Managed Care

Managed Care Organizations

The healthcare community is constantly evolving and restructuring itself to meet state regulations and health plan-specific challenges. That’s why HealthAxis Group believes adaptability is key in navigating the complexities of the managed care environment. Our goal is to keep payers and providers ahead of the change. We strive to ensure that Medicare, Medicaid/Medi-Cal, and “Dual Eligible” members are provided with care that is both quality and government-compliant, thus helping businesses remain competitive and dynamic. Our “latest generation” single/comprehensive/interoperable digital platform was specifically designed to help Medicare organizations increase operational efficiency, decrease operating costs and deliver unprecedented service.

Our solutions enable Medicare & Medicare Advantage organizations to:

  • Enroll and reconcile members accurately and easily.
  • Automatically verify data upon CMS response (through Connect:Direct capability).
  • Receive the highest HEDIS/STAR ratings for high caliber care and clinical outcomes.
  • Achieve and maintain compliance with new government regulations.
  • Track and report on critical quality and compliance measures.
  • Deliver transparency of information for superior customer experience.
  • Lower administrative costs significantly by automating workflows.
  • Leverage key data sources with seamless integration.

Remove your inefficiencies and optimize your performance
through these leading-edge solutions

Core Benefit Admin System

Technological optimization meets financial efficiency in this fully integrated system that is designed to streamline benefits administration, healthcare claims processing, and overall health plan management.

Web Based Self Service Portals

Regardless as to whether you’re a provider seeking to get organized, a member searching for enrollment solutions, or a user looking to increase the efficiency of patient-centric activity, we offer a reliable web portal that meets your needs.

Smart Front End Services

From advanced mailroom services to every facet of health claims management, products and services are balanced in our Smart Front-End® service which enables you to tailor your experience to your day-to-day needs.

Post Adjudication Services

The industry may be hard to keep up with, but with our Post Adjudication Services, you can defy modern limitations to ensure efficient and cost-effective health claims processing, resulting in faster claims settlements.

Business Process Outsourcing

We want you to focus on what matters most to you, which is why we offer BPO solutions that enable us to manage your business processes through our own internally managed system and strategic partnerships.