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Increases payer efficiency, improves productivity, reduces costs and positions your business for growth.
Offers end-to-end solution that pairs modular SaaS products with industry-leading strategic consulting to connect disparate systems, standardize data and enable secure, authenticated access in real-time.
Automates pricing scenarios to provide the best value to payers, providers and patients.
Enables payer/provider collaboration to reduce costs and drive overall quality improvement.
Members may interact anytime, anywhere and receive a detailed view of their coverage information with compelling metrics, timely notifications and relevant healthcare content.
This integrated software and services healthcare BPaaS solution includes process optimization, digitization and large-scale efficiencies.
Enables physicians and other care providers to access detailed information on their patients, efficiently log claims and make templates for common claims, as well as easily create referrals and authorizations.
Manages EDI trading partners with one cost-effective, cloud-enabled technology service.
Connects care managers to members and providers while reducing costs, personalizing interventions and improving care quality.
Automates and simplifies operational tasks associated with our core healthcare technology solutions, Facets and QNXT.
Extends the functionality of your core system by providing critical capabilities, from enrollment through risk adjustment, to efficiently administer government solutions.
Automates transaction processing and information exchange between payer organizations and their external constituents.
Comprehensive, flexible and scalable core administrative solutions that enable the digital transformation required for success in the commercial market.
Support for the economic advantages and efficiencies.
Flexible IT solutions to address requirements with customizable functionality.
Functionality that adapts to meet the complexities and demands of the Medicare Advantage market.
Functionality that adapts to meet the complexities and demands of the Managed Medicaid market.
Flexible solutions to coordinate multiple compliance requirements and ease administration burdens.
Facets, an industry-leading core administrative processing system, incorporates powerful modern technology and best practices to deliver results in real-world, high-demand production environments, 24/7. Facets maintains the flexibility, features and scalability that more than 80 healthcare organizations rely on to serve their members.LEARN MORE