Frequently Asked Questions

Security & Architecture

How do you manage architecture to ensure PHI/PII or other member data is not accessible to unintended customers?

Softheon Marketplace for Issuer will reside on a single-tenant dedicated cloud stack. No Issuer data will be co-mingled with any other customer.

Will my customer data be secure and private?

Trust is at the core of everything we do. We go the distance to ensure that our customers’ data is safe and secure. We meet all the required CMS security standards and continuously adapt to meet changing rules and regulations. We use a multilayered approach to protect your information, constantly monitoring and improving our solutions and the host environment to protect the integrity and availability of the information that is vital to your operations and our shared success.

Our security compliance includes NIST 800-53, FIPS-140, MARS-E v2.0, HIPAA, and PCI SOC I & II.

How is your system architected?

At its core, Softheon Marketplace has adopted Softheon SOA as the basis of its technical architecture. Softheon SOA is an application architecture within which exchange business functions and selected technical functions are performed using interfaces. Services, such as Passive Renewal, Termination upon Grace Period, Check Lockbox, etc. are the building blocks that are designed to perform defined functions, and which communicate with other defined services through Softheon ESB messaging.  Softheon SOA framework can also expand to incorporate and integrate many external technologies which communicate with Issuer HealthEdge, other admin platforms or third-party administrative systems.

Softheon ESB is fully integrated with the SOA for supporting integration with broad capabilities in several key functional areas, including connectivity, message transformation and routing, transaction mediation, basic process orchestration, and security, that are critical to supporting effective integrations between the defined exchange services and business processes.  Softheon ESB interfaces with TIBCO, KAFKA, RabbitMQ, MQSeries, etc. for complex and heterogeneous business process integration at Issuer following open architecture service bus standards, i.e. XML, REST, SOAP, JMS, MQTT, JSON, etc.

Finally, Softheon BPM is the repository of business rules to meet, if not exceed, the requirements of ACA Individual & Family as well as Group Marketplace programs.  Although federal and state-based exchanges may describe, subdivide, and title its primary business areas differently from the hierarchy presented in ACA, Softheon BPM provides a template for describing each exchange. This includes a summary of the business process, trigger event and result, activities, data requirements, predecessor and successor processes, failure points, and other elements.

Softheon Marketplace contains over 72 individual business processes implemented using Softheon Business Process Management (BPM), Enterprise Service Bus (ESB), and Service Oriented Architecture (SOA) frameworks.  Based on .NET Core open-source for Windows, Linux, and macOS operating systems, these frameworks provide the basis for Softheon’s SaaS & BPaaS products and services available in Softheon Cloud that is NIST 800-53, FIPS-140, MARS-E 2.0, PCI, HIPAA compliant.

Pricing

How does pricing work?

Softheon solutions are Modified Off the Shelf (MOTS) products and Softheon handles all implementations directly. There is an implementation cost and then a price per transaction or a per member per month (PMPM) fee. Total pricing is determined on the scope of the project and the type of services that are requested.

Implementation

How long is a typical implementation?

The timeframe for a typical implementation is 90-120 Days. The timeframe for complex implementations including interfaces with multiple systems for which Softheon has not previously integrated is 9-12 months based on the business requirements.

What resources will be provided during implementation?

Softheon will provide a dedicated project management team to your implementation. In addition, you will be assigned a dedicated Client Executive who will be your point of contact from day one, through the length of our contract. We provide onsite training to executives and team leaders following the Train the Trainer approach so that you can control your own rollouts with our support.

What support is available to me once the implementation is complete?

In addition to your dedicated Client Executive, Softheon has a team of Customer Success Agents who are available during business hours to handle any questions or concerns. Finally, you will receive access to a Wiki environment with documentation on your deployment..

Can the solution be customized to work with our unique workflows?

YES! As a Modified Off the Shelf (MOTS) product and during implementation we ensure that we meet all your unique business requirements. 

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