Author: Victoria Bucci

HealthAxis to Participate in The Second Annual Medicare Advantage Leadership Innovations East

TAMPA, FL, July 17, 2023 – HealthAxis, a leading provider of core administrative processing system (CAPS) technology and tech-enabled services, is excited to announce its participation in The Second Annual Medicare Advantage Leadership Innovations East event, taking place on July 18-19 in Arlington, Virginia.

As a prominent industry player, HealthAxis is proud to have Candice McGee, Senior Vice President of Healthcare Operations, as a featured speaker on the panel “Enhancing Member Experience: Tools and Strategies to Meet Members Where They Are.” This panel will delve into the challenges faced by Medicare Advantage programs and present comprehensive solutions to empower members and improve their overall experience.

With an impressive track record of over 20 years in healthcare claims processing and a deep understanding of the evolving needs of Medicare Advantage, Candice McGee is a recognized subject matter expert. Her perspectives and insights are invaluable for driving meaningful change in the industry.

To get a glimpse of the valuable insights Candice will share during the event, watch this exclusive clip:

HealthAxis invites attendees and industry professionals to connect with the team during the event to learn more about their cutting-edge solutions and advancements in healthcare technology.

Fueled by their expertise in the Medicare Advantage market, HealthAxis delivers advanced next-generation CAPS technology and modern BPaaS capabilities designed to address the evolving needs of healthcare organizations. Through their comprehensive solutions, HealthAxis enables healthcare providers to navigate the complexities of the Medicare Advantage landscape with confidence and drive positive outcomes.

To learn how HealthAxis can help you achieve your goals, schedule a discovery call.

Exploring the Business Impact of AI for Payers

Artificial intelligence (AI) is reshaping the landscape of claims processing software, revolutionizing how payers manage risk, optimize internal processes, and enhance customer experiences.

By leveraging AI’s advanced capabilities, payers can streamline operations, gain valuable insights, and make data-driven decisions. This transformative technology has the potential to improve efficiency, accuracy, and overall outcomes in the field of AI claims processing.

However, several challenges need to be addressed to ensure widespread adoption and successful integration of AI. This blog explores the ways AI impacts payers, the barriers it faces, and the potential it holds for the future of claims processing.

How AI Impacts Payers

While the concept of AI is well known, payers are still weary of how it can be used in their day-to-day operations. Here are a few ways your organization can utilize AI.

Risk Management

Payers rely on their risk management teams to analyze their overall membership and population, identifying areas with the highest level of risk. AI can assist in this process by determining and forecasting trends within the at-risk population.

This capability enables payers to create new models and programs aimed at addressing high-risk cases and ensuring appropriate patient care. AI also facilitates the identification of long-term trends and strategies that need to be implemented.

By incorporating AI into their risk management program, payers gain a comprehensive understanding of their entire member population. Additionally, it aids in predicting model trends across various areas, highlighting potential surges, and identifying opportunities for new product development, service enhancements, and expanded capabilities to provide support.

Internal Efficiencies

Payers possess a wealth of data within their organization and employ various technologies to consolidate this information. By leveraging machine learning and AI, they can gain insights into how their teams utilize their skills effectively.

Imagine being a payer with a large team of claims analysts. Instead of individually examining each claim that comes their way, AI can assist in identifying anomalies within these claims and escalating for secondary review. By optimizing the workflow, payers can realize better efficiencies and quickly identify concerning trends or issues that impact claim payment.

In addition, payers can leverage AI models to provide insights into emerging changes based on the claim data that inform policy and anticipate population health changes. Consequently, they can predict these shifts and determine the areas where resources need to be scaled up or allocated differently to better respond to the needs of the members. Taking a broader perspective, the application of machine learning and AI within the entire ecosystem allows payers to predict future events. This way, they can appropriately allocate staff, reallocate resources as needed, and consider additional measures to better support their members and patients.

