Alternatives to Virtual Benefits Administrator (VBA)

Service Center by Office Ally is trusted by more than 80,000 healthcare providers and health services organizations to help them take complete control of their revenue cycle. Service Center can verify patient eligibility and benefits, submit, correct, and check claims status online, and receive remittance advice. Accepting standard ANSI formats, data entry, and pipe-delimited formats, Service Center helps streamline administrative tasks and create more efficient workflows for providers.

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.

With over 30 years’ experience, Hi-Tech Health has the expertise to service payers of all types and sizes, including TPAs, Carriers, Insurtech, Provider Sponsored Plans, and Medicare Advantage plans. Series 3000 is a cloud-based claims administration solution for businesses within the healthcare industry. No matter what your adjudication, reporting, or plan needs are, this platform reduces time processing claims and increases productivity as it assists with: •Client management •Benefits input •Electronic claim submissions •Claims processing With an implementation timeframe of 3-4 months, you can quickly get started with Series 3000. Our professional services and back office support teams are here to guide you through customization and training. With experts available at your fingertips, we’ll be able to support you so outside consultants won’t be needed. As your business grows, we’ll work with you to scale your software system to continue to meet your needs.

Safeguard the reliability of your health plan while pinpointing precise pricing with the Context4 Health Plans Suite, our versatile and cloud-centric technological framework. Experience immediate and actionable insights for detecting Fraud, Waste, and Abuse (FWA), developed by our skilled team of certified experts in clinical, dental, and health benefits. By leveraging accurate data and state-of-the-art cloud technology, we deliver a robust and defensible Medicare reference-based pricing (RBP) solution. Our platform comprises over 100 healthcare data sets, complemented by professional guidance to enhance operational efficiency and ensure regulatory compliance. Additionally, our sophisticated medical coding software is tailored to streamline claim submissions and reduce the likelihood of denials. Furthermore, the cloud-based Payment Integrity Platform harnesses our unique analytics engine to uncover coding mistakes, assess medical necessity, address unbundling, detect fraud, waste, and abuse, evaluate audit risks, and identify pricing discrepancies, all of which can significantly influence your organization's performance. This comprehensive approach not only safeguards your financial health but also positions you for sustainable success in the ever-evolving healthcare landscape.

DataPath Summit is a comprehensive cloud-based software solution tailored for third-party administrators (TPAs) to efficiently oversee and execute employer-sponsored benefits across the United States. With a focus on security and scalability, Summit facilitates the management of various accounts such as health savings accounts (HSAs), flexible spending accounts (FSAs), transit accounts, health reimbursement accounts (HRAs), and premium billing arrangements that encompass COBRA, consumer-driven health (CDH), retiree billing, and additional services. This robust platform streamlines the complexities of benefits administration, ensuring that TPAs can deliver exceptional service to their clients. Furthermore, its user-friendly interface enhances the overall experience for both administrators and employees alike.

Claims adjudication services cover a range of areas including medical, dental, vision, and prescription claims, as well as short and long-term disability cases. These services can be accessed either on-site with a license or through a hosted application model (ASP). Utilizing Microsoft technology, the system is powered by an SQLServer database paired with a Windows front end. Our customer service is highly regarded, staffed by healthcare claims professionals who boast a minimum of 12 years of industry experience. All support inquiries are recorded, and their statuses can be monitored online. The system features a plan copy and modification tool that facilitates rapid plan implementation. Auto-adjudication is achieved through benefit codes that are constructed using business rules derived from over 25 variables connected to both the claims and the claimants, which are then processed by the adjudication engine. Claims can be submitted in various formats, including scanned images, EDI, or paper submissions. The system is compliant with HIPAA EDI 5010 transaction sets, ensuring secure and efficient processing. Additionally, re-pricing fees and UCR schedules can be pre-loaded into the system prior to their effective dates, while the date-driven logic ensures that re-pricing occurs based on the service date, optimizing the claims processing workflow. The comprehensive nature of this system allows for a more streamlined and efficient claims management experience.

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.

