MLR: Making the Most of the Remaining 15%

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® Mercato claims management software was developed to increase employee productivity and reduce costs. HEALTHsuite Mercato is an enterprise solution with fully integrated modules to support a health plan's entire book of business. HEALTHsuite Mercato's 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 / Contact Management
  • Fulfillment
  • Reporting Capabilities and Data Warehouse
  • EDI
  • and more
You can learn more about the HEALTHsuite Mercato claims management software through this web site or by clicking here to have a knowledgeable representative contact you.