Claim360
Claim360: Rules and machine-learning signals support adjudication, review, fraud scoring, and provider workflows. Ranked #7 of 16 in Claims Processing Software by our editors (8.6/10); pricing: Pricing on request; best for mid-market and enterprise health and life insurers.
At a glance
- Editor score8.6 / 10
- PricingPricing on request
- Best forMid-market and enterprise health and life insurers
- Free planNo
- Workflow automationAdvanced
- Facts checked24 Sep 2026
Where it wins
- Automates claims decisions with benefit rules and machine-learning signals
- Routes complex claims for human review and scores real-time SIU fraud signals
- Connects member and provider portals with settlement workflows and audit trails
Where it doesn't
- Focused on health and life insurance claims
- Pricing requires contacting sales for a personalised walkthrough
- Cloud deployment may not suit teams seeking another deployment model
Our verdict on Claim360
Claim360 supports health and life insurers handling claims adjudication and related operations. Configurable benefit rules and machine-learning signals assist automated decisions, while complex claims can be routed for human review. Its scope also includes fraud scoring, provider network analysis, member and provider portals, dashboards, and provider settlement workflows. The product is aimed at mid-market and enterprise organisations seeking to coordinate adjudication and provider interactions in one platform.
The workflow covers more than claim decisions. Providers can submit, code, and reconcile encounters through a portal, with QR-based proof-of-presence capture available to open an encounter at the point of care. Provider payment instructions and benefit accumulator updates support settlement processes. Members can track benefits and claims, while live dashboards surface loss ratios, accumulator burn, SLA compliance, and fraud signals. Role-based access control and a tamper-evident adjudication audit trail add operational controls. This breadth will matter to insurers looking to connect claims, provider activity, and oversight; teams seeking a narrow adjudication tool may find the wider workflow unnecessary.
Claim360 is sold through a contact-sales process rather than published plan prices, and the vendor offers personalised product walkthroughs. Buyers should expect to discuss requirements directly rather than compare public tiers. The platform is cloud-based and available through web and API, making it a fit for organisations planning around those access options. Health and life insurers with complex claims, provider workflows, and fraud review needs are the clearest match. Organisations that need another insurance line or deployment model should consider alternatives better aligned with that scope.
Your product? Our editors can test Claim360 in depth and publish a review, labelled as paid · from $149/mo →
Claim360 pricing
Claim360 fact sheet
| Free plan | No |
|---|---|
| Paid from | Not verified |
| Supported claim lines | Health and life insurance |
| Intake channels | Provider portal; QR proof-of-presence encounter capture |
| Workflow automation | Advanced |
| Integration options | Not verified |
| Deployment | Cloud |
| Deployment | Cloud |
| Platforms | Web |
| Built for | Mid-market, Enterprise (editorial estimate) |
| Pricing | Pricing on request |
| Website | claim360.ai |
| Facts checked | 24 Sep 2026 |
Alternatives to Claim360
- Guidewire ClaimCenterConfigurable claims workflows, digital intake, and analytics for P&C insurers.9.2
- Duck Creek ClaimsAn enterprise claims platform covering intake through recovery with AI-assisted decisioning.9.1
- Origami Risk ClaimsA configurable claims platform spanning intake, adjudication, payments, recovery, and review.9.0
See all Claim360 alternatives →
Claim360 vs the competition
- Claim360 vs Guidewire ClaimCenter
- Claim360 vs Duck Creek Claims
- Claim360 vs Origami Risk Claims
- Claim360 vs Snapsheet Claims
- Claim360 vs ClickClaims
- Claim360 vs VINGS
Compare Claim360 with any tool side by side →
Used Claim360? Be the first to review it
The editor score above is our own research. What this page doesn't have yet is a reader's view — what you used Claim360 for, what worked and what didn't. No stars are seeded and no review is paid for; an editor reads every one before it appears.
Write a reviewTwo minutes · verified accounts only · read by an editor before it appears
Featured on iTechGuides
Claim360 is listed in our Claims Processing Software directory. Add the badge to your site — it links back to this page.
<a href="https://www.itechguides.com/products/claim360/"><img src="https://www.itechguides.com/best/badge/claim360.svg" alt="Featured on iTechGuides" width="230" height="46"></a>
Reviewed by iTechGuides Editors · Editorial team · Updated Oct 2026
Advertiser disclosure: iTechGuides is reader-supported. Vendors can pay for top positions in our rankings and for a place on other products' pages, and we may earn a commission when you click some links. Bought places stand at the number bought; this page and our disclosure say so. Paying vendors may get a fuller, more detailed review from our editors, and that review can change their score. How we rank.
Last updated · How we research and update