Spend more time on your mission and less time managing vendors and their software. Softheon’s modular solutions are versatile, from enhancing new and legacy Medicaid systems to running an entire state-based exchange. A leader in health tech, we also track changing state and federal laws and policies so you don’t take risks with compliance.
Solutions that Simplify
It’s frustrating when your team has to manage multiple systems, new and legacy alike. Softheon’s solutions are built to purpose and designed to integrate into your existing technology or workflows. Simplify operations and get back your peace of mind.
Changing compliance requirements and multiple vendors can mean disaster in government-sponsored markets. But with Softheon, you get more than just tools; get the expertise that protects you. We work closely with CMS and often test proposed changes before they hit the market. Stay in compliance, maintain good relations with CMS, and reduce member abrasion.
Get More Time,
See Less Risk
Softheon provides deep health tech expertise and comprehensive solutions to help government agencies simplify operations and make informed, data-driven decisions.
- Medicaid Reassessment
- Medicaid Enhanced Eligibility
- State-Based Marketplace
- Federal Solutions
- Softheon +AI
Quickly reassess your Medicaid populations for eligibility. Overnight batch processing lets you achieve CMS compliance while saving time and state resources
Medicaid Enhanced Eligibility
Protect your state from fraud, waste, and abuse. We enable integrations with state systems and automatically apply risk scores so you efficiently get the right applicants into the appropriate program.
Offer comprehensive enrollment experiences. AI-powered and user-friendly processes let you meet the health insurance needs of your residents while increasing operational efficiency
Simplify complex health insurance processes. Partnering with an experienced technology vendor can help you mitigate operational issues and provide user-friendly services.
Better Outcomes with Your Data.
Our AI solution enhances data usability, offering personalized member engagement, intuitive call center support, self-guided knowledge for members and staff, and real-time performance insights. Elevate operations using data you already have.
Softheon’s Government Solution
Why Health Plan Leaders
“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 Gunther | CIO, Connect for Health Colorado
“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.”
Jon Cain | CIO, West Virginia DHHR
“Our goal as an agency is to deliver to our members high-quality, efficient customer service that supports a broader variety of consumer needs. We are looking forward to the work with Softheon, so as to improve services for members and carriers.”
Louis Gutierrez | Executive Director of the Massachusetts Health Connector
RFP Guide for Eligibility Verification
Softheon poses relevant questions that government agencies must ask during the eligibility verification procurement process. Find the approach to eligibility verification that works for your agency.