Our patientcentric, comprehensive solution provides an individualized plan of care across the most appropriate continuum of postacute care. Recent reports continue to indicate immense savings from electronic solutions. Health plans health education solutions healthwise. The healthrules platform is the only modern, enterpriseclass software suite for all types of health and specialty insurers.
These saas systems are typically offered in a payasyougo monthly or annual subscription and are hosted and maintained by the vendor. We offer deep expertise, comprehensive services, and hintosthe enterprisegrade dpc management platform that powers the largest and fastestgrowing dpc organizations in the country. Claros analytics is an actuarial software firm that develops cutting edge software for pricing and analysis of risk in health care plans and health care systems. Health solutions plus hsp has been named best in klas for payer claims and administration platforms category in the 2018 best in klas. Claims processing software for health plans beacon. Plexis empowers diverse health plans, such as medicare advantage, managed medicaid, and commercial to manage multiple lines of business including medical, vision, and dental products, enabling payers to grow and innovate across these lines while maintaining a centralized platform. Regular software updates deliver new capabilities, ensuring continued compliance with industry standards, allowing health insurers to stay current and competitive with the latest market developments, and drastically reduce both it and operational costs.
Includes ehrs, consulting firms, medical device providers, population health, revenue cycle management, analytics, staffing, medication management, and more. Payment integrity solutions fraud, waste, and abuse protection improves claims payment accuracy and saves enterprisewide costs healthcare fraud, waste and abuse fwa costs the insurance industry. For example, in the 1980s, makers of cd players relied. For example, some systems are offered completely over the internet as webbased home health software systems.
Includes ehrs, consulting firms, medical device providers, population health, revenue cycle management, analytics, staffing. Healthcare itsoftware companies 2020 over 370 entries. Roundtrip patient transportation for hospitals and. Compare providers and practices, generate outreach lists with just a few clicks. Health plans core administration system software solution. Compare providers and practices, generate outreach lists with just a. We offer deep expertise, comprehensive services, and hintosthe. For example, in the 1980s, makers of cd players relied on oversampling and errorcorrection algorithms to compensate for low quality hardware filters and to overcome diskskipping problems. Health insurance software solutions megaputer intelligence. We manage patient cases from day one of the inpatient. This is also referred to as a softwareasaservice saas. Healthcare payer software solutions services company.
Claims processing software for health plans beacons innovative claims management solutions empower health plans with the ability to maximize automation, streamline benefit administration, and ensure regulatory compliance. Apixio is a data science company focused on healthcare whose artificial intelligencedriven software solutions enable health plans and providers to pull novel insights from both medical text and. Speed up patient payments and free up staff time with paperless billing, online billpay, selfservice payment plans, reliable prepayments based on estimates, financial assistance, and more. Transform the member experience with enterprisewide health education. Solutions for health plans that drive engagement healthx. Healthedge provides the only modern, enterprise class software platform for health plans. Healthrules is a software as a service saas solution, which means lower costs, faster implementations and upgrades for healthedge customers. Software dsp solutions have been vital to the success of many other industries where physical limitations would have impaired their growth. Zoom is the leader in modern enterprise video communications, with an easy, reliable cloud platform for video and audio conferencing, chat, and webinars across mobile, desktop, and room systems. Healthcare it solutions, telemedicine, his software, ehr comarch. Hitachi solutions engage for health plans is a health plan crm that gives payers a holistic, membercentric view of their business to help them build strong, longlasting relationships with both members.
Clarishealth total payment integrity solutions for. Rideshare, medical sedans, wheelchair vans, stretcher vans, and alsbls one workflow. We leverage years of experience and expertise with microsoft dynamics 365 formerly microsoft dynamics ax and crm and business intelligence to build solutions that hit the sweet spot for each vertical and provide an incredibly simplified experience. Plexis empowers diverse health plans medical, dental, vision, and more. Cegedim insurance solutions provides actisure, a flexible, serviceoriented software platform that meets the specific needs to the health insurance industry. Roundtrip patient transportation for hospitals and health plans. Aggregate bond index outperformed the average fixed income investor by an annual difference of 5. Optum offers care management services to more fully meet the needs of complex, highrisk and highspend members. Fraud, waste, and abuse protection improves claims payment accuracy and saves enterprisewide costs healthcare fraud, waste and abuse fwa costs the insurance industry and government programs tens of billions of dollars each year, making it essential for payers to identify potential fraud situations prior to adjudication or audits.
