The QicLink Enterprise Core Administration system is specifically designed to support third party administration of today’s complex self-funded plans. QicLink maximizes efficiencies through automation; enables seamless transactions between your providers, members and within your plans; and delivers affordable, integrated access to innovative vendor solutions that help you manage risk.

As a third party administration platform, QicLink supports multiple lines of business on a single core platform with multi-tenant capabilities, including Consumer-Directed Health, Medical, Dental, Vision, Medicare, Medicaid, Indemnity and Point of Service plans. The application’s comprehensive functionality and flexibility allows TPAs to better manage claim processes while enabling increased control over the cost and quality of care.

Capabilities include:

• Medical and dental claims processing
• Premium billing
• Web-based customer service
• Member and provider portal
• Provider network management
• Claims re-pricing
• Application processing
• Stop loss/reinsurance processing and reporting
• Capitation/risk fund management
• Utilization management/referral management
• Hospital and medical pre-authorization
• Electronic data interchange

QicLink’s third party administration platform open architecture supports rapid integration with ancillary applications. Microsoft SQL Server relational database technology allows ready access to QicLink data elements for export to external programs for reporting, analysis and other key functions.