Average Ratings 0 Ratings
Average Ratings 0 Ratings
Description
HEALTHsuite provides a comprehensive benefit management system and claims processing software solution for health plans that administer Medicare Advantage and Medicaid benefits. HEALTHsuite, a rules-based auto adjudication solution, automates all aspects of enrollment / eligibility and benefit administration, provider contracting / reimburse, premium billing, care management, claim adjudication, customer support, reporting, and more.
Description
The Plan Administrator (TPA) serves as a comprehensive system for group enrollment, eligibility management, and consolidated billing. It features a centralized database that stores all pertinent information regarding clients, participants, dependents, coverage options, and associated rates. The system integrates all plans into a single billing statement and allows for electronic eligibility reporting and online enrollment. Rates are automatically calculated using various factors, such as age, tenure, and health risk assessments. Users can opt for summary billing or name list structures, and the platform supports easy data import and export through formats like CSV, composite files, or ODBC/SQL. With the CSPWeb module, the system can be accessed online, enhancing web functionality. Additionally, it automates all aspects of COBRA administration, managing everything from notifications to conversions. It also includes robust premium accounting capabilities, adeptly handling advance, partial, retroactive payments, and NSF checks. The system's compatibility with other software applications is seamless, utilizing ASCII, CSV, composite files, or ODBC/SQL for integration. Trusted by many of the largest administrators in the country since the inception of COBRA, this solution boasts over 25 years of proven effectiveness in the industry. With its extensive features and reliability, it continues to be an essential tool for effective plan administration.
API Access
Has API
No
API Access
Has API
No
Integrations
No details available.
Integrations
No details available.
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
No
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
Yes
Mac
No
Linux
No
Chromebook
No
Customer Support
Business Hours
No
Live Rep (24/7)
Yes
Online Support
Yes
Customer Support
Business Hours
Yes
Live Rep (24/7)
No
Online Support
Yes
Types of Training
Training Docs
Yes
Webinars
Yes
Live Training (Online)
Yes
In Person
Yes
Types of Training
Training Docs
No
Webinars
No
Live Training (Online)
No
In Person
No
Vendor Details
Company Name
RAM Technologies
Founded
1981
Country
United States
Website
ramtechnologiesinc.com/solutions-services/healthsuite-advantage/
Vendor Details
Company Name
Benefit Plan Systems
Website
www.bencorp.com/index.html
Product Features
Claims Processing
Adjustor Management
Yes
Case Management
Yes
Claim Resolution Tracking
Yes
Co-Pay & Deductible Tracking
Yes
Compliance Management
Yes
Customer Management
Yes
Electronic Claims
Yes
Forms Management
Yes
Paper-Based Claims
Yes
Payor Management
Yes
Policy Administration
Yes
Product Features
Benefits Administration
COBRA Administration
Yes
Claims Management
No
Deduction Management
Yes
Disability Insurance Administration
No
Employee Benefits Administration
No
FMLA Administration
No
FSA Administration
No
Flexible Spending Accounts
No
For Brokers
No
For Employers
No
HIPAA Compliant
No
Health Insurance Administration
Yes
Life Insurance Administration
Yes
Online Benefits Enrollment
No
Premium Billing
No
Provider Management
Yes
Retiree Administration
No
Retirement Plan Management
No