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web-delivered solution aimed at consolidating both the process and performance of any business requirement— alleviating outdated operations and cumbersome processes.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

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.

EHR & Practice Management

Clarity is key, which is why our EHR and Practice Management system offers a full suite of features to serve independent practitioners, clinics, and physician groups in a way that is both efficient and transparent.