The FACTS® suite of products caters to various business sectors through a unified information system, including Health, Indemnity, TPA, PPO, HMO, PHO, IPA, MSO, Group Administration, COBRA, Section 125-Integrated Flexible Benefits, and Workers' Compensation with Integrated Managed Care, ensuring comprehensive 24-hour coverage. Since the establishment of HIPAA, the architecture of the FACTS® system has been rooted in solutions that adhere to HIPAA standards. Committed to facilitating a straightforward and efficient journey toward HIPAA compliance, FACTS® prioritizes readiness well in advance of the required federal deadlines. The fully integrated, interactive systems provided by FACTS®—accessible via the Internet and voice—equip healthcare professionals and administrators with around-the-clock access to vital claims and benefit information, in addition to enabling real-time transactions like EDI claim submissions online. By utilizing these tools, organizations can significantly enhance their risk management and insurance oversight capabilities. Furthermore, FACTS® remains dedicated to continuously improving its offerings to better serve its users.

Streamline the administration of COBRA and tax-advantaged benefits through our adaptable program design and dedicated support services. Reduce expenses while maintaining essential benefits for employees, utilizing either a conventional HSA or our innovative HSA On Demand® option. Our COBRA Administration Services ensure that employees can maintain their insurance coverage without interruptions, granting them peace of mind. Encourage a consumer-driven approach to healthcare with options like Health Care FSAs, Limited Purpose FSAs, and Dependent Care FSAs. Strengthen employee well-being by providing corporate programs for Health & Wellness, Adoption, and Education reimbursement. Introduce an HRA to enhance your oversight of covered costs while addressing employee requirements. Additionally, our Commuter Benefits program enables individuals to allocate pre-tax dollars for qualifying transit and parking expenses, enhancing their financial flexibility. This comprehensive suite of services not only supports employees but also fosters a culture of wellness and responsibility within the organization.

WLT’s MediClaims system presents an economical, user-friendly, and highly effective solution for managing benefits and claims. Its rules-based framework combined with integrated EDI functionalities ensures that claims are handled swiftly, simply, and with precision. The system is designed to manage a diverse array of benefits and claims, including Medical, Dental, Vision, Prescription Drugs, Consumer-Driven Healthcare, Disability, and Capitation processing. With WLT's MediClaims, you can easily customize the configuration of your groups to accommodate either a single line of coverage or intricate benefit plans with multiple coverage lines. To achieve operational efficiency, a robust information system is essential, and WLT consistently utilizes cutting-edge technologies, delivering you the most advanced and adaptable systems available in the market. In an ever-evolving healthcare landscape, having such a dynamic claims processing system is crucial for maintaining competitive advantage and ensuring customer satisfaction.

Authorize, claim processing and payment are available at the point-of-care. Improve care coordination and improve outcomes for lower medical costs while streamlining administrative processes. Engage providers at point of care to share and capture data in real time, resulting in an unprecedented exchange of health information. We work with our clients to develop risk management strategies that produce better outcomes at lower costs. We aim to improve the user experience of everyone in the ecosystem. To optimize clients' resources, we deliver a minimum of a 3:1 ROI. Conexia has created a core technology platform (ONE), which can be customized to meet the different regulatory requirements and operational processes of each client in each geographic region. Our initial implementation is usually an overlay on the existing technology ecosystem of the payer to create real-time processes.

Picwell exists to help people make informed employee benefits decisions. Picwell provides the tools and guidance that HR & Benefits teams need to make long-term decisions. Your employees have access to personalized, intelligent benefits guidance from any device, anytime, anywhere. Help your employees make smarter medical plan choices. Each employee will find the best health plan for them based on their unique health situation, personal preferences, risk tolerance, and risk tolerance in just minutes. Interactive HSA Education. Interactive education is possible with the interactive Health Savings Account module. Give employees personalized education on all benefits. Picwell DX can be configured to go beyond medical decisions and offer personalized education modules on any supplemental benefit from dental insurance and voluntary benefits to an 401(k), or other wellness programs.

PLEXIS offers a comprehensive suite of top-tier applications designed to equip payers with the advanced capabilities required for contemporary core administrative systems. These applications encompass functionalities such as real-time benefit management, adjudication, automated EDI transmission, and self-service customer portals, ensuring that PLEXIS Business Apps meet all your needs. The Passport feature facilitates crucial connections between core administration and claims management systems, PLEXIS business applications, custom applications, and existing internal systems. Its adaptable API layer allows for real-time integration with various portals, automated workflow tools, and business applications, ensuring that connectivity knows no bounds. By employing this centralized, modern core administration and claims management platform, you can enhance workflows effectively. This approach enables the efficient processing of claims while simplifying the complexities associated with benefit administration, resulting in a swift return on investment and the ability to provide exceptional customer service. Ultimately, PLEXIS empowers organizations to thrive in an increasingly complex healthcare landscape.

