Worried about losing members if the enhanced premium tax credits (PTCs) expire at the end of 2022? Health plans and states can use business rules
Create a seamless experience for health plans, government agencies, and their members through Softheon’s vertically integrated cloud modules that offer eligibility, enrollment, premium billing, reporting, payment, reconciliation, and communication solutions.
Enroll, Bill, and Renew Your Health Plan Members with Advanced AutomationWith over 20 years of experience, Softheon's platform has touched millions of people and processed tens of billions of dollars in premiums since ACA's inception.
Streamline Eligibility Determinations
Convenient User Experience on and Reconciliation Automation with Softheon’s Eligibility and Enrollment Modular Solution
Simplify Your Enrollment Processes
100% of Enrollment Scenarios Covered with Softheon’s Enhanced Direct Enrollment (EDE) Phase 3 Solution
Reduce Human Error Through Automation
Simplify and Automate Your Plan Catalogue to Eliminate Costly Mistakes
Provide Convenience for Users with Member Self-Service and Support
Handles all Financial Management & Payment Processing with Our Automated and Intuitive Solutions
Provide Powerful Outreach Tools that Scale Communication
Retain Membership While
Growing Your User Base
Reduce Member Abrasion Through a Seamless, End-to-End User Journey That Addresses Many Pain Points Experienced by Members
Effortlessly Organize & Interpret
Softheon Streamlines State Exchange and Eligibility Systems through Modular Technology – No Overhauls Required
Prevent Fraud and Abuse
with Enhanced Eligibility
Quickly Prioritize High Risk Individuals with Our Multi-Source Medicaid Enhanced Eligibility Verification Solution
Protect & Grow State Resources
Avoid the Clog of Medicaid Reassessments at the End of the PHE Via Overnight Bath Processes
Improve Your Technology & Avoid Overhauls
Integrate Already Established Eligibility Systems with Softheon’s Flexible and Modular Products to Create a Customized Solution
State Based Marketplace
Improve Your User Journey & Prevent Drop Off
Offer a Seamless Experience for Your Members with an All-in-One Platform Solution
Increase User Retention and Satisfaction
Provide Consumers with Decision Support Tools to Create a Seamless Experience While Empowering Them to Manage Their Payment Options
Save Time and Reduce Overhead
Automate all Sections of Your System via Rule-Based Configurations to Easily Manage Your Health Plan Offerings
*MS still in development
A Trusted Leader That’s Partnered with Over 90 Carriers
What People Are Saying about Softheon
Softheon was able to provide outstanding job training and outline a clear understanding of the work progress. Because Softheon leveraged the cloud to automatically scale to fit our product’s demands, we did not have to continually pay for extra space.
Kelly GuntherCIO, Connect for Health Colorado
Softheon’s knowledge of health insurance industry best practices combined with its customizable solutions made them an ideal technology partner for CHP in this endeavor.
Eric SmithCIO at Capital Health Plan
Softheon’s expert knowledge of the ACA marketplace coupled with their leading enrollment and billing technology has made them the perfect partner during Hometown Health’s first open enrollment period on the exchange.
David HansenHometown Health CEO
We are in a unique position where we can blend the latest technology with local experience to offer high quality health and wellness services for our Members.
Theresa ScepanskiPresident & CEO for Community First Health Plans
As Seen In
STONY BROOK, N.Y. and DENVER, C.O. – June 30, 2022 – Softheon, a leading cloud-based eligibility, enrollment, and billing provider for health plans
Research and Discussion with an Aetna/CVS Executive Softheon joined Aetna/CVS and HCEG (Healthcare Executive Group) to discuss successful member
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