Customer Experience

AI in customer service has the potential to enhance patients’ and members’ understanding of various aspects of their medical care, particularly when it involves complex treatments. By examining how their claims were processed and comprehending the implications for their deductible and benefits, AI can play a crucial role.

Through the utilization of AI, technologies like chatbots can be equipped with comprehensive information to address members’ queries proactively. Instead of resorting to traditional call centers and engaging in lengthy conversations with customer service representatives, individuals can conveniently interact with AI-powered chatbots to swiftly obtain accurate answers.

The continuous progress in AI, its increasing adoption, and the diligent handling of challenges such as trust, explainability, and compliance with regulations will significantly contribute to the ongoing advancement and maturation of AI claims processing.

Revolutionizing AI Claims Processing Software

The emergence of AI has revolutionized numerous industries, including claims processing software. While AI has made significant strides in recent years, its application in claims processing is still relatively new.

Traditionally, the claims processing workflow involved manual tasks such as data entry, validation, and evaluation, which were time-consuming, error-prone, and often led to delays and inefficiencies. However, with the introduction of AI, claims processing software has harnessed its capabilities to automate and streamline the entire process.

Enhanced Data Analysis

AI algorithms now possess the ability to analyze and extract relevant information from diverse sources, such as claim forms, medical records, invoices, and policy documents. Through techniques like Natural Language Processing (NLP), the software can understand and interpret unstructured data, including claim descriptions or medical reports.

Fraud Detection and Prevention

AI algorithms also contribute to fraud detection by scrutinizing patterns, identifying anomalies, and flagging suspicious claims for further investigation. This assists insurance payers in mitigating fraudulent activities and improving the accuracy of claims processing.

Minimized Manual Evaluation

Machine Learning (ML) algorithms play a vital role in claims processing software. By leveraging large datasets for training, ML models can learn from historical claims data, recognize patterns, and make predictions.

For instance, ML algorithms can estimate settlement amounts based on similar past cases, reducing the need for manual evaluation and facilitating faster claims resolutions.

Challenges Hindering AI Claims Processing Software

Despite notable progress, the integration of AI into claims processing software faces several key barriers. These obstacles can be categorized into four main areas:

Adoption and Integration

While certain insurance companies have initiated the implementation of AI-based claims processing systems, achieving widespread adoption and integration across the industry is an ongoing process. Many organizations are still exploring the potential benefits and carefully evaluating the most effective methods for incorporating AI into their existing processes.

Fine-tuning and Optimization

Continuous fine-tuning and optimization are necessary to enhance the accuracy and performance of AI algorithms. Given the complexity and ever-evolving nature of claims processing scenarios, there is a need to refine AI models and adapt them to changing patterns and regulatory requirements.

Trust and Interpretability

The decision-making processes of AI can sometimes be perceived as a “black box” or difficult to interpret due to the intricate nature of the underlying algorithms. Building trust in AI-powered claims processing systems necessitates transparent explanations of how decisions are reached, particularly in cases involving claim denials or rejections.

Ensuring clear and understandable communication of AI-generated outcomes is crucial for establishing confidence among stakeholders.

Regulatory Compliance

The utilization of AI in claims processing must adhere to regulatory frameworks and guidelines. As AI technologies evolve, regulators are adapting to ensure fair and ethical practices.

Insurance companies must navigate these evolving regulations to ensure compliance while effectively harnessing AI in their claims processing systems.

Embrace Innovation, Elevate Experiences: Unlocking the Future of Payer Operations

In today’s fast-paced healthcare landscape, staying ahead of the curve is crucial for payers to thrive. By partnering with HealthAxis, you gain access to a team of dedicated technology experts who are constantly at the forefront of the latest healthcare tech trends. We are committed to helping you navigate the ever-evolving industry by providing valuable resources, expert tips, and innovative solutions that address your unique pain points.

Our proprietary CAPS technology and modern BPaaS, BPO, staff augmentation and consulting services are at the core of our commitment to empowering payers like you. With our cutting-edge technology, you can unlock the full potential of your claims processing operations and elevate your member experiences to new heights.

