As of May 2026, there are 18 SaaS companies in Core Administrative Processing Systems Software. They have combined revenues of $1.1B and employ 9.7K people. They have raised $13.2M and serve - customers combined.
Core Administrative Processing Systems Software (CAPS) encompasses a set of solutions that support the administrative functions of organizations, particularly within the healthcare sector. These systems manage critical processes such as claims processing, member enrollment, benefit configuration, and billing, enhancing operational efficiency and accuracy. By automating various administrative tasks, CAPS enable organizations to streamline workflows, reduce operational costs, and improve customer service. Typical users of Core Administrative Processing Systems include healthcare payers, insurance companies, and healthcare providers, who rely on these solutions to ensure smooth claims management and regulatory compliance. Key features of CAPS often encompass data integration, analytics, and reporting capabilities, allowing for better decision-making and performance tracking. As the healthcare landscape continues to evolve, the demand for effective administrative processing software remains crucial to the success of health plans and related organizations.
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Showing 10 of 4 companies ranked by annual revenue.
Washington, District of Columbia, United States
By designing a next-generation clinical NLP engine supporting advanced documentation and coding functions, EZDI turned their vision to reality. Their CAC and CDI solutions received tremendous feedback, providing system accuracy and ease of use. EZDI removes the data complexity and highlights what matters for healthcare professionals.
New York, New York, United States
At Simple Fractal, we take pride in being the premier automation partner for ABA providers. With nearly a decade of collaboration with the industry's largest providers, our in-depth understanding of the specific processes and technology platforms in the ABA sector sets us apart. Our team's extensive operational and automation experience is further enriched by industry veterans, including the former CIO of Autism Learning Partners and former Director of Strategic Initiatives at LEARN Behavioral, bringing unparalleled subject matter expertise to our solutions. At Simple Fractal, we've mastered the art of tailoring automation solutions that perfectly fit the nuanced needs of ABA therapy providers. Our stellar engineering and dedicated maintenance teams have developed over 100 bots that efficiently handle essential functions in Revenue Cycle Management (RCM), Client Services, and HR compliance, ensuring our clients can focus more on delivering exceptional care and serving more families in need of their services. The effectiveness of our solutions is proven by our track record: with ROIs exceeding 10X and bots in continuous operation for 6+ years, we have earned 4.9 out of 5-star rating on G2. An independent report by KLAS Research further validates our success, with 100% of our clients meeting all expected outcomes from our engagements, all of which are now expanding their partnership with us. Building on our achievements with the largest ABA providers, Simple Fractal is committed to making our cutting-edge automation solutions accessible to mid-market providers. We are also exploring expansion into related verticals within the health and human services sector, aiming to leverage our automation expertise to benefit a broader range of organizations. Our approach of combining deep industry knowledge with technical excellence and dedicated support has stood the test of time. For ABA providers looking to level up and grow, Simple Fractal is your dedicated partner.
Elgin, Illinois, United States
26+ YEARS OF INNOVATION IN HEALTHCARE We are at the forefront of the industry, offering fully integrated, customizable workflow solutions, revenue cycle management, and patient management software. Our specialty lies in the optimization of organizational workflows and the application of Robotic Process Automation (RPA) to healthcare processes. Our commitment to innovation and excellence is driven by our mission to empower healthcare organizations with the tools they need to provide efficient, cost-effective, and patient-centric care.
San Antonio, Texas, United States
Health plan administration involves many moving parts. We help Healthcare Payers organize their data, vendors, and business processes behind one login so they can efficiently manage the different pieces of the health plan in one place. For more than 25 years, Third Party Administrators, Health Plans, International Insurance Carriers, Government Payers, Employers, and Health Trusts worldwide have achieved greater efficiencies and greater marketability through their partnership with Health Portal Solutions. Schedule your demo at www.hpsglobal.net.
- Must automate core administrative tasks such as claims processing and billing - Should facilitate member enrollment and benefit configuration - Needs to support regulatory compliance and reporting requirements - Must integrate with existing IT systems and databases - Designed for use by healthcare payers and providers - Not just focused on claims management; must also provide analytics and operational insights
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