--- title: "MediClaims Software Pricing, Alternatives & More 2026 | Capterra" description: "With the help of Capterra, learn about MediClaims Software - reviews, pricing plans, popular comparisons to other Claims Processing products and more." source_url: "https://www.capterra.com/p/25450/MediClaims/" page_type: "product" language: "en" --- # MediClaims Software Review 2026: Features, Integrations, Pros & Cons Last updated on September 7, 2026 Provider data verified by our Software Research team, and reviews moderated by our Reviews Verification team. [Description](#description)[Use cases](#use-cases)[Alternatives](#alternatives)[FAQs](#faqs)[Features](#features)[Pricing](#pricing)[Support](#support)[Reviews](#reviews) MediClaims ## What is MediClaims? WLT Software is a leader in advanced fully customizable benefit administration and claims adjudication software for Insurance Companies, TPAs, Government Plans & Self Administered Groups. Whether you are just starting, acquiring an existing TPA, or already administering millions of lives, our scalable solutions can be tailored to fit your needs. Our systems have two deployment options available; either on-site installation or as a hosted solution, making them the most flexible systems available for your organization. ## What is MediClaims used for? [Claims Processing](https://www.capterra.com/claims-processing-software/)[Benefits Administration](https://www.capterra.com/benefits-administration-software/)[Insurance Policy](https://www.capterra.com/insurance-policy-software/) Top alternative Featured Overall rating Based on 18 user reviews Reviews sentiment Positive \- Neutral \- Negative \- Starting price $1 Per Feature, One Time Free trial available Free version not included Capterra Shortlist charts the highest-rated and most popular products... Our "Best of" badge program showcases products with the highest ratings... Our "Best of" badge program showcases products with the highest ratings... Do you work for MediClaims?[Manage this product listing](https://www.g2.com/products/mediclaims/claim_requests/new?auto=true) ## Compare with a popular alternative Capterra selects software alternatives based on relevant features, verified user reviews and user interactions. Placement may be influenced by client status. ### MediClaims 3.9 (18) VS. [4.7 (56)](https://www.capterra.com/p/225457/Anagram/reviews/) Starting Price $1 Per Feature, One Time Starting Price $150 Flat Rate, Per Month Free Trial Free Version Pricing Options Free Trial Free Version Ease Of Use 3.9 (18) Ease Of Use 4.6 (56) Value For Money 4.0 (14) Value For Money 4.6 (48) Customer Service 4.4 (18) Customer Service 4.7 (54) ## MediClaims alternatives [4.6 (5,315)](https://www.capterra.com/p/153140/Connecteam/reviews/) Starting price $29.00 Per User, Per Month Pricing Options Free Trial Free Version User Rating 96% of reviewers rated it above 4 stars Highest Rated [4.9 (4,881)](https://www.capterra.com/p/172127/Rippling/reviews/) Starting price $8.00 Per User, Per Month Pricing Options Free Trial Free Version User Rating 98% of reviewers rated it above 4 stars [4.9 (4,312)](https://www.capterra.com/p/205015/Deel/reviews/) Starting price $5.00 Per User, Per Month Pricing Options Free Trial Free Version User Rating 98% of reviewers rated it above 4 stars [4.6 (3,558)](https://www.capterra.com/p/110968/BambooHR/reviews/) Starting price $10.00 Per User, Per Month Pricing Options Free Trial Free Version User Rating 95% of reviewers rated it above 4 stars ## FAQs about MediClaims Overview ### Which roles and teams benefit most from MediClaims? MediClaims is most used by claims teams, operations leaders, and administrative executives who manage eligibility, enrollment, and reimbursement workflows. Claims specialists and supervisors rely on it to process and track cases efficiently, while IT and business analysts support implementation, integrations, reporting, and smoother day-to-day system performance. Answer based on 18 reviews Overview ### What company size and industries is MediClaims built for? MediClaims is a third-party administrator built mainly for small businesses, which account for 94% of reviewers, especially in Insurance at 72%. It also serves Hospital & Health Care organizations at 17% and some Executive Office teams at 6%, with claims processing as the most common use case at 54%. Answer based on 18 reviews Features and Usability ### What are the key features of MediClaims? MediClaims offers claims management and claims tracking, plus compliance tracking, regulatory compliance, and HIPAA compliant workflows. It also includes FMLA administration, benefits management, billing and invoicing, document management, custom reports, real-time