USSI takes pride in showcasing its complete range of professional insurance software solutions, crafted as a comprehensive turnkey administration package. These all-inclusive software offerings are designed to guarantee that your insurance firm functions at peak performance in a rapidly evolving and competitive industry landscape. The InsurancePlus Individual Life and Health Administration software from USSI effectively oversees the management of business portfolios for both traditional and innovative Life and Health insurance providers. This solution accommodates various product lines such as Whole Life, Term Life, Interest Sensitive policies, Final Expense plans, Annuities, and Supplemental Health insurance. Additionally, USSI's InsurancePlus Group Life and Health Administration software efficiently manages portfolios for Group Health insurance companies, Self-Insured Funds, and Third-Party Administrators (TPAs), supporting a diverse range of plan options like Point of Service, Major Medical, Term Life, High Deductible, and Traditional Indemnity plans. With such a wide array of features, USSI ensures that its software solutions are versatile and adaptable to meet the unique needs of every client in the insurance sector.

Anagram Prosper allows you to return funds to your patients without imposing any costs on your practice. By enhancing your profit margins and pleasing your patients, you can eliminate the need for courtesy discounts. We have collaborated with top vendors to create wholesale price lists that cater to both your requirements and those of your patients. You can offer rebates on products you already have in stock, encouraging patient engagement and driving increased sales while boosting your revenue. With Anagram Prosper, you not only save your patients money but also maintain your profit margins without resorting to discounts. Utilize our rebate program to enhance customer satisfaction and stimulate more purchases. Many patients are unaware of their out-of-network benefits, and Anagram Access allows you to access real-time vision plan eligibility to ensure maximum savings for them. This tool enables you to swiftly determine the patient's financial responsibility while also showing how much they can expect to be reimbursed by their vision plan, making the entire process smoother and more efficient. By leveraging these innovative solutions, you can elevate your practice while providing exceptional value to your patients, ensuring they leave satisfied and informed.

V3locity®, developed by Vitech, is a groundbreaking cloud-based platform for administration, engagement, and analytics that provides comprehensive business functionalities throughout the entire life cycle, alongside powerful enterprise features. This innovative platform seamlessly integrates essential administrative tasks with an exceptional digital user experience. Its modular architecture allows for adaptable and swift deployment approaches, catering to various business needs. Built on a sophisticated cloud-native framework, V3locity harnesses the distinctive advantages of AWS, ensuring a solution that excels in security, scalability, and resilience, ultimately transforming how organizations operate and engage with their clients.

Founded in 2000, DataGenix is dedicated to delivering innovative claims processing solutions to third-party administrators, adjusters, and insurance firms. Recognizing the complexities that can arise in claims processing and health benefits management, our team has developed the sophisticated ClaimScape software designed to streamline the entire adjudication process, ensuring your business remains unaffected by potential losses. Our mission is to tackle the challenges that prevent an exceptional customer experience for your clientele. By aligning our offerings with current trends and demands, we are committed to facilitating your organization's growth through our software solutions. Trusted by leading TPAs nationwide, we are eager to expand our services to a broader audience. As we continue to evolve, we aim to set new standards in the industry.

TL LeadManager® is a specialized lead management platform tailored specifically for agents in the Life and Health Insurance sectors. It simplifies the management of Medicare Supplement, Long Term Care, Final Expense, and Annuity leads, making the process more efficient than ever. If your current lead or contact management system isn't meeting your needs or you’re not completely satisfied, it's time to give TL LeadManager a try. This comprehensive and user-friendly CRM is designed to reduce the time spent on managing leads while enhancing your selling opportunities. By streamlining paperwork and improving organization, you can focus on increasing your policy sales. When paired with TargetLeads®, your direct mail marketing becomes incredibly smooth and effective. Whether dealing with Turning 65 lists for Medicare Supplement or various other insurance leads, TL LeadManager empowers you to effectively manage, follow up, and generate reports for all your campaigns, ensuring you stay on top of your business. Embracing this innovative tool could be the game-changer you need to elevate your sales strategy.