Schedule a discovery call today to learn how HealthAxis can help transform your health plan operations.

Author:

Lisa Hebert

Lisa Hebert
Senior Vice President of Product Strategy and Management
HealthAxis

A CPO’s View On Leadership Skills And Building Culture

As our Chief People Officer, Angela Benmassaoud is responsible for creating an inclusive and people-first culture that fuels HealthAxis’s mission and drives our growth. Her wealth of experience and leadership acumen ensures that our team members and customers receive exceptional value and remain at the heart of everything we do.

We are proud to share that Angela recently made a guest appearance on the highly anticipated L&D Disrupt podcast by HowNow. In this episode, Angela shared inspiring stories from her early career, delved into the qualities that make a great leader, and explored the importance of fostering openness and collaboration within organizations.

If you’re eager to gain valuable insights and be inspired, don’t miss out on this enlightening conversation! Click here to listen to the full podcast episode.

HealthAxis Showcases Collaborative and Innovative New Office Space at Rivergate Tower

HealthAxis, a leading provider of core administrative processing system (CAPS) technology and tech-enabled services, hosted an open house for its team members on Wednesday, April 26, 2023, at its new Tampa office located in the iconic Rivergate Tower.

The event, as shown in the video below, was a resounding success, with great conversation, delicious food, and plenty of fun activities for everyone in attendance.

The new ‘hoteling’ workspace is designed to facilitate collaboration and innovation, with an open floor plan and dedicated areas for team meetings and brainstorming sessions. The modern design and comfortable furnishings make it a welcoming space for employees to work and collaborate.

Overall, the open house was a great success and showcased the company’s commitment to creating a positive and engaging work environment for its employees. With its new office space, HealthAxis’ is well-positioned to continue innovating and delivering cutting-edge solutions to its clients.

Learn more about HealthAxis, our cutting-edge CAPS technology, TPA services, and current job openings at HealthAxis.com.

HealthAxis to Showcase Next-Gen CAPS Technology and Tech-Enabled Services at AHIP 2023

TAMPA, FL, MAY 3, 2023 – HealthAxis, a leading provider of core administrative processing system (CAPS) technology and tech-enabled services, is proud to sponsor AHIP 2023. This annual event brings together health insurance professionals, policymakers, industry experts, and thought leaders to discuss the latest developments in the health insurance industry, exchange ideas and insights, and explore solutions to the most pressing challenges facing the industry. The event will be held June 13th – 15th in Portland, Oregon.

As the healthcare industry continues to evolve, technology plays an increasingly important role in delivering quality care to patients. Specifically, implementing and maintaining effective claims processing technology can be a challenge due to its complexity and the constantly changing regulatory environment.

HealthAxis is at the forefront of this transformation with its CAPS technology HxPro which incorporates easy-to-use interfaces and is designed for flexibility and performance with highly automated workflows that drive efficiency, reduce errors, and ensure compliance.

Key Benefits:

  • Scalable – Cloud-based architecture supports limitless expansion.
  • Interoperable – Service-oriented design and open APIs allow for easy data access and third-party collaborations.
  • Modifiable – Tailor logic, workflow, and interfaces for unique strategies.

HealthAxis’ tech-enabled services HxOps are built around a customer-first methodology, delivering first-rate experiences and results for clients and their members. Extensive, flexible front and back-office administrative services boost productivity, improve processes and reduce costs.

Key Benefits:

  • Customizable – Outsource all plan operations, or a targeted, single-line service.
  • Cost-Effective – Leverage our operational scale and technical infrastructure.
  • Quality Service – Seamlessly transition and extend your team.

Visit HealthAxis’ team of experts at booth #1335 at AHIP 2023 to learn more first-hand. Ready to learn more now? Request a demo today.

