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Claims checking and payment 8 companies

Health plans run every claim through rules that check it is covered, correctly coded and fairly priced, then pay the provider electronically.

Zelis logoZelisZelis, with engineers in Hyderabad, checks bills and pays doctors electronically on behalf of health plans.HyderabadHired recently
MDI NetworX logoMDI NetworXMDI NetworX processes claims for health plans and the firms that administer them.Pune
Lyric logoLyricLyric, with engineers in Hyderabad, sells the claim-checking rules American health plans run on every claim before paying it.Hyderabad
Cotiviti logoCotivitiCotiviti, with engineers in Hyderabad, checks that health plans pay claims correctly, and works out extra payments for plans with sicker members.
CoverSelf logoCoverSelfCoverSelf, with engineers in Bengaluru, sells a cloud platform for checking claims before they are paid.
Simplify Healthcare logoSimplify HealthcareSimplify Healthcare, with engineers in Pune, sets up each plan's benefits and claim rules inside its core system.
LightSpun logoLightSpunLightSpun automates the checking of dental claims.
Acentra Health logoAcentra HealthAcentra Health, with engineers mostly in Chennai, processes claims and runs care programmes for American state Medicaid agencies.
The tech, explainedPayment integrityClaims adjudication and administrationClaims editing softwareHealthcare paymentsHealth plan benefits configuration
2

Care management and health plans 4 companies

Health plans manage the care of members with serious illnesses, and some new plans are paid for keeping people healthy.

Evolent logoEvolentEvolent, with engineers in Pune, manages the care of health-plan members with complex illnesses such as cancer and heart disease.PuneHiring now
XO Health logoXO HealthXO Health, with engineers in Bengaluru, builds health plans for employers that are paid for keeping staff healthy, not for each treatment.
Loop logoLoopLoop, with engineers in Bengaluru, sells Indian companies group health insurance with its own doctors.
Alegeus logoAlegeusAlegeus runs the health savings and spending accounts of American employees.BengaluruHiring nowSee alsoBenefits administration software
The tech, explainedCare management softwareValue-based care for employersGroup health insurance↗ Insurtech
How it all worksMedical billing and claimsOne bill, from the clinic's code to the plan's payment.
See how it works →

What's changing

AI models are starting to check claims.

Checking claims against thousands of rules is slow. AI models now flag the claims likely to be wrong, and the question regulators ask is how a claim denied by a model can be explained and appealed.

Read moreClaims adjudication and administration
← Previous in InsurtechEmbedded insuranceNext in Insurtech →Digital insurers
Elsewhere in Insurtech:Core insurance software (policy, billing and claims)Insurance agency and broker softwareUnderwriting, pricing and claims analyticsInsurance aggregators and online brokers

Companies: ingrid's company map. Hiring signals: postings feed of 5 Nov 2026.