Citra health supporting our citra clients during the. Developed in collaboration with health plans, directassure uses a subset of the caqh proview data that health plans now use for credentialing. These web portals consolidate data from disparate payer systems, allowing you to offer a selfservice portal that your plan members, providers, internal. Claims processing software for health plans beacons innovative claims management solutions empower health plans with the ability to maximize automation, streamline benefit administration, and. Find new opportunities to grow premium and service members needs hitachi solutions engage for health plans is a health plan crm that gives payers a holistic, membercentric view of their business to help them build strong, longlasting relationships with both members and brokers alike. Should your health plan build or buy a technology solution. This is also referred to as a software asaservice saas. We leverage years of experience and expertise with microsoft dynamics 365 formerly microsoft. Each industry cloud is powered by the microsoft cloud plus hitachi solutions vertical specific software. The hfbs health insurance solution is three intergrated software modules used to analyse and plan health insurance policies and the coverage of health care. Cmm is an ongoing, holistic approach to patient care management, and involves the consolidation and coordination of a patients medication therapy. Answer your toughest clinical and financial improvement questions. For more than a decade, adherehealth has helped medicare advantage, managed medicaid and commercial plans improve health outcomes. List of over 370 healthcare it software and services companies.
Empowered with this information, providers and health plans can take prompt action to promote adherence before costly health impacts surface. Business problems solved with vertical healthcare software. Driven by technology, collaborative care management for payers focuses on providerled health programs to improve quality of life, clinical status, and patient satisfaction. Hint is the direct primary care solutions company that partners with visionary provider organizations to build successful dpc programs. Convey health solutions serves governmentsponsored health plans through a combination of purposebuilt member management technology and comprehensive outsourced service solutions our expertise and understanding of regulatory requirements allow your health plan team to focus on driving new business and not on the daytoday administrative. Rx savings solutions knows the health plan world well, but more importantly they know prescription benefits and how to help our members make the best choices for their lives and their budgets. These solutions may include features designed to handle product creation and. Regular software updates deliver new capabilities, ensuring continued compliance. The direct primary care solutions company hint health. Both horizontal and vertical industries need to find solutions that align. With billions of annual federal and state valuebased care incentive dollars at stake, health plans are challenged to capture these payments. Convey health solutions serves governmentsponsored health plans through a combination of purposebuilt member management technology and comprehensive outsourced service solutions our expertise.
For more than ten years, health plans implementing. Plexis empowers diverse health plans, such as medicare advantage, managed medicaid, and commercial to manage multiple lines of business including. Actuarial advisor, our health benefits rating manual, is used by underwriters, carriers, reinsurers, and consulting actuaries. Health insurance system cegedim insurance solutions. Document care manager notes and task followups to other members of the care team and push notes bidirectionally back to the ehr for. For more than a decade, adherehealth has helped medicare. Medical software business plan sample executive summary. As valuebased reimbursement becomes the standard, cotivitis quality and performance solutions allow health plans to move from. Empowering healthcare payer software solutions that emphasizes on continuity of care across provider networks. While medicare data suggests that only 5 percent of a healthcare. Clarishealth leads the industry with innovative payment integrity solutions for health plans. Our unique data set combines realtime medication adherence information and unique health status indicators for risk stratification and proactive management of members. Engaging members through individualized interaction addresses their endtoend medical, behavioral and social needs across fragmented services.
Their combination of clinical and claims expertise is the right blend. Drive value with improved health outcomes and reduced costs. Two key challenges faced by insurers are a shaky regulatory environment and a squeezed profit. Health insurance exchanges insurance software solution. This prestigious award is an independent rating based on hard facts from the payer community. Comarch healthcare is a supplier of innovative remote medical care solutions that use its own software, equipment, and medical infrastructure. Consolidate all of a patients outstanding balances hospital, physician, and postacute bills into a single statement to simplify and improve the. Health insurance companies use health insurance platforms software as a. This goes beyond mtm by not only identifying dtps, but addressing them by collaborating with the patients caregivers to close gaps in care and optimize their medication therapy. Directassure reduces the extraordinary number of requests providers receive from each health. While medicare data suggests that only 5 percent of a healthcare organizations population consumes 50 percent of its resources, health systems must look beyond that 5 percent and also use a strategy that will allow them to identify and work with the. Data driven insights for health plans that drive member engagement, improve member health, and lower healthcare costs. Clarishealth total payment integrity solutions for health. Health plans empower your care teams, impact your health programs, and engage members with a single source for trusted health education.
Solutions for healthcare payers healthcare payer portals are key tools for managing multiple benefit plans and efficiently communicating with the stakeholders that interact with your company. Healthcare management solutions convey health solutions. Driven by technology, collaborative care management for. Get priority access to expertise about the latest developments in health payer technology. Care management, done at its best, will reduce the cost and increase the quality of care for those individuals identified in the program. Healthrules payor is a next generation core administration system that provides transformational capabilities to health plans of all types and sizes. Healthcare itsoftware companies 2020 over 370 entries list of over 370 healthcare it software and services companies. Population health management software for value based care. Citra health supporting our citra clients during the covid. As valuebased reimbursement becomes the standard, cotivitis quality and performance solutions allow health plans to move from simply reporting quality measures to driving the purchase, delivery, and utilization of higher value healthcare. Newgen software is a global provider of business process management bpm, enterprise content management ecm, customer communication management ccm solutions with a footprint in 66. With over 10m members served, citra provides integrated software solutions solving for the administrative, financial. Leverage solutions designed to advance quality of care and simplify operations, helping improve health outcomes and reduce medical costs.
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