We went with Inovalon because their system integrates with and was offered by other vendors we were...

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InstaMed Clearinghouse InstaMed Clearinghouse
 

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Manager

We don't really like InstaMed, but we went with them because they were cheap. Their support is...

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NextGen Healthcare NextGen Clearinghouse NextGen Clearinghouse
 

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Manager

NextGen Healthcare is sunsetting this product, so we are being forced to find another solution.

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Olive Claims Management Olive Claims Management
 

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Physician

When Olive went insolvent, Waystar picked the system up, and then Waystar essentially said the...

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COO

We flipped from Assurance Reimbursement Management to another solution during the Change Healthcare...

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CMO

During the Change Healthcare incident, we had a lot of problems with posting payments. Within a...

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Unknown

We are looking to make a change to our patient connect program. We used Optum's systems for our...

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Unknown

We moved away from Change Healthcare because of the cyberattack on their clearinghouse solution.

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COO

We are replacing Change Healthcare's system because of the Change Healthcare data breach. Change...

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Director

Before the Change Healthcare disaster, we decided that we were going to switch to another vendor's...

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Unknown

We were affected by the Change Healthcare ransomware attack very significantly. Nobody can work with...

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Physician

We are replacing Change Healthcare after their cybersecurity incident. The confidence factor is nil....

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Manager

Change Healthcare performed well in the space, and if we had to make the choice again, I would...

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Manager

We want to switch away from Assurance Reimbursement Management for a number of reasons. Change...

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Manager

We are looking at Change Healthcare because they are preferred by our EHR vendor.

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Director

We were looking for a vendor with a more efficient workflow than the one we were with, so we looked...

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Manager

The product is not part of our long-term plans, unfortunately. We are switching to a new EHR, so...

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Director

We switched clearinghouses because Change Healthcare went down, and we couldn’t submit anything...

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Manager

We decided to move away from Optum along with other solutions that could be replaced by Epic's...

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Director

We were looking for vendors that had a vision for making long-term goals, and we considered Optum....

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Unknown

Because we have had such high denial and authorization issues with Xpeditor where things are just...

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Manager

We aren't happy with the customer service that we have been receiving lately from Quadax. We have...

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Director

We decided Quadax was no longer a good fit for our organization. We saw a lack of vision with...

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Analyst/Coordinator

We were looking for a new claims management and clearinghouse vendor, so we searched for some of the...

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Manager

We are looking at Xpeditor because the solution is not complicated to use. We like that everything...

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COO

We looked at Quadax's system, but we decided to go with another vendor's system that had better technology....

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The Craneware Group Medessary (ClaimTrust) Medessary (ClaimTrust)
 

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Unknown

We did not look at any other vendors before deciding to go with The Craneware Group. Their system...

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Manager

We are moving away from The SSI Group because of inefficiencies.

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Manager

Our potential move away from The SSI Group has a lot to do with a lack of satisfaction with our...

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Manager

We are replacing The SSI Group due to a lack of a client relationship between the vendor and us. We...

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Analyst/Coordinator

We are leaving SSI Claims Management because our organization is moving to an EMR, and we needed...

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Analyst/Coordinator

SSI Claims Management wasn't something that I expected us to be interested in. SSI Claims Management...

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Manager

We are looking at The SSI Group because they were highly rated by KLAS.

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Director

We did not like that our previous vendor would charge us every time we requested a report, so we...

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CNO

We are leaving TruBridge Claims Management because our parent company is forcing us to.

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Manager

TruBridge is one of the vendors we are leaning toward because their product is user friendly. And...

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Manager

We are unsure whether Waystar is in our long-term plans because our organization may consolidate...

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CMO

We went with Waystar because their ownership model aligned with our desires for alignment. The...

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Analyst/Coordinator

We wanted to go with whoever was going to be best in class, and for most of the areas we were...

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Manager

We are going with Waystar because they can drive more efficiencies than our current vendor.

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CNO

We are moving to Waystar Claims Management because it is the solution that our new EHR primarily supports....

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Manager

We are switching to Waystar because we are doing a certain component with our EHR vendor, and that...

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Manager

I was at a NextGen Healthcare user group meeting, and Waystar was there. They said they were...

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Unknown

We were having to use different clearinghouses for our different needs because one of the...

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Director

We are switching all of our systems to Waystar's systems, including our clearing house, real-time...

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Unknown

We have had such high denial and authorization issues within our facility. Things are just being...

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Manager

We decided to move to Wastar in order to have multiple products under one entity and vendor. We came...

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Director

We did not like our previous vendor’s lack of vision. And we didn't like the product's reporting...

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COO

We looked at Waystar's system. We also looked at a couple of other systems, but our choice came down...

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Physician

Waystar wanted customers to move to their newer platform. We were not just going to move over to...

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COO

We considered Waystar's system, but we chose a system from another vendor who offered a better price...

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Manager

We have Waystar right now, but in the future, our health system will be doing vendor consolidations,...

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Waystar Clearinghouse Waystar Clearinghouse
 

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Analyst/Coordinator

We looked at Waystar in our search for a new clearinghouse vendor. Waystar is huge and wasn’t a good...

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Subject Expert
Dustin Cragun
VP of Revenue Cycle Research
KLAS VP of Revenue Cycle Research - Dustin Cragun