Top 10 Best Healthcare Claims Processing Software of 2026

Waystar is a leading revenue cycle management (RCM) platform focused on healthcare claims processing, automating submission, scrubbing, tracking, and payment posting across hospitals, health systems, and physician practices. It leverages AI and machine learning to predict and prevent denials, optimize reimbursements, and provide real-time analytics for financial performance. With integration into major EHRs and direct connections to over 1,000 payers, Waystar processes billions of transactions annually, boasting industry-leading first-pass acceptance rates above 98%.

Availity is a leading healthcare revenue cycle management platform that facilitates electronic claims submission, status tracking, eligibility verification, and electronic remittance advice (ERA) between providers and payers. It connects to virtually every major payer in the US through its extensive network, enabling seamless data exchange and reducing manual processing. The platform also supports patient payments, denial management, and integrations with popular EHR systems like Epic and Cerner.

Athenahealth is a cloud-based electronic health record (EHR) and revenue cycle management platform that excels in healthcare claims processing through automated scrubbing, electronic submission, and denial management. It streamlines the entire claims lifecycle by integrating with EHR data for accurate coding, eligibility verification, and payer reimbursements. Designed for ambulatory practices, it boasts high first-pass claim acceptance rates and tools for appeals and AR management, reducing revenue leakage.

Optum offers a robust healthcare claims processing platform as part of its Revenue Cycle Management solutions, automating claims submission, scrubbing, adjudication, and denial management for providers and payers. Leveraging AI and advanced analytics, it optimizes revenue capture by identifying errors pre-submission and predicting denial risks. Integrated with major EHR systems, it supports end-to-end claims lifecycle management for large-scale healthcare organizations.

Kareo is a cloud-based healthcare platform focused on revenue cycle management and claims processing for independent practices and small groups. It automates the entire claims workflow, including eligibility checks, scrubbing, electronic submission via integrated clearinghouses, denial management, and payment posting. With strong analytics and patient billing tools, it aims to accelerate reimbursements and minimize errors in healthcare billing.

AdvancedMD is a cloud-based practice management and EHR platform with robust revenue cycle management (RCM) capabilities, specializing in healthcare claims processing for medical practices. It automates electronic claims submission, scrubbing, eligibility verification, denial management, and payment posting to major payers and clearinghouses. The software integrates billing with scheduling and patient records to streamline workflows and maximize reimbursements.

Quadax offers a comprehensive revenue cycle management (RCM) platform, with QDx Clarity at its core, specializing in healthcare claims processing for labs, hospitals, and physician groups. It automates claims scrubbing, submission via EDI, tracking, denial management, and AR follow-up to minimize errors and accelerate reimbursements. The solution integrates with major EHRs and PM systems, providing end-to-end visibility into the claims lifecycle.

DrChrono is a cloud-based electronic health record (EHR) and practice management platform that offers comprehensive healthcare claims processing tools integrated with patient scheduling, charting, and telehealth. It enables electronic claims submission to over 3,000 payers via major clearinghouses, automated ERA posting, denial management, and real-time eligibility verification to streamline revenue cycles. The software's mobile-first design supports claims tasks on the go, making it suitable for modern medical practices seeking efficiency in billing workflows.

eClinicalWorks is a comprehensive EHR and practice management platform with robust healthcare claims processing capabilities, automating electronic claims submission to over 3,000 payers including Medicare, Medicaid, and commercial insurers. It features claim scrubbing to reduce errors, real-time eligibility verification, and denial management tools to optimize revenue cycle management. The system integrates seamlessly with patient records for accurate coding and billing, supporting practices of various sizes.

NextGen Healthcare provides an integrated electronic health records (EHR) and revenue cycle management (RCM) platform with robust claims processing capabilities tailored for ambulatory care practices. It automates claims scrubbing, electronic submission to major payers, eligibility verification, and denial management to optimize revenue cycles. The solution offers real-time analytics and reporting to track claims status and financial performance, supporting specialties like primary care and pediatrics.