analytics, API access, and third-party integrations for employee benefits and insurance administration. Integrations ### Which third-party tools and platforms does MediClaims integrate with? MediClaims integrates with Zelis. Answer based on 1 reviews Getting Started and Support ### What training and onboarding options does MediClaims offer? MediClaims provides in person training, live online sessions, webinars, and documentation to help teams get started. In person training supports face-to-face instruction, live online sessions and webinars offer guided remote learning, and documentation gives written reference material for self-paced review. Getting Started and Support ### What customer support options does MediClaims offer? MediClaims provides Email/Help Desk, Phone Support, 24/7 Live Rep, and Chat. No reviewer feedback is available to describe support speed, helpfulness, or common frustrations, so the support experience cannot be characterized further from the catalog data alone. ## Features AI summary Based on 447 Claims Processing reviews Capterra reviewers highlight these as the features buyers care about most when choosing claims processing software: - **HIPAA Compliant** (**81%** of reviewers rated this feature as critical) - **Payment Processing** (**59%**) - **Claims Tracking** (**64%**) MediClaims supports **HIPAA Compliant** and **Claims Tracking**, so teams can protect sensitive patient data and monitor claim status throughout the reimbursement process. However, it does not offer **Payment Processing**. Instead, it provides **Document Management** (**44%**), **Billing & Invoicing** (**54%**), and **Workflow Management** (**47%**), which can help staff organize claim records, manage billing tasks, and keep work moving between steps, helping businesses improve accuracy, maintain compliance, and process claims more efficiently. HIPAA Compliant 4.6 (9) 100.00% of 9 reviewers that rated this feature as important or highly important Compliant with HIPAA, which sets standards for sensitive patient data protection Employee Benefits Administration 3.8 (9) 66.67% of 9 reviewers that rated this feature as important or highly important Manage benefit portfolio selection that is available to your employees through workplace and automate related administrative tasks Provider Management 3.8 (9) 55.56% of 9 reviewers that rated this feature as important or highly important System that helps businesses manage their relationships with various third-party vendors, suppliers, and service providers Reporting/Analytics 3.6 (7) 57.14% of 7 reviewers that rated this feature as important or highly important View and track pertinent metrics to find patterns and gain insights from data COBRA Administration 3.8 (6) 50.00% of 6 reviewers that rated this feature as important or highly important Manage mandated benefit continuation for employees who no longer work for the company for a limited time period Health Insurance Administration 3.7 (6) 100.00% of 6 reviewers that rated this feature as important or highly important Set up and manage health insurance benefits for employees MediClaims 45 features ### All Features - Accounting Integration: Integrate with a third-party accounting system - API: Application programming interface that allows for integration with other systems/databases - Benefits Dashboard: Use a dashboard to view benefits that are selected by employees or offered by employers - Benefits Management: Record employee's benefit plans and selections throughout career progression - Billing & Invoicing: Create, manage, and send invoices or bills to customers - Case Management: Work on a set of tasks related to a particular charge, patient, legal issue or any other complex entity or process - Claims Adjuster Management: Manage insurance and claims adjuster agents - Claims Management: Process of submitting and following up on claims with insurance companies - Claims Tracking: Process of tracking new and submitted claims and the status of submitted claims - COBRA Administration: Manage mandated benefit continuation for employees who no longer work for the company for a limited time period - Compensation Management: Manages compensation such as salary, bonus, and benefits processes, aligning with policies - Compliance Management: Track and manage adherence to policies for any service, product, process, or supplier - Compliance Tracking: Track and report regulatory data to either internal management or external stakeholders - Configurable Workflow: Configure existing workflows to meet your organization's needs - Customer Management: Store and organize information about customers and previous interactions - Customizable Reports: Alter the layout and