HealthAxis provides integrated solutions to payers, providers, and health organizations. These integrated solutions include an advanced claims processing system, TPA services, and actionable analytics. We simplify operations and improve patient and client outcomes. Healthcare is becoming more technologically connected, but it is still hindered by legacy technology, coordination problems, and information management. We aim to bring innovation to those who are struggling with these issues. Our client philosophy is to be a complete business partner. HealthAxis believes that our success is not based on selling our solutions, but rather on our business partners' continued success and growth. We empower our partners to bring value to the communities that they serve. We thrive with them as they grow their membership and expand their scope. Each member of our team is aware of their responsibility to help our partners realize their potential.

The KMR Claims Processing Manager is an advanced, fully integrated, and customizable solution designed for Third Party Administrators (TPAs), Self-Insured entities, and Claims Administrators. This sophisticated system features an all-inclusive Medical and Dental Reimbursement module, supports electronic claim submissions, seamlessly integrates with Document Imaging technologies, offers debit card processing capabilities, and ensures full compliance with HIPAA regulations. Additionally, users can easily tailor the system to meet their specific needs and enhance operational efficiency.

Benefitexpress was founded by benefits experts and offers industry-leading cloud-based benefits management software, solutions, and services to employers, brokers, and other partners. My Benefit Express™, our fully outsourced solution, simplifies your benefits administration responsibilities. It helps employees make informed decisions and enhances employee engagement and satisfaction. Software and services include a full-service phone center, integrated ACA administration and reimbursement account administration, dependent eligibility audits and total compensation statements. Our clients' success is assured by our commitment to creative problem solving and scalable systems.

BRMS excels in the efficient and precise processing of all Medical, Dental, Vision, and Retiree claims, ensuring a swift turnaround time. We seamlessly update eligibility each night through our MyHealthBenefits system, maintaining up-to-date information. Our expertise in PPO negotiations allows us to effectively lower costs for employers regarding claims. We oversee the full spectrum of claims administration, from initial receipt and eligibility verification to negotiation and final payment. By centralizing all operations in-house, including claims processing, medical management, PPO network oversight, and billing, we offer a responsive and personalized service experience. For self-insured entities, BRMS serves as an invaluable partner in handling Medical, Dental, and Vision claims with exceptional accuracy and efficiency. Our commitment to quality and customer satisfaction sets us apart in the industry.

PlanXpand™ is the specialized transaction processing engine developed by Acero, which serves as the backbone for all products aimed at health benefits administrators. With this innovative engine, clients have the flexibility to implement Acero’s offerings either all at once or gradually over time. Beyond simply selecting from our standard range of products, administrators have the option to harness PlanXpand™ to create tailored solutions that enhance their current system functionalities. Acero’s distinctive, integrated solutions utilize a Service-Oriented Architecture, enabling health benefits administrators and insurers to augment their existing adjudication platforms with new features and capabilities. Furthermore, our advanced design and engineering facilitate real-time adjudication for all claim types, directly interacting with the core claims system, which leads to improved processing accuracy, increased customer satisfaction, and a reduced necessity for claims adjustments. This adaptability and precision in processing claims ultimately positions Acero as a leader in the health benefits administration sector.

Centauri Health Solutions is a company specializing in healthcare technology and services, motivated by our commitment to enhance the efficiency of the healthcare system for our clients while offering compassionate assistance to those in need. Our software, powered by advanced analytics, supports hospitals and health plans—including Medicare, Medicaid, Exchange, and Commercial sectors—in effectively managing their fluctuating revenue through a bespoke workflow platform. Moreover, our personalized support for patients and members grants them access to vital benefits that can significantly improve their quality of life. Our array of solutions encompasses Risk Adjustment (including Medical Record Retrieval, Medical Record Coding, Analytics, and RAPS/EDPS Submissions), management of HEDIS® and Stars Quality Programs, Clinical Data Exchange, Eligibility and Enrollment services, Out-of-State Medicaid Account Management, Revenue Cycle Analytics, and both Referral Management & Analytics, as well as addressing Social Determinants of Health to further bolster healthcare outcomes and accessibility. Each of these components is designed to work in harmony, ultimately creating a more effective and compassionate healthcare experience for everyone involved.

