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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
William, the advanced automated premium billing and payments platform by Certifi, streamlines membership accounting, payment management, collections, and remittance specifically for digital benefits-based billing. With William, users can enjoy the convenience of fully electronic billing transactions across intricate billing situations, which include payer-sponsored marketplaces catering to both group and individual demographics, as well as specialized segments like Medicare Advantage and Medicaid. This robust enterprise-class accounting system ensures compliance with GAAP standards while providing clear audit trails for effective general ledger management. Additionally, all customer-facing invoices, reports, portals, and tools are customized to align seamlessly with your organization's branding. The platform also features rules-driven communications for managing delinquency and policy terminations, facilitating everything from initial notifications to eventual policy suspension or termination. Moreover, both consumers and employers benefit from the flexibility to establish either one-time or recurring payments, utilizing their preferred methods of payment. This comprehensive approach not only enhances user experience but also reinforces the importance of maintaining financial accuracy and transparency within the billing process.
API Access
Has API
API Access
Has API
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
Certifi
Founded
2006
Country
United States
Website
www.certifi.com/services-2/
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