Revenue Cycle Management


Reliable Claims Management System for Medical Facilities

SIMPLEX HIMES also has an e-Claims service option. It comes integrated with our end to end software solution. The feature assists healthcare service providers in maintaining control over every receivable. With our solutions by your side, you will find it easy to reach out to Insurance agencies and communicate with them.

This will reduce the rejection rates significantly. Most revenue cycle operations, like remunerations and billing, are exhaustive processes and many challenges may arise in administering the compensation norms, payer-centric variables, and other directives.

Our Revenue Cycle Management module will help with all the major problems you face while billing. By having SIMPLEX HIMES backing your services, your RCM team will find it easy to handle even the most demanding processes. Its rule-based core will authorize you to redefine the payer-centric variables and reimbursement guidelines. Your team will only have to input these values once, and the software will remember them for future reference.

Modules and Features


  • End to end Prior authorization workflow
  • Eligibility checks
  • Claim Imports
  • Claim Data management
  • Claim Submission
  • Claim Remittance
  • Claim Re-submission
  • Claim Reconciliation


  • Claim Submission report
  • Claim rejection report
  • Claim Re-submission report
  • Claim Analysis based on doctor, department, Insurance company, network and plan.


  • Insurance Company Master
  • Price List Master
  • Network and Plans
  • Copay and deductible rules
  • Coverage, exclusions
  • Posting to Accounts