The FundOfficeXG system by basys can significantly enhance the efficiency of your benefits administration by meticulously tracking all facets of your contributions accounting and eligibility management. This robust administration suite, combined with easy-to-use online self-service portals, equips you with the necessary tools to oversee, monitor, and compute eligibility and employer contributions effectively. FundOfficeXG boasts an extensive array of advanced processing capabilities, offering a comprehensive solution for both the remittance and collection of benefit contributions, as well as managing eligibility for your members and their families. Built on a secure and reliable calculation engine with adaptable parameters under your control, FundOfficeXG streamlines even the most intricate tasks, such as administering multiemployer health eligibility, managing hour banks, handling retiree health benefits, processing premium billing, and facilitating COBRA procedures. By leveraging this powerful tool, organizations can improve their overall operational efficiency and ensure compliance with benefits regulations seamlessly.

IMPACT serves as the cornerstone of our comprehensive suite of healthcare administration software, designed to facilitate all aspects of health care data transactions. Users of IMPACT rely on it to handle enrollment processes, manage provider contracts and re-pricing, oversee benefit plans, and navigate authorizations and referrals, in addition to claims payments and the complexities that arise from these tasks. Offering remarkable flexibility, IMPACT comes equipped with a diverse range of features tailored specifically for the healthcare industry. The satisfaction and appreciation expressed by our clients bring us immense joy, highlighting the importance of our collaborative interactions and the software we provide that enhances their professional experiences. We believe that technology should prioritize the needs of the customer, which is why MCSI is dedicated to developing solutions that seamlessly integrate into our clients' enterprises, allowing them to adapt and thrive in their respective markets. Our wealth of experience encompasses all dimensions of healthcare data management and solution implementation, and we take great pride in crafting software that emphasizes automation, precision, and dependability, ensuring our clients’ success in an ever-evolving landscape. In this way, our commitment to innovation and excellence drives us to continually improve our offerings, aligning them with the dynamic demands of the healthcare sector.

Collective Health stands out as the pioneering integrated solution enabling self-funded employers to manage their plans, control expenses, and prioritize the well-being of their employees, all from a single platform. We invite you to discover how our tailored programs, seamless administration, and intelligent member experience enhance the benefits we provide. Serving a diverse clientele that includes scientists, truck drivers, and musicians, we take pride in having the most satisfied clients and members in the health insurance sector. Explore why many leading self-funded employers nationwide opt for Collective Health. If you are a broker or consultant aiming to advance your clients’ healthcare strategies, Collective Health offers a streamlined technology solution that optimizes employee healthcare for all stakeholders. With a membership nearing 250,000 and a portfolio of over 50 clients—including notable names like Driscoll’s, Pinterest, Red Bull, Restoration Hardware (RH), and Zendesk—Collective Health is revolutionizing the healthcare journey for innovative organizations. By focusing on integration and member satisfaction, we aim to reshape the future of health insurance.

Streamline your operations and prioritize your employees’ well-being. With Alan, you can eliminate the hassle of paperwork and confusion, ensuring that fulfilling your responsibilities doesn’t require specialized knowledge. Experience time-saving health insurance with a clear, straightforward offer. Your employees can easily access a simple online table of benefits anytime, without any physical documents to handle. Forget about the complexities of managing arrivals, departures, and portability; everything is conveniently handled through your mobile device or computer. Alan's insurance is fully authorized by the ACPR Banque de France and backed by reputable reinsurers like CNP and SwissRe, consolidating all your employees' protections in one accessible location, free from obligations. Alan green provides health coverage that delivers comprehensive protection without excessive costs. Alan blue offers health coverage that ensures excellent reimbursements regardless of the healthcare provider or optician chosen. Lastly, Alan Foresight features provident insurance, which safeguards your employees against unforeseen challenges such as long-term illness or disability, ensuring that their needs are met during tough times. This innovative approach allows you to focus on growth while providing essential support to your team.

