Average Ratings 0 Ratings
Average Ratings 0 Ratings
Description
HEALTHsuite provides a comprehensive benefit management system and claims processing software solution for health plans that administer Medicare Advantage and Medicaid benefits. HEALTHsuite, a rules-based auto adjudication solution, automates all aspects of enrollment / eligibility and benefit administration, provider contracting / reimburse, premium billing, care management, claim adjudication, customer support, reporting, and more.
Description
InsightPro is an online platform designed for workforce analytics and operations specifically aimed at health insurance payers, third-party administrators, benefit administrators, and health plans. It facilitates claims management, quality assurance, and support for member contact-center teams. The claims functionalities encompass inventory tracking, task allocation and distribution, production planning, forecasting, KPI dashboards, activity surveillance, and query resolution capabilities. Quality assurance teams are equipped with tools for configurable audits, sampling, capacity planning, error feedback mechanisms, rebuttal workflows, and performance reporting options. The platform's contact-center capabilities include access to member and call-history views, adjustable workflows, real-time insights, and performance analytics. Additionally, workforce dashboards enable managers to oversee productivity, workload, quality, and operational trends, while administrative features aid in user and workflow management. As a SaaS solution, this platform is customizable to meet the unique operational needs of payers, with pricing and plan scope tailored according to customer specifications, ensuring flexibility and adaptability in service delivery. This comprehensive suite of features empowers organizations to enhance their operational efficiency and improve overall service quality.
API Access
Has API
No
API Access
Has API
Yes
Integrations
No details available.
Integrations
No details available.
Pricing Details
No price information available.
Free Trial
No
Free Version
No
Pricing Details
Flexible payment options include monthly plans and pay-per-transaction billing. SaaS pricing is tailored to selected features and customer requirements; no long-term commitment is required.
Free Trial
No
Free Version
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Customer Support
Business Hours
No
Live Rep (24/7)
Yes
Online Support
Yes
Customer Support
Business Hours
No
Live Rep (24/7)
No
Online Support
No
Types of Training
Training Docs
Yes
Webinars
Yes
Live Training (Online)
Yes
In Person
Yes
Types of Training
Training Docs
No
Webinars
No
Live Training (Online)
No
In Person
No
Vendor Details
Company Name
RAM Technologies
Founded
1981
Country
United States
Website
ramtechnologiesinc.com/solutions-services/healthsuite-advantage/
Vendor Details
Company Name
MDI NetworX
Founded
2014
Country
United States
Website
insightpro.ai/
Product Features
Claims Processing
Adjustor Management
Yes
Case Management
Yes
Claim Resolution Tracking
Yes
Co-Pay & Deductible Tracking
Yes
Compliance Management
Yes
Customer Management
Yes
Electronic Claims
Yes
Forms Management
Yes
Paper-Based Claims
Yes
Payor Management
Yes
Policy Administration
Yes
Product Features
Alternatives
Alternatives
No Alternatives