Healthcare Claims Management Software Market: Introduction

  • Healthcare claims management is a process that involves numerous tasks such as billing, organization, updating, filing and processing of medical claims related to the treatment, diagnosis, and medication of patients. Healthcare claims management software manages medical claims and reimbursement processes in the healthcare sector.
  • Furthermore, healthcare claims management software is used to streamline the medical claims process, which eases the relationship between provider and insurance company, in order to efficiently speed up the patient’s payment lifecycle.
  • The COVID-19 pandemic has strained the healthcare system worldwide. Ensuring timely treatment and complete patient safety is the major concern during this pandemic outbreak. Healthcare claims management software plays an important role in restoring the trust of people, as no country, whether developed or developing, has an infrastructure or software that can deal with this virus. Epidemiological handling and preventive strategies are being implemented with the help of healthcare claims management software in order to relieve the strained healthcare facilities across the world.

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Global Healthcare Claims Management Software Market: Dynamics

Global Healthcare Claims Management Software Market: Key Drivers and Restraints

  • Increase in aging population, and rise in incidence of COVID -19, is expected to be the major factor boosting the growth of the healthcare claims management software market.
  • Besides, improved focus on quality healthcare services and advent of innovative treatments & technologies in the healthcare sector across the world is expected to drive the market.  
  • Furthermore, increasing importance of denials management is expected to fuel the growth of the market over the forecast period.
  • Rising initiatives of governments in developing countries to provide better healthcare services, in order to improve healthcare infrastructure is expected to drive the healthcare claims management software market.
  • Moreover, rising investments by governments of both developed and developing economies to modernize the healthcare infrastructure and also to adopt healthcare IT solutions is expected to enhance the growth of the market worldwide.
  • However, increasing concerns about patient data safety & security and rise in cybercrime are expected to hamper the healthcare claims management software market.
    • For instance, according to the National Health Insurer Report Card published in 2011 by American Medical Association (AMA), around US$17 Bn a year (on an average) could be saved by removing errors in claims.

Asia Pacific to Account for Major Share of the Global Healthcare Claims Management Software Market

  • In terms of region, the global healthcare claims management software market can be divided into North America, Europe, Asia Pacific, Middle East & Africa, and South America.
  • The healthcare claims management software market in North America is anticipated to expand at a rapid pace over the forecast period, due to well-established players. This in turn is expected to boost the growth of the market in the region.
  • Europe is expected to hold significant share in the global healthcare claims management software market due to the increased use of software and hardware for processing claims, and presence of top insurance companies in the region.
  • The healthcare claims management software market in Asia Pacific is expected to hold a significant share due to rising awareness of medical claims across the region, which in turn is expected to boost the market. India and China are the major countries enhancing the growth of the healthcare claims management software market, due to rising population.

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Global Healthcare Claims Management Software Market: Competitive Landscape

Key Players Operating in the Global Healthcare Claims Management Software Market

Local, regional, and international players are active in the healthcare claims management software market. The market is highly consolidated, with top manufacturers accounting for approximately 25%–30% share of the market. Key players operating in the global healthcare claims management software market are:

  • Athenahealth
  • Cerner Corporation.
  • Comindware Inc.
  • Conifer Health Solutions, LLC.
  • eClinicalWorks
  • McKesson Corporation
  • nThrive, Inc
  • Optum, Inc.
  • OSPLabs
  • PLEXIS Healthcare Systems
  • PokitDok, Inc.
  • Thermo Fisher Scientific Inc.

Global Healthcare Claims Management Software Market: Research Scope

Global Healthcare Claims Management Software Market Segmentation, by Deployment   

  • On-premise
  • Cloud- based

Global Healthcare Claims Management Software Market Segmentation, by Component      

  • Software
    • Integrated Solutions
    • Standalone Solutions
  • Services
    • Professional Services
      • Training & Consulting
      • Support & Maintenance
      • Integration & Implementation
    • Managed Services

Global Healthcare Claims Management Software Market Segmentation, by Solution

  • Claims Integration
  • Claims Review Management
  • Claims Management Reporting
  • Claims Status Management
  • Remittance Management Solutions
  • Others 

Global Healthcare Claims Management Software Market Segmentation, by End-user    

  • Healthcare Providers
  • Healthcare Payers

Global Healthcare Claims Management Software Market Segmentation, by Region

  • North America
    • U.S.
    • Canada
    • Rest of North America
  • Europe
    • Germany
    • France
    • U.K.
    • Rest of Europe
  • Asia Pacific
    • China
    • Japan
    • India
    • Australia
    • Rest of Asia Pacific
  • Middle East & Africa
    • U.A.E.
    • Saudi Arabia
    • South Africa
    • Rest of Middle East & Africa
  • South America
    • Brazil
    • Rest of South America

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