content of reports - Data Import/Export: Import and export data to and from software applications - Disability Insurance Administration: Set up and manage short and/or long term disability insurance benefits - Document Management: Store, manage, and track all electronic documents in a centralized location - Document Storage: Store and organize documents in a centralized system - EDI: Transfer of data from one computer system to another - Electronic Claims: A paperless claim form that is electronically shared - Employee Benefits Administration: Manage benefit portfolio selection that is available to your employees through workplace and automate related administrative tasks - Employee Database: Electronic storage of staff/employee contact information and job status in a centralized repository - Employee Onboarding: Process of familiarizing new employees with the company, their position, and responsibilities - Employee Portal: Online portal where employees can access and track their own information - Employee Self Service: Gateway through which employees can access the system - FMLA Administration: Track employee time off under the family and medical leave act (FMLA) - Forms Management: Store, manage and track all forms in a centralized location - Health Insurance Administration: Set up and manage health insurance benefits for employees - HIPAA Compliant: Compliant with HIPAA, which sets standards for sensitive patient data protection - HSA/FSA Administration: Set up and manage health savings and flexible spending accounts for your employees - Life Insurance Administration: Set up and manage life insurance benefits for your employees - Online Benefits Enrollment: Select benefits and provide information needed to participate in a benefit via an online portal - Provider Management: System that helps businesses manage their relationships with various third-party vendors, suppliers, and service providers - Real-Time Analytics: Analyze and gain insights into data in real-time - Real-Time Data: Receive data and information in real time - Real-Time Reporting: Active reporting of data and metrics - Real-Time Updates: Receive system updates as soon as any changes are made - Reporting & Statistics: Collection, analysis, and representation of numerical data and generation of reports to understand various patterns - Reporting/Analytics: View and track pertinent metrics to find patterns and gain insights from data - Self Service Portal: Online portal through which end users can access the system, manage tasks, or obtain information - Task Scheduling: Track and manage the scheduling of tasks - Third-Party Integrations: Set up connections to third-party platforms to improve business processes - Workflow Management: Create, design and manage workflows for repetitive tasks --- Get Advice We can help you find the software with the features you need. Features 3.8 (18) 3.8 Based on 18 reviews ## Pricing Value for money 4.0 (14) Free Trial Basic $1.00 Per Feature,One Time Value for money 4.0 (14) 4.0 Based on 14 reviews Connect with a Capterra advisor for a free 15-minute consultation Get a personalized software list aligned to your business needs with guidance from our expert advisors. Our team has helped 1 million+ businesses like yours find options that fit their needs. ## Support, customer service and training options Customer Service 4.4 (18) Support - Email/Help Desk - FAQs/Forum - Knowledge Base - Phone Support - 24/7 (Live rep) - Chat Training - In Person - Live Online - Webinars - Documentation - Videos Deployment - Web - Android - iPhone/iPad Typical users - Freelancers - Small businesses - Mid size businesses - Enterprises Customer Service 4.4 (18) 4.4 Based on 18 reviews ## User reviews Overall rating 3.9 Based on 18 reviews Filter by rating 5(3) 4(11) 3(4) 2(0) 1(0) Mentioned topic Sorted by most recent LN Lori N. Director Insurance ### "ARM Ltd Review" 4.0 Overall Rating 4.0 4.0 Ease of Use 4.0 4.0 Features 4.0 4.0 Customer Service 5.0 5.0 Likelihood to Recommend 9/10 December 12, 2023 The customer service is impeccable. It is obvious that the culture at WLT is positive, and the personal tutorial interaction is greatly appreciated. Pros The opportunity to be unique in plan building by client needs. Cons It would be helpful to logging historical changes in Group Maintenance. Review source Vendor Referred - Incentive Offered: This reviewer was invited by the software vendor to submit an honest review and offered a nominal incentive as a thank you. DS Denise S. COO Executive Office ### "WLT Review" 4.0 Overall Rating 4.0 4.0 Ease of Use 5.0 5.0 Features 4.0 4.0 Customer Service 4.0 4.0 Likelihood to Recommend 9/10 December 7, 2023 Over the 19 years. Pretty