INTEROPERABILITY

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

BETTER TECHNOLOGY

The HealthAxis Core Benefit Admin System includes benefits enrollment, member management, billing, claims workflow, auto-adjudication, and consumer-driven health plans, allowing access to technology with low ongoing costs and efficient benefit plan administration.

INTEGRATION

Our system is fully integrated with our Front-End systems capability and our web portals, allowing for the complete integration of member management and claims processing from claims receipt to claims payment.

RISK BEARING PROVIDER ORGANIZATION (RBPO) 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.
Risk Bearing Provider Organization Solutions (MSO/IPA/ACO)

Risk Bearing Provider Organizations (RBPOs) include:

  • Accountable Care Organizations (ACOs)

  • Management Service Organizations (MSOs)

  • Independent Practice Associations (IPAs)

  • Physician Hospital Organizations (PHOs)

  • Integrated Delivery Systems (IDSs)

  • Knox-Keene RBOs (delegated IPAs and medical groups)

KEY FEATURES

  • Ability to manage and reconcile capitation and eligibility
  • Provider and clearinghouse integration supports instant eligibility inquiries
  • Clinic, PCP and Facility Assignment
  • Complete Credentialing Module
  • Provider appeals and dispute resolution
  • Provider and Hospital Capitation
  • Provider Portals for Claims, authorizations and eligibility
  • Authorizations and Care Coordination
  • Acute and Complex Case Management
  • Care Planning and Disease Management
  • Integrated Inbound and Outbound eFax
  • HEDIS and 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
  • Integrated Document Management and BPO Services Available
  • HCC and P4P administration, tracking and reporting
  • Extensive library and report write
  • Industry standard letters, report cards and management reports
  • Regulatory Memo Tracking
  • PR Utility Portal and Activity System
  • Provider Directory
HealthAxis Solutions Platform

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

COORDINATED CARE SOLUTIONS

Our Coordinated Care Solution is a web-delivered solution incorporating full functionality for all business requirements of any managed care organization, ACO, MSO or 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.

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REQUEST A DEMO

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

HealthAxis Solutions Platform