Are you ready to gain the Medicare Advantage?
Support our seniors and the aging population by offering a simple and intuitive Medicare eCommerce platform. With Softheon Medicare, your consumers are provided a no wrong door approach to enrolling in coverage and managing associated payments going forward.
Partner with experts in government insurance
No Wrong Door
Engagement with your members doesn’t stop at 65. Keep your members engaged through a no wrong door eCommerce platform.
Softheon’s Medicare Cloud offers government-grade compliance to keep your Medicare data secure.
Simplicity and ease of use are of utmost importance for our Medicare solution. Our platform is WCAG compliant for enhanced accessibility.
Plan Shopping & Decision Support
Our white-labeled platform takes a no wrong door approach to health insurance shopping. With a conversational interface, the platform is user-friendly for seniors and truly guides them through the shopping experience. PCP selection and drug lookup are both included to assist with confirming in-network and coverage options. In addition, Medicare Advantage, Medicare Supplement, and more can be added to the shopping experience for your seniors or existing members becoming Medicare eligible.
Eligibility & Enrollment
Configurable business rules
Determine eligibility for Medicare products in real-time through a series of screener questions. Upon completing an enrollment application, Softheon Medicare features a configurable back-end workflow for additional verification and processing.
We offer a full-suite PCI DSS 3.1 payment/banking platform that connects with all major card brands and other payment channels (cash, money orders, etc.), including Fiserv and MoneyGram, to support our issuers. As a designated Payment Facilitator, we can also quickly and conveniently process payments without any third-party involvement. Members can manage their digital wallets to support single and reoccurring payments.
Softheon finance allows you to track subsidies, member discounts/incentives, and track/pay agent and broker commissions with fully integrated accounting functions. In addition, managing general ledger and month/year-end closing has never been easier with a full suite of financial reports.
Softheon Payload Management allows you to integrate with the Federally Facilitated Marketplace (FFM), all major State-Based Marketplaces (SBMs), and your claims administration platform without changing your existing infrastructure. We facilitate data exchanges through secure, real-time APIs, as well as standard and ad-hoc file types, including EDI 834, 820, 837, XML, CSV, etc.
Product & Pricing
Plan Management & Rating
Build and manage your Medicare product repository through Softheon Product & Pricing. Softheon Medicare utilizes APIs to pull in plan data, including associated plan documents.
Data Intelligence & Governance
Softheon’s data intelligence suite offers intuitive state-of-the-art tools for all members of the health plan from the C-Suite to the individual contributor. Users can analyze data in near-real-time reviewing transaction trends, member demographics, geography, financial information, and cost comparisons.
Trusted by over 55 Health Insurance Issuers
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