good. Within the last year, notice a different in customer service response time. Pros Ease of learning and using MediClaims with all departments Cons Turn around in customer service members. Alot of delay in responses. Switched from [FACTS](https://www.capterra.com/p/148464/FACTS/) What WLT had to offer. Web Based. Was 19 years ago. Dont' recall all reasons Review source Vendor Referred - Incentive Offered: This reviewer was invited by the software vendor to submit an honest review and offered a nominal incentive as a thank you. Response from Vendor December 19, 2023 Your feedback is very important to us. We value your partnership. As you may have seen during our recent updates we have grown our customer service team and strengthen it with new management. These changes will ensure our customer service response times to get back to the levels you are accustomed to getting from WLT. Sincerely, Your partners at WLT JY Jason Y. President Hospital & Health Care ### "Mediclaims is a great platform for administration of group benefit plans" 4.0 Overall Rating 4.0 4.0 Ease of Use 4.0 4.0 Features 4.0 4.0 Customer Service 5.0 5.0 Likelihood to Recommend 8/10 December 6, 2023 Pros The team behind MediClaims is second to none when it comes to customer service and engaging with you directly to solve your problems. The value and voice that WLT gives to the user community in the continued development and improvement of the platform is second to none when it comes to SAAS services. Cons The system interface has a lot of dropdowns and menu items that can become overwhelming for personnel who has not operated in a similar database type program. Switched from [TeamUp](https://www.capterra.com/p/150357/Teamup/) Our previous system was proprietary and the programmers were on staff. As the programmers aged out we went to market and analyzed what was available and found Mediclaims and WLT to be the best fit for our TPA. Reasons for choosing MediClaims The price point weighed heavily but even more so were the people behind the product and their engagement and investment in our success as a business unit. Review source Vendor Referred - Incentive Offered: This reviewer was invited by the software vendor to submit an honest review and offered a nominal incentive as a thank you. Response from Vendor December 19, 2023 Jason, Thank you for your review. Your feedback is very important to us. We wanted to let you know we heard you and in 2024 our top priority is to improve our end user experience. We will provide more details throughout the year as we progress. Sincerely, Your friends at WLT JW Jeffrey W. Partner Insurance ### "WLTSMHA Review " 5.0 Overall Rating 5.0 5.0 Ease of Use 4.0 4.0 Features 5.0 5.0 Customer Service 5.0 5.0 Likelihood to Recommend 10/10 December 6, 2023 We have been satisfied so far, \[sensitive content hidden\] has been incredible at helping us onboard our 1st few clients. Pros Has lots of the features we needed to do business Cons It is a lot, training has been great, but lots to learn Review source Vendor Referred - Incentive Offered: This reviewer was invited by the software vendor to submit an honest review and offered a nominal incentive as a thank you. Response from Vendor December 19, 2023 Jeffrey, Thank you for your review. Your feedback is very important to us. In 2024 end user experience and training are our top priorities, which we expect to ease the burden on our end users. Stay tuned for our updates in 2024. Sincerely, Your partners at WLT YR yamiled R. tecnico farmaceutico Pharmaceuticals ### "It is a reliable, efficient and profitable company." 5.0 Overall Rating 5.0 5.0 Ease of Use 5.0 5.0 Features 5.0 5.0 Customer Service 5.0 5.0 Likelihood to Recommend 10/10 April 29, 2022 Pros I liked it a lot, for the trust, responsibility and service they provide when obtaining the product. satisfies customer needs and expectations. Cons complies with all the characteristics, and ease of use, in addition to meeting the quality standards. Review source Non-incentivized review: any software user can leave a review for any product listed on our site. All submitted reviews are subject to our verification process prior to publication. VD Victoria D. Claims Supervisor Insurance ### "Know the System" 4.0 Overall Rating 4.0 4.0 Ease of Use 5.0 5.0 Features 4.0 4.0 Customer Service 4.0 4.0 Likelihood to Recommend 6/10 February 23, 2022 GBS offers customized health plans to our clients and WLT has been able to keep up with most of our demands. The frequent updates allow us to continue to refine our processes and be more efficient - although the roll out could be smoother. Pros I have worked on the claims side for about 4 years and use the system