List of McKesson ClaimsXTen Customers
McKesson
6555 State Highway 161,
Irving, 75039, TX,
United States
Irving, 75039, TX,
United States
n/a
Distribution
45000
$359.1B
Since 2010, our global team of researchers has been studying McKesson ClaimsXTen customers around the world, aggregating massive amounts of data points that form the basis of our forecast assumptions and perhaps the rise and fall of certain vendors and their products on a quarterly basis.
Each quarter our research team identifies companies that have purchased McKesson ClaimsXTen for Payment Integrity from public (Press Releases, Customer References, Testimonials, Case Studies and Success Stories) and proprietary sources, including the customer size, industry, location, implementation status, partner involvement, LOB Key Stakeholders and related IT decision-makers contact details.
Companies using McKesson ClaimsXTen for Payment Integrity include: Cigna Healthcare, a United States based Insurance organisation with 71295 employees and revenues of $244.38 billion, AmeriHealth Caritas, a United States based Insurance organisation with 10000 employees and revenues of $23.70 billion, Horizon Blue Cross Blue Shield of New Jersey, a United States based Insurance organisation with 5000 employees and revenues of $4.70 billion, BlueCross BlueShield Kansas, a United States based Insurance organisation with 1757 employees and revenues of $3.00 billion, Lifetime Healthcare, a United States based Non Profit organisation with 7000 employees and revenues of $2.46 billion and many others.
Contact us if you need a completed and verified list of companies using McKesson ClaimsXTen, including the breakdown by industry (21 Verticals), Geography (Region, Country, State, City), Company Size (Revenue, Employees, Asset) and related IT Decision Makers, Key Stakeholders, business and technology executives responsible for the software purchases.
The McKesson ClaimsXTen customer wins are being incorporated in our Enterprise Applications Buyer Insight and Technographics Customer Database which has over 100 data fields that detail company usage of software systems and their digital transformation initiatives. Apps Run The World wants to become your No. 1 technographic data source!
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| Logo | Customer | Industry | Empl. | Revenue | Country | Vendor | Application | Category | When | SI | Insight |
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Aetna Better Health | Insurance | 3500 | $650M | United States | McKesson | McKesson ClaimsXTen | Payment Integrity | 2021 | n/a |
In 2021, Aetna Better Health of Illinois began migration from Change Healthcare's ClaimCheck to McKesson ClaimsXTen as a Payment Integrity implementation, with a documented go live date of 08/2021. The initiative centers on deploying McKesson ClaimsXTen as the primary auditing engine within the claims adjudication workflow to reinforce coding and billing compliance across the Illinois Medicaid line of business.
McKesson ClaimsXTen was configured to apply enhanced audit logic and standard code edits, ensuring correct coding and billing practices are enforced during claim processing. Implemented capabilities included expanded calendar month and calendar year editing, with and without modifier editing, and other customizable rule components that extend the prior edit set while preserving provider-facing edit continuity similar to ClaimCheck.
The rollout included an explicit QNXT and ClaimsXten integration to operationalize state specific validation rules. As part of that integration Illinois State Edits were added, including state age requirements by CPT code and frequency limitations enforced per unit or per date. Providers retain the ability to influence adjudication evaluation through Clear Claim Connection C3 for coding combinations on individual claims.
Governance notes for the upgrade state the migration was driven by the announced sunsetting of ClaimCheck in March 2023, positioning McKesson ClaimsXTen as the vendor next generation code auditing software to transition Aetna Better Health of Illinois from the existing ClaimCheck environment. Deployment details focus on claims processing orchestration and audit rule deployment in the Payment Integrity layer, with operational scope tied to Illinois provider adjudication workflows.
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AmeriHealth Caritas | Insurance | 10000 | $23.7B | United States | McKesson | McKesson ClaimsXTen | Payment Integrity | 2022 | n/a |
In 2022 AmeriHealth Caritas implemented McKesson ClaimsXTen as a Payment Integrity platform to automate claims adjudication and strengthen compliance controls. The McKesson ClaimsXTen deployment targeted claims processing and associated payment integrity workflows, with a clear objective to reduce manual intervention in adjudication and accelerate processing timelines.
Configuration work focused on automated adjudication workflows, rules based claims scoring, exception management, and claims editing capabilities consistent with Payment Integrity functionality. Technical deliverables included entity relationship diagrams and SQL based data validation and migration scripts to map inbound claims feeds into ClaimsXTen and to validate rule outcomes against source datasets.
Integrations were a central element of the implementation, with McKesson ClaimsXTen connected to Epic Systems EHR to provide claims processing with timely patient and clinical context. The program integrated SAI Global Compliance 360 to feed regulatory tracking and to automate HIPAA compliance reporting, and it used Mulesoft Anypoint for API management and secure data exchange. API encryption protocols implemented via Mulesoft Anypoint were configured to meet HIPAA standards, and the integration approach eliminated data silos between clinical, claims, and compliance systems.
Operational scope covered claims operations, care management, and compliance functions, enabling care managers to access Epic Systems EHR derived records to inform claims adjudication and care coordination. Governance and delivery used a hybrid methodology, employing Waterfall for upfront requirements analysis and Agile sprints for iterative development and testing. Business analysis activities included authoring user stories, defining acceptance criteria, and facilitating user acceptance testing to ensure the solution met business requirements.