About HealthAxis

HealthAxis is a leading provider of modern core administrative processing system (CAPS) technology and tech-enabled services to healthcare payors, providers, and health organizations. We offer our clients scalable and flexible solutions for their most complex challenges. Our next-generation enterprise solution suite combines our HxPro, core benefits administration software platform and HxOps, tech-enabled business process outsourcing capabilities under one unified offering. These solutions combine to make HealthAxis the leading partner for payors seeking reliability, innovation, and efficiency across their most mission-critical business functions. Visit HealthAxis.com for more information.

HealthAxis Moves Corporate Headquarters to Iconic Rivergate Tower

HealthAxis, a leading provider of Core Administrative Processing Solutions and related software and services to healthcare payors, announced that their corporate office is relocating to the Rivergate Tower. The tower is located along the Tampa Bay Riverwalk at 400 N Ashley Drive, Suite 920, Tampa, Florida. This new space is a remarkable place that will be perfect to collaborate and entertain current and prospective customers.

“We were looking for a place that reflects the new future of HealthAxis and the Rivergate Tower did just that. It is the perfect environment for our employees to thrive,” said Matthew Hughes, CEO of HealthAxis.

HealthAxis is passionate about creating a culture that empowers their employees which is why they have a hybrid work model and work-from-home options available. This design offers employees more flexibility and freedom, giving them more control over how they work and where they work.

With 92% of HealthAxis’ employees desiring a fully-remote option, they decided to downsize from their current space, which boasted over 200 employees pre-Covid. After conducting a thorough search and review of several criteria, they knew that the Rivergate Tower would be the perfect place for their team.

Angela Benmassaoud, Chief People Officer and a member of the selection team, says, “Having a comfortable setting for my coworkers and I to visit when we want work together has helped us create a collaborative culture where we can bounce ideas off each other and build off on one another’s insights.”

The new office will be a ‘hoteling’ workspace with 30 desks, two standing desks in each section, and five offices. When one walks through the floor-to-ceiling glass doors, the main focal point is a large conference room. Additionally, a creative zone exists for meetings, team building, and planning. In the layout, one will also see a small cozy space to use for lunch breaks, small team gatherings, or just taking in the view during a break.

About HealthAxis
HealthAxis is a leading provider of modern Core Administrative Processing Solutions and related software and services to healthcare payors. We offer our clients scalable and flexible solutions for their most complex challenges. Our next-generation enterprise solution suite combines our HxPro, core benefits administration software platform and HxOps, tech-enabled business process outsourcing capabilities under one unified offering. These solutions combine to make HealthAxis the leading partner for payors seeking reliability, innovation, and efficiency across their most mission-critical business functions. Visit HealthAxis.com for more information.

HealthAxis Names New CEO

HealthAxis, a leading provider of core administrative processing solutions (CAPS) and related software and services to healthcare payors, announced that Matt Hughes, former COO of HealthAxis, has been named the new chief executive officer of HealthAxis.

Revelstoke Capital Partners with the HealthAxis Board of Directors conducted an extensive and arduous search for the exact fit for an organization where the rest of the senior leadership team was already in place.

“We felt strongly that Matt was the right person for the role,” said Gabriel Gonzalez, Vice President at Revelstoke Capital Partners. “No other candidate possessed the quality experience and cultural drive Matt has demonstrated in the past year.”

Mr. Hughes joined HealthAxis as its chief operating officer in May 2022. He brings more than 30 years of experience to HealthAxis. Most recently, he held the position of CFO at HealthEdge Software, Inc. for over 12 years. Matt’s forte is creating and maturing a company’s operational, financial, administrative, and structural discipline during early and high-growth stages. He is passionate about creating a culture fostering employee engagement and developing a customer-centric organization.

“I am honored to be selected as the new CEO of HealthAxis,” said Matt Hughes. “I have had the privilege of getting to know the amazing team and see the countless possibilities for our team, our products and services, and our customers. Today’s healthcare systems are transitioning to value-based care and are in urgent need of improving efficiency, digitalization, and interoperability. Our team is equipped to meet the challenges ahead and ready to embark on an aggressive plan to be the most advanced healthcare core administration suite in the payer market.”