extensively for claims process, auto-adjudication, reporting, FSA, and fee scheduling. There is a learning curve when it comes to setting up the system to your specifications, but once you get enough time using it, it becomes intuitive finding issues and making the system work better for your process. We rarely have issues with claims processing and we generally find the auto-adjudication and the fee scheduling to be highly useful. Cons There are some aspects that could be fine tuned to be better utilized. The three that come to mind is Provider Maintenance, FSA, and Reports. While there is some customization available with Provider Maintenance as far as provider types go, there could be further customization when it comes to group level. Having options in Group Edit Specifications to pend tax ID numbers or only pend certain provider types instead of all providers types would go a long way in boosting our efficiency. FSA claims processing always seems to have issues. The syncing process is lengthy and must be done daily and even then there seems to be claims that get held up with Alegus. Most issues cause us to have to force pay claims and deal with grumbling members who are waiting on their checks. The Reports application leaves a lot to be desired. The reports that are available are pretty clunky and no reports can be converted to excel easily. It is best to run customized reports in excel or have a data manager build customized reports for you. Review source Vendor Referred - Incentive Offered: This reviewer was invited by the software vendor to submit an honest review and offered a nominal incentive as a thank you. SS Shannon S. Eligibility/Claims Processing Insurance ### "MediClaims Review" 4.0 Overall Rating 4.0 4.0 Ease of Use 4.0 4.0 Features 4.0 4.0 Customer Service 4.0 4.0 Likelihood to Recommend 8/10 February 4, 2022 I do like working in WLT. I need to study the manual and study up on more of the features. Pros The product is easy to use and navigate for the most part. If I have questions or concerns, customer service is great to work with. Cons When I'm not working in the site and am logged in, I am quickly disconnected. I'd like to see the time extended before I'm disconnected. Review source Vendor Referred - Incentive Offered: This reviewer was invited by the software vendor to submit an honest review and offered a nominal incentive as a thank you. DP Donna P. VP Administration Insurance ### "WLT Software Review" 4.0 Overall Rating 4.0 4.0 Ease of Use 3.0 3.0 Features 3.0 3.0 Customer Service 4.0 4.0 Likelihood to Recommend 7/10 February 2, 2022 Very good. Pros Customer Service is very responsive and easy to work with. Cons The billing upgrade was a total nightmare. Review source Vendor Referred - Incentive Offered: This reviewer was invited by the software vendor to submit an honest review and offered a nominal incentive as a thank you. RF Robin F. PLAN BUILDER Insurance ### "A good system and fairly easy to integrate." 4.0 Overall Rating 4.0 4.0 Ease of Use 4.0 4.0 Features 4.0 4.0 Customer Service 4.0 4.0 Likelihood to Recommend 7/10 February 2, 2022 We have been overall happy with this product. It is fairly easy to train on and has many options available. Pros Claims administration on this system is very accurate and easy to use. WLT updates the system yearly based upon what their clients need which is a great feature. WLT is up to date with all compliances being enforced. Cons Plan Building portion of the system needs to have more work arounds or fixes to be able to enter in complicated or even some simple plans. We have several manual processes which is not good in our industry. Obtaining auto adjudication seems to be difficult with all of the tables/programs which need to be updated. Voiding procedures are not up to date nor easily done. Review source Vendor Referred - Incentive Offered: This reviewer was invited by the software vendor to submit an honest review and offered a nominal incentive as a thank you. AB Annette B. WC Coordinator Insurance ### "Workers' Comp user" 3.0 Overall Rating 3.0 3.0 Ease of Use 4.0 4.0 Features 4.0 4.0 Customer Service 5.0 5.0 Likelihood to Recommend 7/10 February 2, 2022 Very satisfied with the overall customer service. Love working with the people at WLT. Pros Ease of use, reliability, and the customer service provided when issues arise. Cons The request for enhancements to the software to meet the requirements of the NYS Workers' Compensation Board. Lengthy processes Review source Vendor Referred - Incentive Offered: This reviewer was invited by the software vendor to submit an honest review and offered a nominal incentive as a thank you. 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