Claims Management Software

With the passage of Health Care Reform medical loss ratios are rising, in some cases as high as 85%.  As a result health plans must find ways to tighten business processes and control administrative expense.  The HEALTHsuite® claims management software was developed to maximize operational efficiencies, increase employee productivity and reduce costs.  HEALTHsuite is an enterprise claims management software solution with fully integrated modules to support a health plan's entire book of business.  HEALTHsuite's claims management software includes functionality for:

            - Member Management / Group Administration

            - Benefit Administration

            - Provider Contracting and Reimbursement

            - Utilization Management

            - Premium Billing

            - Case Management

            - Claims Management / Adjudication

            - Subrogation and Overpayment Recovery

            - Customer Service

            - Reporting Capabilities and Data Warehouse

            - EDI

            - and more

You can learn more about the HEALTHsuite claims management software through this web site or by clicking here to have a knowledgeable representative contact you.