Top 20 Global Healthcare Claim Management Companies 2025: Market Intelligence And Investment Trends (2024–2035)
RELEASE DATE: Oct 2025 Author: Spherical InsightsRequest Free Sample Speak to Analyst
Description
According to a research report published by Spherical Insights & Consulting, The Global Healthcare Claim Management Market Size is projected to Grow from USD 21.35 Billion in 2024 to USD 75.71 Billion by 2035, at a CAGR of 12.2% during the forecast period of 2025–2035. The market is driven by due to the growth of factors including a greater emphasis on offering the target population high-quality healthcare services and the increasing rate of acceptance of technology-related services, the market is experiencing spectacular expansion on a global scale.
Introduction
The term "healthcare claims management" describes an all-inclusive procedure for managing medical claims, from filing to settlement. In the market for services and software used to handle and process medical insurance claims. Medical claims for services provided by healthcare providers are submitted, processed, and settled as part of healthcare claims management.
October 8, 2025, Mumbai, India (Maharashtra): One of the top general insurance providers in India, SBI General Insurance, recently announced the release of Health Alpha, its flagship retail health insurance offering.
With effect from January 15, 2025, MSIG Singapore is happy to announce that Inova Care has been appointed as its new health claims service provider. This strategic alliance demonstrates MSIG's dedication to providing its clients with exceptional value and improved services, guaranteeing the affordability and sustainability of health plans for business clients.
Governments are acting in several nations to incentivize payers to lower their administrative expenses. The Affordable Care Act, for example, requires that 85 percent of the premiums paid by members of individual market plans in the United States be spent for medical care. This leaves just 15 percent for businesses to cover administrative and overhead costs.
Technological innovations like health information exchange (HIE) systems and electronic health records (EHR) facilitate smooth data interchange, increasing the precision and speed of claims processing. Additionally, claims management is being revolutionized by automation and artificial intelligence (AI), which are maximizing reimbursement, expediting procedures, and lowering errors.
Navigate Future Markets with Confidence: Insights from Spherical Insights LLP
The insights presented in this blog are derived from comprehensive market research conducted by Spherical Insights LLP, a trusted advisory partner to leading global enterprises. Backed by in-depth data analysis, expert forecasting, and industry-specific intelligence, our reports empower decision-makers to identify strategic growth opportunities in fast-evolving sectors. Clients seeking detailed market segmentation, competitive landscapes, regional outlooks, and future investment trends will find immense value in the full report. By leveraging our research, businesses can make informed decisions, gain a competitive edge, and stay ahead in the transition toward sustainable and profitable solutions. The increased propensity for online shopping and rising internet penetration worldwide are likely to fuel significant growth in the online stores' Healthcare Claim Management Market in the upcoming years.
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Global Healthcare Claim Management Market Size & Statistics
- The Market Size for Global Healthcare Claim Management Market was estimated to be worth USD 21.35 Billion in 2024.
- The Market Size is Going to Expand at a CAGR of 12.2% between 2025 and 2035.
- The Global Healthcare Claim Management Market Size is anticipated to reach USD 75.71 Billion by 2035.
- North America is expected to generate the highest demand during the forecast period in the Global Healthcare Claim Management Market
- Asia Pacific is expected to grow the fastest during the forecast period in the Global Healthcare Claim Management Market.
Regional growth and demand
North America is expected to generate the highest demand during the forecast period in the Global Healthcare Claim Management Market. Growing hospital admissions and the incidence of chronic illnesses are the market's main drivers. A strong healthcare infrastructure is the result of healthcare organizations' increasing use of cutting-edge technologies, which raises medical expenses. Most people in North America are aware of the different reimbursement procedures that both private and public organizations have. Key companies' presence further boosts the growth of the healthcare claims management market.
Asia Pacific is expected to grow the fastest during the forecast period in the Global Healthcare Claim Management Market. A number of factors are contributing to Asia's high growth during the forecast period, including investments in modernizing the healthcare infrastructure and the increasing use of healthcare IT solutions in China, initiatives to improve the quality of healthcare delivery in Japan, and the swift expansion of the healthcare sector in India.
Top 10 Trends in the Global Healthcare Claim Management Market
- Increasing complexity of healthcare billing and coding regulations
- Rise in healthcare costs and need for cost containment
- Advancements in technology
- Increased adoption of cloud-based solutions
- Focus on patient-centric care
- Increased adoption of revenue cycle management solutions
- Growing adoption of AI and analytics in claim processing
- Growing health insurance market
- Growing Geriatric and chronic disease population
- Escalating financial impact of claim denials
1. Increasing complexity of healthcare billing and coding regulations
Healthcare professionals must handle complicated coding systems, documentation standards, and billing criteria as regulations become increasingly complicated and strict to submit proper claims. Payment rejections, audits, and fines may follow noncompliance with these rules.
2. Rise in healthcare costs and need for cost containment
There is pressure on healthcare institutions and payers to lower costs and enhance financial performance due to rising healthcare prices. Finding billing problems, fraudulent activity, and incorrect payments, all of which can lead to needless expenses, is made possible by healthcare claims management.
3. Advancement in technology
Adoption of health information exchange (HIE) and electronic health record (EHR) systems facilitates the easy processing and sharing of patient data, improving the precision and efficiency of claims processing. Furthermore, technological developments enable healthcare institutions to take advantage of data and automation, which leads to more efficient claims processing procedures, increased precision, and better revenue cycle management.
4. Increased adoption of cloud-based solutions
Because of their affordability, scalability, and flexibility, cloud-based healthcare claims management solutions are becoming more and more popular. Companies are switching from on-premise to cloud-based solutions in an effort to lower the cost of their IT infrastructure.
