ssi-claims-management

JSON twin: https://www.healthaidb.com/software/ssi-claims-management.json

Company Name

The SSI Group

Product URL

https://thessigroup.com/claims-management/

Company URL

https://thessigroup.com

Categories

Summary

SSI Claims Management (Claims Director) is an enterprise claims and clearinghouse solution that automates claim edits, submission, statusing, remittance posting and denial management to improve first-pass acceptance and accelerate reimbursement.

Description

An end-to-end revenue cycle claims management platform (Claims Director) from The SSI Group that provides extensive payer-specific and industry edits, an EDI clearinghouse, electronic attachments, claim status automation, denial/root-cause analytics, remittance management, audit & appeals integration (RevKeep), document/file folder storage and workflow-driven queues to minimize manual work and increase clean-claim rates.

Api Available

yes

Certifications

Company Founding

1988

Company Offices

Compliance

Customers

Data Residency

Data Standards

Deployment Model

Features

Id

P1562

Integration Partners

Integrations

Languages Supported

Last Updated

2025-09-07

License

commercial, proprietary

Links

Market Segment

Optional Modules

Os Platforms

Pricing Details

Contact vendor for pricing and implementation options; demo available; enterprise contracts and custom quotes.

Pricing Model

enterprise_quote

Privacy Features

Ratings

Regions Available

Release Year

Security Features

Specialties

Support Channels

System Requirements

Target Users

Training Options

Type

product

User Reviews

Version

1.0

Canonical JSON

{
  "company_name": "The SSI Group",
  "company_url": "https://thessigroup.com",
  "company_offices": [
    "United States"
  ],
  "company_founding": "1988",
  "product_url": "https://thessigroup.com/claims-management/",
  "categories": [
    "administrative",
    "revenue cycle",
    "claims management",
    "clearinghouse",
    "denial management",
    "claims analytics"
  ],
  "market_segment": [
    "enterprise",
    "health system",
    "payer"
  ],
  "links": [
    "https://thessigroup.com/claims-management/",
    "https://thessigroup.com/",
    "https://thessigroup.com/aboutus/",
    "https://thessigroup.com/clearinghouse/",
    "https://thessigroup.com/rcm-performance-insights/",
    "https://thessigroup.com/client-support/",
    "https://elion.health/products/ssi-claims-management/customers",
    "https://www.g2.com/products/the-ssi-group-ssi-claims-management/reviews",
    "https://klasresearch.com/review/the-ssi-group-ssi-claims-management/1220",
    "https://thessigroup.com/hipaa/"
  ],
  "summary": "SSI Claims Management (Claims Director) is an enterprise claims and clearinghouse solution that automates claim edits, submission, statusing, remittance posting and denial management to improve first-pass acceptance and accelerate reimbursement.",
  "description": "An end-to-end revenue cycle claims management platform (Claims Director) from The SSI Group that provides extensive payer-specific and industry edits, an EDI clearinghouse, electronic attachments, claim status automation, denial/root-cause analytics, remittance management, audit & appeals integration (RevKeep), document/file folder storage and workflow-driven queues to minimize manual work and increase clean-claim rates.",
  "target_users": [
    "hospital billing teams",
    "revenue cycle managers",
    "hospital administrators",
    "medical coders/billers",
    "physician office billing staff",
    "denial management specialists",
    "payer connectivity teams",
    "billing service bureaus"
  ],
  "specialties": [
    "hospital/acute care",
    "physician billing",
    "long term care",
    "skilled nursing",
    "home health and hospice",
    "durable medical equipment",
    "ambulance billing",
    "dialysis",
    "infusion therapy",
    "behavioral health",
    "reference laboratory",
    "inpatient/outpatient rehabilitation"
  ],
  "regions_available": [
    "United States",
    "Canada"
  ],
  "languages_supported": [
    "English"
  ],
  "pricing_model": "enterprise_quote",
  "pricing_details": "Contact vendor for pricing and implementation options; demo available; enterprise contracts and custom quotes.",
  "license": "commercial, proprietary",
  "deployment_model": [
    "SaaS",
    "on_prem",
    "hybrid"
  ],
  "os_platforms": [
    "Web"
  ],
  "features": [
    "Claims processing workflow and queues",
    "Billing edits (extensive payer/provider edits)",
    "EDI clearinghouse (real-time and batch)",
    "Flexible claim status (276/277 support)",
    "Electronic attachments and automated submission",
    "Remittance management and ERA retrieval (835)",
    "Claims analytics and reporting",
    "Denial management with AI-assisted root cause",
    "Audit & appeals workflow (RevKeep integration)",
    "Bill date and confirmation note posting",
    "File Folder document repository",
    "Correspondence conversion (scanned indexing)",
    "EOB conversion to ERA",
    "Pre-billing eligibility checks",
    "Payer status query (Epic integration support)"
  ],
  "optional_modules": [
    "Pre-Billing Eligibility Edits",
    "Claim Status Module (Medicare DDE and EDI)",
    "Electronic Attachments",
    "Denial Management",
    "Audit & Appeals (RevKeep)",
    "Claims Analytics",
    "Clearinghouse services",
    "File Folder document management"
  ],
  "integrations": [
    "Epic (bidirectional payer status query)",
    "MEDITECH Expanse",
    "Medicare Common Working File (CWF)",
    "RevKeep (audit & appeals)",
    "Major commercial and government payers (900+ direct payer connections)",
    "Patient accounting / host HIS systems",
    "EMR systems (for attachment retrieval)"
  ],
  "data_standards": [
    "ANSI X12 (837, 835, 270/271, 276/277, 278)",
    "CAQH CORE",
    "HIPAA EDI"
  ],
  "api_available": "yes",
  "system_requirements": "",
  "compliance": [
    "HIPAA",
    "CAQH CORE",
    "EHNAC",
    "SOC 2",
    "HITRUST CSF",
    "NIST frameworks"
  ],
  "certifications": [
    "CAQH CORE certified",
    "EHNAC accredited",
    "SOC 2 compliance",
    "HITRUST CSF certification"
  ],
  "security_features": [
    "Encryption in transit and at rest",
    "Role-based access control (RBAC)",
    "SSO/SAML support",
    "Audit logging",
    "Secure EDI/payer registration and file retrieval"
  ],
  "privacy_features": [
    "BAA available"
  ],
  "data_residency": "",
  "customers": [
    "Northern Regional Hospital"
  ],
  "user_reviews": [
    "The SSI Group is really solidly focused on core edits and clearinghouse functionality.",
    "Automates tasks like claims processing, coding, and denial management, helping ensure faster reimbursements and reduced administrative burden.",
    "Industry-leading clean claim rate and extensive edits — customers report improved first-pass acceptance rates."
  ],
  "ratings": [
    "KLAS Best in KLAS (2020) — Score 93 (Business Wire)",
    "KLAS (2023) — Score 88.4 (KLAS report)",
    "G2 — Product listed with user reviews (G2)"
  ],
  "support_channels": [
    "email",
    "phone",
    "ticketing",
    "client_support"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online",
    "onsite",
    "implementation_services"
  ],
  "release_year": "",
  "integration_partners": [
    "RevKeep",
    "Epic",
    "MEDITECH Expanse",
    "Various commercial and government payers (900+ direct payer connections)"
  ],
  "id": "P1562",
  "slug": "ssi-claims-management",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-09-07",
  "links_json": {
    "self": "https://www.healthaidb.com/software/ssi-claims-management.json"
  }
}