Bring member records, eligibility checks, claims, benefits, and provider settlements into one system. We agree on the modules and integrations your operation needs before setup.
A third-party administrator helps coordinate health insurance work between insurers, members, and healthcare providers. That includes checking coverage, handling approvals, and processing claims.
Our system brings these records and steps together, with benefit rules, provider information, and audit records available to your team.
Tell us how your operation works. We’ll review your schemes, users, providers, and required integrations before putting together a proposal.
Receive and review claims, apply rules, record decisions, and follow payment status with an audit history.
Manage enrollment, eligibility, dependents, and cards. Capacity is agreed in your proposal.
Maintain hospitals, clinics, pharmacies, contracts, and fee schedules.
Set benefit limits, co-payments, and exclusions for your plans and claims workflows.
Track provider payments, reconciliations, and financial reports.
Review service use, member costs, and provider activity through dashboards and exports.
Let members and providers access the records and services relevant to them.
Connect other systems through APIs, with the scope and access agreed for each integration.
Plans start at $2,000/year · Final features and scale depend on scope
We’ll review your modules, users, and integrations, then prepare a proposal. Plans start at $2,000 per year.
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