HEALTHsuite 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.
HEALTHsuite Alternatives
Act! Advantage, a full front-office CRM solution with all-new functionality that unites sales, marketing, and customer management in one intuitive, affordable platform, is the culmination of nearly four decades of feedback. Every feature is designed to reflect how today’s SMBs run their businesses and helps them stay organized, attract new customers, and turn relationships into results.
Act! Advantage includes the largest injection of new functionality in Act’s history, broadening its footprint across your entire front office, and reducing your need for costly, third-party tools. Additionally, you can select the perfect fit, cost-effective tier to meet your current needs with peace of mind knowing that Act! will grow with you.
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Service Center by Office Ally is trusted by more than 80,000 healthcare providers and health services organizations to help them take complete control of their revenue cycle. Service Center can verify patient eligibility and benefits, submit, correct, and check claims status online, and receive remittance advice. Accepting standard ANSI formats, data entry, and pipe-delimited formats, Service Center helps streamline administrative tasks and create more efficient workflows for providers.
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PlanXpand
PlanXpand™ is the specialized transaction processing engine developed by Acero, which serves as the backbone for all products aimed at health benefits administrators. With this innovative engine, clients have the flexibility to implement Acero’s offerings either all at once or gradually over time. Beyond simply selecting from our standard range of products, administrators have the option to harness PlanXpand™ to create tailored solutions that enhance their current system functionalities. Acero’s distinctive, integrated solutions utilize a Service-Oriented Architecture, enabling health benefits administrators and insurers to augment their existing adjudication platforms with new features and capabilities. Furthermore, our advanced design and engineering facilitate real-time adjudication for all claim types, directly interacting with the core claims system, which leads to improved processing accuracy, increased customer satisfaction, and a reduced necessity for claims adjustments. This adaptability and precision in processing claims ultimately positions Acero as a leader in the health benefits administration sector.
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Virtual Examiner
Virtual Examiner®, PCG Software’s flagship product, monitors an organization's internal claims process to track provider data for fraudulent or abusive billing patterns and maximizes financial recovery. The Virtual Examiner®, a PCG Software product, allows healthcare organizations to improve their claims adjudication system by allowing for more than 31,000,000 edits per claim. The software monitors an organization's internal claim process to identify and reduce payments for incorrect or erroneous code to save premium dollars. Virtual Examiner®, is more than a claims management solution that focuses on code combinations. It is a cost containment solution that evaluates the claim not only for abusive billing patterns but also identifies those claims that may involve third-party liability/coordination of benefits, case management opportunities, physician billing education and many other cost recovery reports.
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Integrations
No Integrations at this time
Company Details
Company:
RAM Technologies
Year Founded:
1981
Headquarters:
United States
Website:
ramtechnologiesinc.com/solutions-services/healthsuite-advantage/
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Product Details
Platforms
Web-Based
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Customer Support
Online Support
Live Rep (24/7)
HEALTHsuite Features and Options
Claims Processing Software
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
HEALTHsuite User Reviews
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