5. Focus on patient-centric care
Patients are at the heart of their care as the healthcare sector shifts to a patient-centric care paradigm. Solutions for managing medical claims are being developed to give patients more information access and control over their medical expenses.
Empower your strategic planning:
Stay informed with the latest industry insights and market trends to identify new opportunities and drive growth in the Global Healthcare Claim Management Market. To explore more in-depth trends, insights, and forecasts, please refer to our detailed report.
Top 20 Companies Leading the Global Healthcare Claim Management Market
- Athenahealth
- Optum
- Cognizant (Trizetto)
- CareCloud
- eClinicalWorks
- Quest Diagnostics
- McKesson
- Oracle
- Accenture plc
- IBM
- PLEXIS healthcare systems
- Allscripts
- Cerner Corporation
- Change Healthcare
- The SSI Group, LLC
- Conifer Health Solutions
- Kareo
- ClaimXperience
- Inova Care
- Tego Insurance
- Others
1. Athenahealth
Headquarters: Boston, Massachusetts, U.S
Athenahealth is a privately held American company that provides network-enabled services for healthcare and point-of-care apps in the United States. The company’s headquarters is in Boston, Massachusetts, U.S. The Athenahealth More Disruption Please program was launched in 2011. The initiative is both a partner program and an incubator environment for independent companies to develop products and services connected to Athenahealth's ecosystem. Athenahealth's MDP Labs offered workspace in its downtown San Francisco office, tailored programming, dedicated mentorship, opportunities for partnerships and funding, and exposure to potential clients, though it ended around 2019 with the closure of the San Francisco and other offices.
2. Optum
Headquarters: Eden Prairie, Minnesota, U.S
Optum is an American healthcare company that provides technology services, pharmacy care services, and various direct healthcare services. In August, A physician-owned healthcare organization with more than 200 providers and more than 70 locations that primarily serves Northeast Tennessee and Southwest Virginia, Holston Medical Group, was acquired by Optum. Optum claims solutions help you tackle barriers to improve cash flow by automatically flagging claims for inaccurate coding and billing documentation before payer submission. On Average, they help clients achieve a 23:1 return on investment.
3. Cognizant (Trizetto)
Headquarters: Teaneck, New Jersey, U.S.
Cognizant Technology Solutions Corporation is an American multinational information technology consulting and outsourcing company originally founded in India. It is headquartered in Teaneck, New Jersey, U.S. Cognizant is a part of the NASDAQ-100 and traded under CTSH. Cognizant’s TriZetto healthcare products and services are connecting payers, providers, and patients like never before, unifying healthcare in near real time. See why America’s leading healthcare organizations trust TriZetto solutions to support 200 million members and 875,000 providers. On 22 April 2024, Cognizant announced its partnership with Microsoft Corporation to extend its reach of Generative AI and Copilots, also to enhance the experiences of employees and speed up their cross-industry innovation
4. CareCloud Inc.
Headquarters: New Jersey, U.S.
CareCloud is a leading cloud-based and AI-powered healthcare solutions provider. CareCloud headquarters in New Jersey, U.S. Hospitals and healthcare providers can use the services of this publicly traded American healthcare IT company. Based in Somerset, New Jersey, the company employs over 4,000 people worldwide. American entrepreneur Mahmud Haq founded CareCloud in 1999 under the name Medical Transcription Billing Corporation (MTBC). According to sources, CareCloud bought two major healthcare technology companies in 2020: Meridian Medical Management and CareCloud Corporation.
5. eClinicalWorks
Headquarters: Westborough, Massachusetts, United States.
eClinicalWorks is the largest cloud-based EHR software in the U.S. Our EHR, telehealth, and other practice management solutions help you grow and maintain your practice. It is used by more than 8,50,000 medical professionals in more than 20 countries. It's developed innovative, customizable tools for documentation, population health, patient engagement, and Revenue Cycle Management. Through leading-edge technology and putting the needs of clients first, they help medical professionals improve the quality of care, reduce costs, and meet regulatory requirements.
Are you ready to discover more about the Global Healthcare Claim Management Market?
The report provides an in-depth analysis of the leading companies operating in the Global Healthcare Claim Management Market. It includes a comparative assessment based on their product portfolios, business overviews, geographical footprint, strategic initiatives, market segment share, and SWOT analysis. Each company is profiled using a standardized format that includes:
Company Profiles
1. Athenahealth
- Business Overview
- Company Snapshot
- Products Overview
- Company Market Share Analysis
- Company Coverage Portfolio
- Financial Analysis
- Recent Developments
- Merger and Acquisitions
2. Optum
3. Cognizant (Trizetto)
4. CareCloud
5. eClinicalWorks
6. Quest Diagnostics
7. McKesson
8. Oracle
9. Accenture plc
10. IBM
11. PLEXIS healthcare systems
12. Allscripts
13. Cerner Corporation
14. Change Healthcare
15. The SSI Group, LLC
16. Conifer Health Solutions
17. Kareo
18. ClaimXperience
19. Inova Care
20. Tego Insurance
21. Others
Conclusion
The Global Healthcare Claim Management Market is driven by due to the growth of factors, including a greater emphasis on offering the target population high-quality healthcare services and the increasing rate of acceptance of technology-related services, the market is experiencing spectacular expansion on a global scale. Technological advancements such as electronic health records (EHR) and health information exchange (HIE) systems allow for seamless data interchange, improving the accuracy and speed of claims processing. Artificial intelligence (AI) and automation are also revolutionizing claims management by increasing reimbursement, speeding up processes, and reducing errors. North America is the largest growing market in the Healthcare Claim Management Market, and the Asia Pacific is the fastest growing market in the Healthcare Claim Management Market.
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