According to the global healthcare claims management market report by IMARC Group, the market reached a value of US$ 14.3 Billion in 2022, and it is projected to reach a value of US$ 24.4 Billion by 2028, exhibiting a CAGR of 9.1% during 2023-2028.

Healthcare claims management represents solutions that include optimizing, updating, filing, and processing medical claims related to a patient’s treatment, diagnosis, and medications. They can be categorized into integrated and standalone variants and comprise of clinical billing software, healthcare practice management software, revenue cycle management software, etc. which are available to payers, insurance companies, and healthcare providers.Healthcare claims management services offer an accurate and quick process to resolve claims as quickly as possible, streamline the medical claims process, ease the relationship among providers and insurance companies, improve patient payment processes, etc. As a result, they find extensive applications in the healthcare sectors across the globe.

Market Trends:

The growing geriatric population and the rising number of individuals suffering from chronic diseases are among the key factors driving the healthcare claims management market. In addition to this, the elevating complexity of claims administration and the medical billing procedures and the escalating awareness about the management of claim denials are acting as significant growth-inducing factors.Apart from this, the shifting preferences toward cloud-based and web-based operation modes in healthcare software are also positively influencing the global market. Moreover, the launch of several initiatives by the government bodies across the globe aimed at enhancing insurance coverage is further stimulating the market growth.

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Besides this, the increasing mergers and acquisitions (M&As) among leading market players, the launch of new product, the expanding urbanization, and the inflating investments in medical research and development (R&D) activities are expected to propel the healthcare claims management market over the forecasted period.

Competitive Landscape:

The competitive landscape of the market has been studied in the report with the detailed profiles of the key players operating in the market.

Accenture plc, Allscripts Healthcare Solutions Inc., Athenahealth, Carecloud Inc, Cognizant, Conifer Health Solutions (Tenet Healthcare Corporation), Mckesson Corporation, Optum Inc. (UnitedHealth Group Incorporated), Oracle Corporation, Plexis Healthcare Systems, Quest Diagnostics and The SSI Group LLC.

Key Market Segmentation:

Breakup by Product:

  • Medical Billing
    • Professional
    • Institutional
  • Claims Processing

Breakup by Component:

  • Services
  • Software

Breakup by Solution Type:

  • Integrated Solutions
  • Standalone Solutions

Breakup by Delivery Mode:

  • On-premises
  • Cloud-based
  • Web-based

Breakup by End User:

  • Healthcare Payers
  • Healthcare Providers
  • Others

Regional Insights:

  • Asia Pacific
  • North America
  • Europe
  • Middle East and Africa
  • Latin America

On the geographical front, Asia Pacific enjoys the leading position in the market. This can be attributed to the rising establishment of international companies in the region, on account of low manufacturing costs and cheap labor.

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