Employers can select a monthly stipend while we manage the entire process from selection through to payment, ensuring that any unutilized funds revert back to your budget since you only pay for what is actually used. Employees have the opportunity to explore customized health and wellness benefits, including lab tests, pet care, fitness activities, meditation, egg freezing, and yoga, all accessible via a virtual corporate card. With Fijoya, you unlock a vast array of medical, health, and wellness services within one convenient app. Our intelligent recommendation engine provides options specifically tailored to your individual preferences, and by utilizing virtual cards, we remove the hassle associated with traditional reimbursement methods. This streamlined approach not only enhances employee satisfaction but also promotes healthier lifestyles in the workplace.

Transform and enhance every element of your benefits program using PlanSource. Reach your employees through personalized messaging and communication initiatives that can be tailored by group and automatically disseminated via email, text, mobile app, and additional platforms. With integrated self-billing and invoice reconciliation, you'll spend less time auditing and correcting insurance bills monthly, allowing for a more productive workflow. Our comprehensive compliance solutions provide reassurance regarding ACA measurement and reporting, COBRA administration, eligibility criteria, and much more. Efficient workflows and immediate integrations offer an enrollment process crafted to increase engagement and participation in plans. Our fully mobile experience—available on both our app and website—simplifies the process of exploring benefits, making it as easy as online shopping. By removing manual tasks and countless hours of HR administrative duties, you can achieve genuine end-to-end automation for your benefits system. This not only elevates employee satisfaction but also enhances the overall effectiveness of your benefits administration.

PayorLink solutions provide a holistic platform that goes beyond mere management of medical claims for employers, aiming to enhance employee benefits while simultaneously lowering healthcare expenses, encouraging healthy lifestyles, and boosting workforce productivity. The escalating costs of employee health care are a global issue that raises concerns for both payor organizations and healthcare providers. PayorLink™ is specifically crafted to decrease health expenditures for payors, incentivize employee productivity, and improve the quality of provider claims, largely through effective information exchange between payor entities and affiliated healthcare facilities such as clinics, medical centers, or hospitals. Additionally, it is equipped with tools for Employee Health Profiles and Assessments, which contribute to the realization of wellness and productivity among staff. By focusing on these areas, PayorLink not only addresses immediate financial concerns but also fosters a healthier work environment.

TPA Stream revolutionizes the management of employee benefits by automating processes and addressing communication hurdles across various benefit categories, thereby enhancing efficiency, security, and cost-effectiveness for all involved in facilitating employee benefits. Based in Cleveland, OH, TPA Stream is an insurtech software firm that collaborates with health insurance brokers and third-party administrators to boost their business success and optimize their operational workflows. Our clients often express their appreciation for TPA Stream, highlighting our adaptability, ease of collaboration, and ongoing commitment to creating cutting-edge solutions. Not only do we assist in acquiring new business and streamlining claims processing, but we also focus on boosting employee engagement. With our user-friendly automation for the employer invoicing process related to CDH and COBRA, we simplify intricate tasks. Additionally, our technology automates file consumption, transformation, and integration with administrative systems, ensuring a seamless experience for all stakeholders involved. By choosing TPA Stream, organizations can enhance their operational capabilities and improve overall satisfaction among employees and administrators alike.

Sagitec offers a range of innovative software solutions, including Neospin™, a comprehensive browser-based pension administration system designed for efficient management of pension benefits. Additionally, Sagitec Neosurance™ provides a fully integrated platform for handling unemployment insurance, disability insurance, and paid family leave, all accessible through a user-friendly web interface. The Sagitec HealthConnect platform facilitates Medicaid member engagement by empowering users to take an active role in their health management, utilizing Microsoft’s Azure cloud, which is HITRUST certified for security. Furthermore, Xelence™ serves as Sagitec's low-code/no-code platform, providing a visual environment that enables both citizen developers and IT professionals to create, test, and launch a variety of applications. This platform simplifies the development process for everything from basic consumer applications to complex enterprise solutions, featuring intuitive drag-and-drop capabilities and integrated enterprise architecture tools that streamline application deployment. With these tools, organizations can enhance their operational efficiency and improve service delivery across various sectors.

