INTEROPERABILITY

In an ever-changing marketplace, the need for interoperability and performance based care is paramount. HealthAxis Group’s Solutions Platform is web-delivered, incorporating full functionality for all business requirements of various healthcare organizations.

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INTEGRATION

HealthAxis Group’s System is integrated with our Front-End systems capability and web portals, allowing for the complete integration of member management and claims processing from claims receipt to claims payment.

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BETTER TECHNOLOGY

HealthAxis Group’s Solutions Platform is web-delivered, incorporating full functionality for all business requirements of any Managed Care Organization, Health Plans, Medicare Advantage Plans, ACO, TPA, MSO, IPA and FQHC.

RISK BEARING PROVIDER ORGANIZATION (RBPO) ORGANIZATION SOLUTIONS

HealthAxis Group understands the varying types and requirements associated with the delegation of risk and responsibility between health plans and intermediate entities.  Our fully scalable, “now generation”, Healthcare Technology Platforms meet and exceed the needs of Risk Bearing Provider Organizations (RBPO), including:
  • Accountable Care Organizations (ACOs)
  • Management Service Organizations (MSOs)
  • Independent Practice Associations (IPAs)
  • Physician Hospital Organizations (PHOs)
  • Integrated Delivery Systems (IDSs)
  • Knox-Keene (California)
  • RBOs (delegated IPAs and medical groups – California)
The HealthAxis RBPO (Risk Bearing Provider Organization) Solution is a web delivered solution incorporating full functionality for all business requirements of any Risk Bearing Managed Care Organization, ACO, or MSO/IPA. The solution is delivered on a per member per month basis and is highly scalable. Our RBPO Solution is customer-driven and guaranteed to comply with the latest regulations or compliance standards from CMS and any Federal, State or Industry Organization.
RBPO Solutions

KEY BENEFITS

  • Cloud-Based SaaS offering
  • Supports Numerous Care Delivery Network Arrangements including IPA, ACO, Regional Government and Self-Insured Arrangements
  • Scalable to millions of lives and thousands of users, supports multi-administrative office models
  • Turnkey EDI integration for eligibility and capitation data for all health plans

KEY FEATURES OF OUR RBPO SOLUTIONS

  • Ability to manage and reconcile Capitation & Eligibility
  • Provider Appeals & Dispute Resolution
  • Provider Portals for Claims, Authorizations & Eligibility
  • Acute & Complex Case Management
  • Care Planning & Disease Management
  • HEDIS & EHR Interoperability Options
  • Supports High Auto-Adjudication Rates
  • Comprehensive benefit plan, DOFR and fee schedule configuration options
  • Electronic EDI for Claims, Encounters, EOR, EOB and eligibility request and response; HIPAA 5010 ready
  • Provider and clearinghouse integration supports instant eligibility inquiries
  • Clinic, PCP and Facility Assignment
  • HCC and P4P administration, tracking and reporting
  • Extensive library and report write
  • Industry standard letters, report cards and management reports
  • Appeals and Grievances
  • Document Management Solutions
  • Regulatory Memo Tracking
  • OEV
  • Provider Directory
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COORDINATED CARE SOLUTIONS

The HealthAxis Coordinated Care Solution is a web-delivered solution incorporating full functionality for all business requirements of any managed care organization, ACO, or MSO/TPA. The solution is delivered on a per member per month basis and is highly scalable, it is also customer driven and guaranteed to comply with the latest regulatory or compliance standards from CMS and any Federal, State or Industry organization.

REQUEST A DEMO

Interested in what HealthAxis Group can do for you? Request a demo to see our Solutions in action!

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