Best practices for Public & Private Exchanges
Manage QHP certification workflow
Automate small group enrollment, defined contributions, and more
Real-time eligibility and enrollment for Individual products
Control financial activities
Empower Members' interaction thru existing channels and portals
Proactively manage CMS Star rating
Optimize business processes for continuous ROI
Real-time pharmacy prior authorization with automated approval
Real-time enrollment for Group and Individual products
Increase auto adjudication rate with automated Claims edits
Significantly reduce Claims exception processing time with workflow
Enhanced CRM for unified call center and web inquiries
Manage and organize billing related documents
Capture and digitize document at the moment they arrive in mailroom
Ensure timely processing of Commercial, Medicare Appeals & Grievances
Proven solutions to address ACO challenges
Coding and Billing for medical records
Electronical storage of medical records
Review and evaluation of medical records in pre-service and post-servi...
A proven framework designed for managed health care
Components
Automate and streamline back office business processes
Real-time messaging at the core of health care transactions
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