Risk Bearing Organizations

Risk Bearing Provider Organizations

The process of balancing risk management while meeting modern regulations and compliance standards does not have to halt or slow your management capability. HealthAxis Group offers a web-delivered solution aimed at consolidating both the process and performance of any business requirement— alleviating outdated operations and cumbersome processes. Our RBPO solution is not only customer-driven but is highly scalable and delivered on a per member per month basis.

Our solutions enable Risk Bearing Provider organizations to:

  • Manage multiple markets and lines of business with vastly different rules or requirements within a single code- based system alleviating the need for employees to log into multiple systems and serve multiple clients
  • Achieve turnkey integration among Claim Adjudication, Enrollment Portal, Broker Portal, Member Portal and Care Manager.
  • Review eligibility in real time through the Health Plan Enrollment Portal.
  • Customize dashboards to manage daily task through workflow queue for claims, authorization and other departments.
  • Satisfy the requirements for full delegation of financial risk
  • Manage and reconcile Capitation & Eligibility
  • Easily configure complicated benefit plan, DOFR and fee schedules.
  • Resolve Provider Appeals & Disputes
  • Improve Care Planning & Disease Management
  • Scale services to any population size
  • Obtain seamless connectivity through our business partner for DRG/ARP DRG.

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