Documented outcomes from the program included a reduction in manual interventions in claims adjudication, faster processing times, and improved claims accuracy through Epic Systems data integration. Compliance automation via SAI Global Compliance 360 provided real time regulatory tracking and automated HIPAA reporting, and API management with Mulesoft Anypoint secured data exchange while reducing siloed information flows.
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Avalon Healthcare Solutions | Insurance | 350 | $200M | United States | McKesson | McKesson ClaimsXTen | Payment Integrity | 2023 | n/a |
In 2023 Avalon Healthcare Solutions implemented McKesson ClaimsXTen as a Payment Integrity solution. The implementation was scoped to support Avalon's Lab Benefit Management programs, embedding payment integrity controls into claims processing to identify inappropriate or overused laboratory testing and to enforce policy-driven adjudication outcomes.
Configuration work centered on claims editing and rule engine capabilities in McKesson ClaimsXTen, including claim-level clinical and payment edit libraries, adjudication staging, and audit trail capture for appeal workflows. McKesson ClaimsXTen was configured to host custom edit rules aligned to Avalon’s lab benefit policies, apply clinical logic for test appropriateness, and generate adjudication recommendations for downstream claims operations.
Integration efforts emphasized API integration, structured data extracts, and mapping of HIPAA transaction sets, with specific attention to 837 data feeds and file-based exchanges common in payer ecosystems. Connectivity followed standard payer patterns for interfacing to claims adjudication engines and operational platforms used by health plans, including environments such as FACETS and QNXT where those systems are present.
Governance and operational ownership were formalized under a Director, Technical Implementation who led technical integration, quality assurance, testing, and post-production reliability. Implementation governance included assignment of matrixed internal resources, documented process standards, defined KPIs for deployment success, and escalation procedures to manage rule updates, data mapping issues, and client-facing technical decisions.
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Insurance | 1100 | $2.1B | United States | McKesson | McKesson ClaimsXTen | Payment Integrity | 2015 | n/a |
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Insurance | 600 | $1.0B | United States | McKesson | McKesson ClaimsXTen | Payment Integrity | 2017 | n/a |
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Insurance | 3161 | $960M | United States | McKesson | McKesson ClaimsXTen | Payment Integrity | 2015 | n/a |
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Insurance | 1757 | $3.0B | United States | McKesson | McKesson ClaimsXTen | Payment Integrity | 2021 | n/a |
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Insurance | 71295 | $244.4B | United States | McKesson | McKesson ClaimsXTen | Payment Integrity | 2022 | n/a |
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Insurance | 5000 | $4.7B | United States | McKesson | McKesson ClaimsXTen | Payment Integrity | 2016 | n/a |
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Non Profit | 7000 | $2.5B | United States | McKesson | McKesson ClaimsXTen | Payment Integrity | 2021 | n/a |
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Buyer Intent: Companies Evaluating McKesson ClaimsXTen
ARTW Buyer Intent uncovers actionable customer signals, identifying software buyers actively evaluating McKesson ClaimsXTen. Gain ongoing access to real-time prospects and uncover hidden opportunities. Companies Actively Evaluating McKesson ClaimsXTen for Payment Integrity include:
- Hellman & Friedman (H&F), a United States based Banking and Financial Services organization with 220 Employees
- Pepco Sales Of Dallas, a United States based Distribution company with 32 Employees
- UBS, a Switzerland based Banking and Financial Services organization with 106789 Employees
Discover Software Buyers actively Evaluating Enterprise Applications
| Logo | Company | Industry | Employees | Revenue | Country | Evaluated | ||
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FAQ - APPS RUN THE WORLD McKesson ClaimsXTen Coverage
McKesson ClaimsXTen is a Payment Integrity solution from McKesson.
Companies worldwide use McKesson ClaimsXTen, from small firms to large enterprises across 21+ industries.
Organizations such as Cigna Healthcare, AmeriHealth Caritas, Horizon Blue Cross Blue Shield of New Jersey, BlueCross BlueShield Kansas and Lifetime Healthcare are recorded users of
McKesson ClaimsXTen for Payment Integrity.
Companies using McKesson ClaimsXTen are most concentrated in Insurance and Non Profit, with adoption spanning over 21 industries.
Companies using McKesson ClaimsXTen are most concentrated in United States, with adoption tracked across 195 countries worldwide. This global distribution highlights the popularity of McKesson ClaimsXTen across Americas, EMEA, and APAC.
Companies using McKesson ClaimsXTen range from small businesses with 0-100 employees - 0%, to mid-sized firms with 101-1,000 employees - 27.27%, large organizations with 1,001-10,000 employees - 63.64%, and global enterprises with 10,000+ employees - 9.09%.
Customers of McKesson ClaimsXTen include firms across all revenue levels — from $0-100M, to $101M-$1B, $1B-$10B, and $10B+ global corporations.
Contact APPS RUN THE WORLD to access the full verified McKesson ClaimsXTen customer database with detailed Firmographics such as industry, geography, revenue, and employee breakdowns as well as key decision makers in charge of Payment Integrity.