Top 10 Best Medical Claims Management Software of 2026

Kareo is a cloud-based medical billing and revenue cycle management platform tailored for independent practices, specializing in end-to-end claims processing from eligibility checks and scrubbing to submission, tracking, and denial management. It integrates seamlessly with EHR systems to automate workflows, reduce errors, and accelerate reimbursements. With advanced analytics and patient payment tools, Kareo helps practices maximize revenue while minimizing administrative burdens.

AdvancedMD is a cloud-based, all-in-one practice management and EHR platform with robust medical claims management capabilities, enabling electronic submission, scrubbing, and tracking of claims to major payers. It features automated eligibility verification, denial management, and revenue cycle analytics to minimize errors and accelerate reimbursements. Designed for medical practices, it integrates billing with patient records for efficient workflows and high first-pass claim acceptance rates exceeding 98%.

Athenahealth's athenaOne platform offers comprehensive medical claims management as part of its integrated EHR and revenue cycle management suite, automating eligibility verification, claims scrubbing, submission, and denial management. It leverages AI to predict denials, optimize coding, and accelerate reimbursements, achieving high first-pass acceptance rates. The cloud-based system provides real-time analytics and reporting to help practices improve financial performance and reduce administrative burdens.

Waystar is a leading revenue cycle management platform specializing in medical claims management for healthcare providers, offering end-to-end solutions for claims submission, scrubbing, denial management, and payment acceleration. It leverages AI and automation to achieve high clean claims rates, real-time eligibility verification, and predictive analytics to minimize revenue leakage. The platform integrates with major EHRs and PMS systems, providing comprehensive visibility into financial performance across the claims lifecycle.

DrChrono is a cloud-based EHR and practice management platform with robust medical claims management capabilities, including automated claims submission to clearinghouses like Availity and Change Healthcare, eligibility verification, and denial management. It streamlines revenue cycle management through features like electronic remittance advice (ERA) auto-posting, AR aging reports, and scrubber tools to reduce claim rejections. Designed for ambulatory practices, it integrates billing seamlessly with clinical workflows for efficient claims processing.

Availity is a leading healthcare revenue cycle management platform that connects over 1 million providers with more than 700 payers through a secure, nationwide network. It specializes in medical claims management by enabling electronic claims submission, real-time status tracking, eligibility verification, and electronic remittance advice (ERA) processing. The platform automates workflows to reduce denials, accelerate payments, and provide analytics for optimizing billing efficiency.

Office Ally is a web-based medical claims clearinghouse platform designed for healthcare providers to streamline electronic claims submission, eligibility verification, ERA posting, and claim status tracking. It supports ANSI 5010 formats, HIPAA compliance, and integrates with numerous EHR and practice management systems. With a focus on affordability, it provides essential claims management tools particularly suited for small to mid-sized practices.

CollaborateMD is a cloud-based medical billing and claims management software tailored for healthcare practices to optimize revenue cycle management. It provides automated claims scrubbing, electronic submission to over 3,000 payers, real-time eligibility verification, denial management, and ERA auto-posting. The platform integrates scheduling, patient statements, and robust reporting to support efficient practice operations.

eClinicalWorks is a comprehensive EHR and practice management platform that includes robust medical claims management capabilities, enabling automated claims submission, scrubbing, and tracking across multiple payers. It integrates seamlessly with electronic health records to streamline revenue cycle management, from eligibility verification to denial resolution and AR follow-up. Designed for ambulatory practices, it supports both cloud-based and on-premise deployments with tools for compliance and reporting.

NextGen Healthcare offers a comprehensive EHR and practice management platform with robust medical claims management features tailored for ambulatory practices. It automates claims scrubbing, eligibility verification, electronic submission, and denial management to optimize revenue cycle processes and ensure compliance with payer requirements. The solution integrates seamlessly with its EHR system, providing end-to-end visibility into billing workflows and financial performance.