About HealthAxis
HealthAxis is a leading provider of modern Core Administrative Processing Solutions and related software and services to healthcare payors. We offer our clients scalable and flexible solutions for their most complex challenges. Our next-generation enterprise solution suite combines our HxPro, core benefits administration software platform and HxOps, tech-enabled business process outsourcing capabilities under one unified offering. These solutions combine to make HealthAxis the leading partner for payors seeking reliability, innovation, and efficiency across their most mission-critical business functions. Visit HealthAxis.com for more information.

HealthAxis Leaders #EmbraceEquity On International Women’s Day And Beyond

International Women’s Day (IWD), celebrated annually on March 8th, is both a day to honor women’s social, economic, cultural, and political achievements worldwide and a day to rally for progress toward gender equality. Collective action and shared ownership for driving gender parity make IWD impactful. 

The 2023 IWD theme is #EmbraceEquity – a call to create a genuinely inclusive world. Through the process of equity, we can reach equality. 

 

Some members of the HealthAxis leadership team reflected on how they personally and professionally intend to make #EmbraceEquity a reality… 

 

I recognize that a change in behaviors and mindset is necessary to embrace equity. We must remove barriers and level the playing field to facilitate sharing diverse thoughts and experiences, ultimately contributing to stronger teams and better results. As a leader at HealthAxis, I’m committed to our pledge to embrace people of all genders, races, disabilities, and cultures, among many other notable differences that make someone unique and valued. The health of our company depends on embracing cultural diversity, and we are committed to creating an inclusive environment, acknowledging, and honoring the fundamental value and dignity of all individuals.

Matt HughesMatt Hughes
Chief Executive Officer

 

Diversity in the workforce is paramount to ensuring we have our company’s brightest minds and strongest talent. I’ve worked with great women leaders, subject matter experts, and innovators throughout my career. These women have driven the success of their teams and companies and, more importantly, delivered improved patient care and outcomes. I greatly appreciate the opportunities to learn from these women in my past roles and am thrilled to be part of such a diverse team at HealthAxis, where I continue to learn from our strong women leaders.

Chris House
Chris House
Chief Technology Officer

 

I have a vision to create a workplace where people are seen as just that, people! Inspired by a work environment that fosters growth, creativity, empowerment, and trust. A place where you are not a resource, but a powerful source of creative energy full of innovative ideas where we, as leaders, can unlock your true potential.

Angela Benmassaoud, Chief People OfficerAngela Benmassaoud
Chief People Officer

 

I have had the honor of working for, working with and leading strong, intelligent women for over 20 years in technology and services. These experiences have made me a better leader and a leader who seeks out and supports the development of women in technology, where there is a great need today. At HealthAxis, we are blessed with female leaders whose voice will be heard and will be a driving force for our future.

Greg von der LippeGreg von der Lippe
Chief Growth Officer

 

Throughout my career, I’ve had the privilege of working alongside some of the most extraordinary women leaders in healthcare. I’ve learned that it’s important to maintain an open mind and an open heart for others, and in doing that, one will naturally advocate for workplace equity. At HealthAxis, we don’t have to agree with a colleague to learn from them and what’s important at their core. In our culture, we expect others to be interested in what has shaped individuals’ views, value systems, and identity; that alone will present opportunities for awareness, education, and the advancement of an equitable culture. At HealthAxis, WE do expect that WE will treat others with civility and respect, and that leads to the discovery of equitable leadership in surprising ways.

Robert Nolan

Robert Nolan
Chief Compliance Officer

 

Over my 20-year career working primarily in software, I have had the honor and privilege of working alongside and for some amazing women. These women have had a hand in shaping my leadership style and approach to business and helping me become a more well-rounded individual. Without these leaders’ influence, guidance, knowledge, and mentorship, I would not be in the position I am in today. I am thankful and appreciative that I have had the opportunity to watch, learn and ultimately excel under their leadership.

