Enhanced Direct Enrollment (EDE) Phase 3 approved
Softheon is a leading SaaS and BPaaS platform built to support brokers to navigate their consumers through healthcare. A highly configurable cloud-based solution, Softheon manages decision support and plan shopping, integrations with multiple issuers as well as downstream core admin platforms. With the main goal of adding value to your clients, the Softheon platform enables brokers to optimize strategy, contain costs and simplify the administration process.
Decision Support and Anonymous Shopping
For brokers offering products directly to the consumer, Softheon offers a decision support and anonymous shopping platform to assist consumers in choosing the plan that is best for them. Using a combination of providers, drug formularies and demographic information, Softheon’s shopping experience is intuitive and easy to navigate while integrating with the exchange for subsidy validation through a health plan branded portal.
NEW: Enhanced Direct Enrollment
Streamline the shopping experience with Softheon’s newest offering, Enhanced Direct Enrollment. To learn more, click here
Softheon’s EDI gateway is responsible for the integration, data transfer and reconciliation between the health insurance exchanges and carrier downstream core admin systems. Through experience in the ACA and other markets, Softheon’s EDI gateway has been built to meet the specifications of nearly all companion guides and continues to expand.
Enrollment and Eligibility
Softheon’s platform comes standard with several built-in business rules which are configurable based on federal, state and health plan specific requirements. These business rules allow for automated processes to act on specific conditions and require others to pend for review prior to moving to the next step.
Premium Billing and Presentment
Softheon’s premium billing & payment aggregation tool, Equity, offers an integrated online & banking solution that provides a customer-friendly billing experience while allowing you to manage financial transactions, premium payments & financial reconciliation. As an accessible PCI DSS 3.1 Electronic Payment platform, Equity serves individuals and brokers with multi-channel options, and offers the back-end processes needed to continually manage and track their payment statuses. To assist with higher membership retention, we support all payment types including credit cards, ACH & e-Check, and lockbox processing.
As a designated Payment Facilitator, we can also conveniently and quickly process payments without any third-party involvement. This prevents payments from building up and means we’re able to deliver outstanding service with unmatched reliability.
Softheon’s data analytics and reporting platform, Foundry, captures and tracks every member touchpoint, analyzing both their interactions and behaviors. Foundry’s reporting capabilities provide you with all the tools necessary to access and parse data from a high-level population overview down to an individual applicant.
Foundry BI, the solution’s business intelligence component, features configurable, state-of-the-art tools for non-technical users. Providing the ability to “slice and dice” data in near real-time, the reporting and business intelligence suite offers comprehensive analysis of transaction trends and key performance indicators (KPIs), including member demographics, geography and more.
Managing Director, Merchant Solutions
In this role Sarah is responsible for strategic partnerships with clients, vendors, and potential partners. In her tenure at Softheon she has had many roles operationally allowing her to understand our core business inside and out.