HEALTHsuite®

Plans, Products and Benefit Administration Module

 

The Plans, Products and Benefits module controls the definition of a health plan or organization, the lines of business, and the benefits covered. This module automates a typical Member Benefit Summary Booklet defining benefits; deductibles; copays; coinsurance; penalties; maximums; authorization / pre-certification requirements; age/gender restrictions; and other benefit constraints.

 

Complete support to administer Medicare, Medicaid, Indemnity, Managed Care, Commercial, and Federal Employee Health Benefits is included.

 

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Benefit Administration System