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Average Ratings 0 Ratings

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features
design
support

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Write a Review

Description

HM Health Solutions offers a comprehensive end-to-end solution designed specifically for health plans. With the Enterprise Health Solution, you can obtain the necessary support and achieve the desired business outcomes from a singular, integrated health plan administration platform. This suite of applications and tools oversees a wide range of functions, spanning from sales and enrollment to billing and claims, along with provider and clinical management, as well as customer service. The Enterprise Health Solution (EHS) stands out as the sole verified end-to-end solution that ensures a smooth transition for members from the enrollment stage all the way to claims payment. While other providers may assert that they deliver a fully integrated solution, they often fail to clarify that this may require the sequential purchase of multiple modules to realize true integration. In contrast, the Enterprise Health Solution maintains a singular focus on health plan administration, ensuring that our expertise in the payer space is unmatched. Consequently, when you choose EHS, you are opting for a platform that prioritizes your health plan’s unique needs and operational efficiency.

Description

Achieving significant advancements in both clinical and administrative outcomes, Evolent Care Partners, a healthcare system in the Midwest, has earned the distinction of being ranked third nationally for both total shared savings and the percentage of savings against benchmarks. By providing independent primary care physicians with essential capital and resources, Evolent Care Partners empowers them to engage in and thrive under two-sided payer contracts while mitigating their financial exposure. New Century Health enhances cost-effectiveness and quality of care in oncology and cardiology by leveraging clinical evidence to inform care decisions, a process that enjoys support from both payers and providers alike. Furthermore, Evolent Health Services streamlines health plan operations through a suite of comprehensive services backed by a modern, integrated platform and a genuine model of strategic partnership. Additionally, the organization encourages exploration of insights and news related to value-based care, population health, health plan administration, and various topics concerning the transformation of healthcare. Through these initiatives, Evolent aims to foster a more efficient and effective healthcare landscape.

API Access

Has API No 

API Access

Has API No 

Screenshots View All

Screenshots View All

Integrations

OpenPM No 

Integrations

OpenPM Yes 

Pricing Details

No price information available.
Free Trial No 
Free Version No 

Pricing Details

No price information available.
Free Trial No 
Free Version No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Customer Support

Business Hours Yes 
Live Rep (24/7) No 
Online Support Yes 

Customer Support

Business Hours Yes 
Live Rep (24/7) Yes 
Online Support Yes 

Types of Training

Training Docs No 
Webinars No 
Live Training (Online) No 
In Person No 

Types of Training

Training Docs Yes 
Webinars No 
Live Training (Online) Yes 
In Person Yes 

Vendor Details

Company Name

HM Health Solutions

Founded

2014

Country

United States

Website

www.hmhs.com

Vendor Details

Company Name

Evolent Health

Founded

2002

Country

United States

Website

www.evolenthealth.com

Product Features

Claims Processing

Adjustor Management No 
Case Management No 
Claim Resolution Tracking No 
Co-Pay & Deductible Tracking No 
Compliance Management No 
Customer Management No 
Electronic Claims No 
Forms Management No 
Paper-Based Claims No 
Payor Management No 
Policy Administration No 

Product Features

Benefits Administration

COBRA Administration Yes 
Claims Management Yes 
Deduction Management Yes 
Disability Insurance Administration Yes 
Employee Benefits Administration No 
FMLA Administration No 
FSA Administration Yes 
Flexible Spending Accounts No 
For Brokers No 
For Employers No 
HIPAA Compliant Yes 
Health Insurance Administration Yes 
Life Insurance Administration Yes 
Online Benefits Enrollment Yes 
Premium Billing No 
Provider Management Yes 
Retiree Administration No 
Retirement Plan Management No 

Claims Processing

Adjustor Management No 
Case Management No 
Claim Resolution Tracking Yes 
Co-Pay & Deductible Tracking Yes 
Compliance Management No 
Customer Management Yes 
Electronic Claims Yes 
Forms Management No 
Paper-Based Claims Yes 
Payor Management Yes 
Policy Administration Yes 

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