Softheon Business Connector
1) is the most efficient (least amount of effort) and effective (best results) ways of accomplishing a task, based on proven, repeatable procedures.
2) is used to describe the process of developing and following a standard way of doing things that multiple organizations can use for management, policy, and software systems
Softheon enables health plan issuers to measurably reduce administrative costs, improve member and provider satisfaction, generate new revenue opportunities, and address regulatory compliance challenges in new business, underwriting and enrollment, pharmacy and medical prior authorization, claims, grievance and appeals, member and provider services, and other critical administrative processes.
For health plan issuers seeking to streamline business operations and lower administration costs, Softheon Business Connector is the most efficient and effective way of accomplishing a task, based on proven, repeatable procedures. It is designed to describe the process of developing and following a standard way of doing things that multiple organizations can use for management, policy, and software systems.
Softheon Business Connector enables healthcare payers to:
- Achieve continuous process improvement
- Improve process quality, consistency and compliance
- Enhance organization agility and flexibility
- New Business, Underwriting & Enrollment
- Pharmacy Prior-Adjudication
- Claims Pre-Adjudication
- Claims Post-Adjudication
- Customer Support & Service
- Billing Management System
- Mailroom Correspondence Management
- Complaints, Appeal & Grievances