Claims-Flow Software

  Claims Adjudication & Repricing

  Provider Data Management

  EDI Generation & Parsing

  Intake, Authorization, & Appeals

  Utilization Management

  Integrated Auditing & Quality Control

What We Do

Provident Solutions offers claims processing software for health care organizations such as health plans, managed care organizations, and provider associations.

We specialize in non-traditional, large management claims systems that sit between the payor and the provider. These systems perform any number of tasks from billing, pricing, and AR management.


Since 2002

Providing health care solutions and services for nearly 20 years, and in that time, we've developed a series of reusable claims-flow modules. These modules work together seamlessly and can be installed as needed to fit your business needs.

Claims Software

Our customizable software can be configured to meet your specific claims processing needs. Features include billing, payment, episodic pricing and repricing, E&M reporting, AR management and more. All of these features are automated and reduce the need for repetitive daily tasks.

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EDI Tools

Automated EDI functionality is built-in to our claims solution allowing generation and parsing of complicated ANSI files. We support the latest X12 specifications required by Medicare and other payors. Solutions include 837, 835, 277, TA1 & 999 capabilities and more.

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Provider Portal

A self-serving portal will make providers happy and save you time. Our portal allows providers to safely retrieve EOP's, 835's, investigate open claims, start an appeal or upload claim documentation. Offices can manage their own user set and can only access claims data assigned to their NPI.

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Flexible Pricing

Choose from our various modules for your custom claims solution. Our software includes a wide range of tools to fit your particular claim processing needs. Automation is our specialty. Use our time-tested modules to improve productivity, billing & payment accuracy, AR tracking, and utilization management.

The Claims-Flow modules are listed below. Mix and match to fit your business needs.

Claims-Flow Overview