HEALTHsuite®

Plans, Products and Benefit Administration Module

 

This module controls the definition of a health plan or organization, the lines of businesses supported, 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, Consumer-Driven, and Federal Employee Health Benefits is included.

 

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Healthcare Claims Processing

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Benefit Administration System