As a pioneering force and leader in the insurance sector, we boast the most comprehensive straight-through processing platform available in the UK. Discover how our digital solution can cater to your business requirements. Our approach to business transformation emphasizes enhanced agility and a seamless end-to-end digital experience. With self-service options for both advisers and consumers, productivity sees significant improvement. Furthermore, we aim to increase customer lifetime value by fostering proactive and ongoing engagement. Through our Customer and Adviser Portals, users can effortlessly manage their policy documentation and update their personal information in real time. Our platform encompasses every aspect of user interaction, featuring extensive reinsurance reporting, integration with external portals, and both automated and manual underwriting processes. We also offer flexible deployment options, allowing for complete end-to-end installation of the SSG Digital platform or the option to implement individual integrated components, such as underwriting or new business functions, tailored to your needs. Ultimately, this flexibility ensures that your organization can adapt and thrive in an ever-evolving market landscape.

SpyGlass, our advanced software for managing health claims at the enterprise level, presents a robust and adaptable solution for efficient and accurate claims processing. The platform simplifies the setup of benefits and plans significantly. Fully integrated with SpyGlass, BenefitDriven offers eligibility verification, contribution accounting, and pension management specifically tailored for the Taft-Hartley sector, encompassing a comprehensive suite of data and processes for both Participants and Employers. Our all-encompassing EDI gateway and scheduler, HIPAA Director, functions as a central hub, enabling seamless connections with vendor partners to minimize transaction costs, streamline batch transfers, and automate the transfer process. With SpyGlass, you gain an in-depth, panoramic view of your population while also having the capability to drill down to granular details with ease. You can access an extensive selection of unique reports, fully customizable dashboards, and maintain total control over your system, ensuring that you have everything you need at your fingertips to make informed decisions and optimize your operations. In this way, SpyGlass empowers organizations to enhance their efficiency and effectiveness in managing health claims.

Workpartners aims to enhance your organization’s benefit engagement rates while simultaneously lowering overall human capital expenses. We prioritize an employee-centric strategy that leverages data-driven insights to provide tailored tools and solutions that maximize engagement. Our goal is to assist employees in effectively navigating their benefits so they can excel in their roles and contribute to the success of your company—this concept we refer to as People Activation. A comprehensive understanding of your workforce extends beyond just medical and pharmacy claims, also considering the ramifications of employee time off. Our evaluation encompasses various aspects, including long- and short-term disability, workers’ compensation, FMLA, sick leave, and paid time off, alongside critical factors such as benefit design, benefits administration information, compensation frameworks, employee demographics, and organizational policies. Each of these elements serves as vital indicators of health and productivity performance, ultimately driving better outcomes for both employees and employers. By focusing on these diverse metrics, we aim to create a more engaged and efficient workforce.

PeopleStrategy is a full-service broker that offers expert benefits consulting, intuitive software for HR and comprehensive administrative services. This allows employers to have one source for all the tools and resources they need to attract, manage, and retain talent. PeopleStrategy's cloud-based, HR platform is perfect for companies with 50 to 500 employees. It also allows for easy scaling up and down. It offers HRIS, Payroll and Benefits Administration, Time and Attendance, Onboarding, Applicant tracking, Performance, Compensation Planning Compliance, Reporting & Analytics all in one platform. PeopleStrategy Insurance Services helps employers develop a long-term and sustainable benefits strategy. Expert benefits consultants can help you choose the right mix of non-insured and insured benefits options for your employees and their families.

HealthRules® Payer represents a cutting-edge core administrative processing system that offers transformative features for health plans across various types and sizes. For over a decade, health plans utilizing HealthRules Payer have effectively capitalized on market opportunities, maintaining a competitive edge. What sets HealthRules Payer apart from other core administrative solutions is its innovative application of the patented HealthRules Language™, which resembles English and introduces a groundbreaking methodology for configuration, claims management, and information transparency. This system empowers health plans by enabling them to expand, innovate, and outperform their peers more effectively than any other core system available today. As a result, HealthRules Payer not only streamlines operations but also fosters a culture of agility and responsiveness within health organizations.

PeopleKeep provides software for employee stipend administration and health reimbursement arrangement (HRA). This software allows organizations to create customized benefits packages to increase employee engagement and strengthen the workplace culture. Today's employees expect more personalized and diverse benefits from their employers. Employers need to offer more flexibility and inclusion in their benefits packages to attract and retain top talent. Employers can create a customized benefit plan with PeopleKeep that increases employee satisfaction, reduces administrative tasks, and is essential in retention and recruitment.

