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Average Ratings 0 Ratings

Total
ease
features
design
support

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Write a Review

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

The Plan Administrator (TPA) serves as a comprehensive system for group enrollment, eligibility management, and consolidated billing. It features a centralized database that stores all pertinent information regarding clients, participants, dependents, coverage options, and associated rates. The system integrates all plans into a single billing statement and allows for electronic eligibility reporting and online enrollment. Rates are automatically calculated using various factors, such as age, tenure, and health risk assessments. Users can opt for summary billing or name list structures, and the platform supports easy data import and export through formats like CSV, composite files, or ODBC/SQL. With the CSPWeb module, the system can be accessed online, enhancing web functionality. Additionally, it automates all aspects of COBRA administration, managing everything from notifications to conversions. It also includes robust premium accounting capabilities, adeptly handling advance, partial, retroactive payments, and NSF checks. The system's compatibility with other software applications is seamless, utilizing ASCII, CSV, composite files, or ODBC/SQL for integration. Trusted by many of the largest administrators in the country since the inception of COBRA, this solution boasts over 25 years of proven effectiveness in the industry. With its extensive features and reliability, it continues to be an essential tool for effective plan administration.

API Access

Has API

API Access

Has API

Screenshots View All

Screenshots View All

Integrations

No details available.

Integrations

No details available.

Pricing Details

No price information available.
Free Trial
Free Version

Pricing Details

No price information available.
Free Trial
Free Version

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Vendor Details

Company Name

RAM Technologies

Founded

1981

Country

United States

Website

ramtechnologiesinc.com/solutions-services/healthsuite-advantage/

Vendor Details

Company Name

Benefit Plan Systems

Website

www.bencorp.com/index.html

Product Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

Product Features

Benefits Administration

COBRA Administration
Claims Management
Deduction Management
Disability Insurance Administration
Employee Benefits Administration
FMLA Administration
FSA Administration
Flexible Spending Accounts
For Brokers
For Employers
HIPAA Compliant
Health Insurance Administration
Life Insurance Administration
Online Benefits Enrollment
Premium Billing
Provider Management
Retiree Administration
Retirement Plan Management

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