Peter Murphy

Peter Murphy
Chief Operating & Customer Experience Officer

 

As a woman in operations leadership, I am passionate about educating others in understanding equity in the workplace and how it can help move companies forward. I have had the privilege to work for many strong female leaders, and they have inspired, encouraged, and motivated me to ensure that I continue to support other female leaders to grow in their careers. The work I am doing today at HealthAxis within operations and the support I have to grow, learn and share ideas from my leaders is priceless.

Candice McGeeCandice McGee
Senior Vice President Healthcare Operations

 

As a success-driven and goal-oriented woman in the healthcare technology industry, I will lead by example. I will provide a workplace environment where all people feel equally valued and unequivocally supported.

Lisa HebertLisa Hebert
Vice President of Product Management

 

Learn more about HealthAxis, an innovative partner for those who want to revolutionize healthcare services and become leaders in the industry.

HealthAxis Names New COO and CTO

Leadership Structure Bolster by Dynamic Talent    


TAMPA, FL, June 7, 2022 – HealthAxis, a leading provider of Core Administrative Processing Solutions and related software and services to healthcare payors, announced today that Matthew Hughes has joined the company as chief operating officer and Neal Reizer has joined as chief technology officer.

“We’re excited to have both Matt and Neal join the HealthAxis team,” said HealthAxis Founder Shilen Patel. “Matt and Neal are both established industry veterans that will add tremendous value to our organization and help us better serve our customers.”

Matt Hughes brings over thirty years of operational and financial leadership, most recently serving as the chief financial officer at HealthEdge for more than eight years. While at HealthEdge, Matt helped lead strategic planning, the creation of optimal staffing structures, and financial planning and analysis to support accelerated growth. In his role with HealthAxis, Matt will be responsible for leading HealthAxis’ day-to-day operations and strategy to continuously improve the customer experience.

“It is an honor to be joining HealthAxis as COO during this exciting phase of growth and to help lead the company in its mission to best serve the complex needs of value-based plans. I look forward to working alongside the rest of the leadership team as we deepen customer relationships and capitalize upon numerous growth opportunities in this dynamic market,” said Matt.

Neal Reizer brings more than thirty years of experience working in information technology across healthcare and other industries. Neal has deep expertise in software development, product, strategic planning, and organizational change management. Prior to joining HealthAxis, Neal served in various senior technology and product roles most recently with Homecare Homebase, nThrive, and AristaMD. In his role with HealthAxis, Neal will be responsible for accelerating innovation and capabilities across the HxOne technology platform.

“HealthAxis has done a great job leveraging its leading HxOne platform to provide highly differentiated solutions to its customers. I look forward to building on the company’s past successes and helping HealthAxis provide the highest level of quality and innovation for its customers,” said Neal.

About HealthAxis

HealthAxis is a leading provider of modern Core Administrative Processing Solutions and related software and services to healthcare payors. We offer our clients scalable and flexible solutions for their most complex challenges. Our next-generation enterprise solution suite, HxOne, is a comprehensive healthcare management solution that combines our HxPro, core benefits administration software platform, HxLogic, data-driven analytics tools, and HxOps, tech-enabled business process outsourcing capabilities under one unified offering. These solutions combine to make HealthAxis the leading partner for payors seeking reliability, innovation, and efficiency across their most mission-critical business functions. Visit HealthAxis.com for more information.

HealthAxis Sponsoring AHIP 2022

HealthAxis is sponsoring & exhibiting at AHIP 2022.

Date: June 21 – 23, 2022

Location: Las Vegas, NV

HealthAxis is proud to be sponsoring and exhibiting at AHIP 2022 once again. AHIP is the perfect event for our industry to come together to share ideas and solutions, and discuss the most relevant topics regarding healthcare.

We will be featuring the benefits of our payer administration enterprise solution HxOne. Our integrated, end-to-end system and services incorporate next-generation technology, comprehensive third-party services, and advanced analytics to help eliminate legacy and manual processes for health plans. We are excited to connect and talk with anyone interested in enhancing their operations and partnering to make a difference in healthcare.

Visit us at our booth or contact us ahead of time to schedule a meeting at the event.