Startups can simplify their payroll, compliance, and benefits management processes while saving an average of $20,000 annually. Warp offers full-service payroll support for both employees and contractors across all 50 states, automating tax deductions and filing while consolidating numerous compliance accounts into one platform. Additionally, users can acquire small group or ICHRA coverage and seamlessly synchronize health benefits deductions with payroll. The service facilitates payments to global contractors in over 150 countries, allowing transactions in either US dollars or local currencies. With its automated compliance and monitoring features, Warp enables startups to save up to six hours each month and avoid up to $20,000 in yearly fines. When you onboard new employees through Warp, the platform automatically sets up the necessary tax accounts in each jurisdiction, remits taxes to the relevant agencies, and handles all quarterly filings. Moreover, users can effortlessly send employment contracts, set up payroll, and implement health coverage among other functionalities in just a few clicks. Comprehensive medical, dental, and vision coverage is available through leading carriers, enhancing the overall benefits experience for startups and their employees. This streamlined approach not only improves efficiency but also ensures that startups remain compliant with ever-changing regulations.

Web Benefits Design (WBD) stands out as a premier firm in the realm of employee benefits technology, communication, and administration on a national scale. Collaborating with businesses of various sizes, WBD crafts cutting-edge employee benefit solutions that emphasize both innovation and value. Our comprehensive approach serves as a single resource for both employees and Human Resources to efficiently manage benefits. Clients receive a tailored benefits website that features their company logo, colors, images, and branding for a personalized touch. The Supersite acts as a centralized hub for enrollment, benefit comparisons, plan documents, forms, contacts, and tools for decision-making. To create an engaging and impactful experience, our interactive decision support tool enables employees to evaluate future healthcare needs, annual premium costs, and benefit designs to ensure they select the most suitable plan. Additionally, WBD is proud to provide industry-leading COBRA and ACA services! Our benefits administration platform boasts fully integrated eligibility logic, complete with real-time updates and reports for COBRA and ACA data. With WBD, clients benefit from one cohesive team, a singular eligibility source, and a unified solution to all their benefits needs. Furthermore, we are dedicated to continuously enhancing our offerings to better serve our clients and their employees.

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.

Coronis Health has more than 30 years experience in revenue cycle management and medical billing. We understand the impact that new legislation can have on medical facilities. We're breaking down the No Surprises Act and how it could impact your bottom line as the No Surprises Act goes into effect. Coronis Health, a global healthcare revenue cycle management and medical bill company, offers specialized solutions and global capabilities. Coronis Health combines industry-leading technology with high-touch relationships building to allow healthcare professionals & facilities focus on patient care, financial independence, and financial success.

We've streamlined the process for employers by offering comprehensive benefit packages that include full medical, dental, vision, and additional perks, all without the typical headaches or hidden charges. Experience substantial savings and exceptional, contemporary benefits designed for both you and your workforce. If your team appreciates complimentary smart toothbrushes along with excellent dental care, they'll be thrilled with our collaboration with Beam Dental. We've reimagined the conventional health plan to enhance its value. Our approach eliminates complexities related to co-insurance and referrals, driven by a straightforward goal: to provide comprehensive coverage that exceeds expectations. Say goodbye to outdated networks; all our offerings are PPO Plus, granting you access to the expansive Sana Care ecosystem and provider network, while allowing you the flexibility to choose any provider without incurring out-of-network costs. We ensure that you receive a clear breakdown of what you're getting, how much it will cost, and the reasons behind it, presenting only the essential information without any fluff. Manage your organization's benefits with unprecedented ease and efficiency, making the entire process user-friendly and accessible for everyone involved.

myCobraPlan provides an exceptionally intuitive and all-encompassing administration solution that stands out in the market. This platform is designed as a fully automated web-based system, ensuring effortless access to all pertinent COBRA details. By eliminating the necessity for paper forms for submissions related to COBRA-eligible individuals, myCobraPlan offers real-time visibility into your company's data. Additionally, it guarantees hassle-free adherence to all mandatory notifications. Depending on the specific event, the appropriate notification will be dispatched to either the qualified beneficiary or the new plan member. Your organization’s COBRA benefits compliance is diligently overseen by our administrators and seamlessly integrated into our automated system. With myCobraPlan, you can access all your information securely and conveniently from anywhere at any time. This level of accessibility ensures that you are always in the loop regarding your COBRA administration needs.