Ebix FACTS
FACTS®, a family of products, supports multiple lines of business within a single system: Health, Indemnity, TPA, PPO, HMO, PHO, IPA, MSO, Group Administration, COBRA, section 125-Integrated Flexible Benefits, Workers' Compensation with Integrated Managed care for 24-hour coverage. The FACTS®, system infrastructure was built on HIPAA-compliant standards since the inception. FACTS®, is fully committed to providing a clear and simple path to HIPAA compliance - well ahead the federally mandated compliance deadlines. FACTS®, a fully integrated, interactive Internet-based and voice-based system, provides healthcare professionals with 24 x7 access to claims and benefit information. It also allows for real-time transactions like EDI claim uploads.
Learn more
HEALTHsuite
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.
Learn more
Complete Claims
Claims adjudication for short- and long-term disability claims. Available as an on-site license (ASP) or as a hosted app (ASP). Microsoft technology: SQLServer database with Windows front end. Highly acclaimed Customer service, staffed by experts in health care claims with at least 12 years of experience in the field. Support calls are recorded and status is available online. Plans can be copied and modified quickly using the plan modification feature. Auto-adjudication with benefit codes built using business principles based on more than 25 variables from the claimant and claim records that were made available to the adjudication engines. Inbound claims can either be scanned images or EDI. HIPPA EDI-5010 transaction sets. The system can be loaded with UCR Schedules and re-pricing fees in advance of the effective date. The date-driven logic will reprice based on the date service was rendered.
Learn more
Hi-Tech Series 3000
With over 30 years’ experience, Hi-Tech Health has the expertise to service payers of all types and sizes, including TPAs, Carriers, Insurtech, Provider Sponsored Plans, and Medicare Advantage plans. Series 3000 is a cloud-based claims administration solution for businesses within the healthcare industry. No matter what your adjudication, reporting, or plan needs are, this platform reduces time processing claims and increases productivity as it assists with:
•Client management
•Benefits input
•Electronic claim submissions
•Claims processing
With an implementation timeframe of 3-4 months, you can quickly get started with Series 3000. Our professional services and back office support teams are here to guide you through customization and training. With experts available at your fingertips, we’ll be able to support you so outside consultants won’t be needed. As your business grows, we’ll work with you to scale your software system to continue to meet your needs.
Learn more