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Managed Care Organizations

Managed care organizations compete in a highly competitive and regulatory environment while serving the increasingly complex needs of their members. We believe adaptability is key to navigating these complexities and offer our unique HxOne solution with this in mind. We designed our latest-generation, single, comprehensive and interoperable digital platform to help organizations increase operational efficiency, decrease operating costs and maintain and improve the quality of care.

Services Provided to:

  • Medicare
  • Medicaid/Medi-Cal
  • Special Needs (I-SNP, IE-SNP, D-SNP, C-SNP)
  • Specialty – Dental and Vision

Our solutions enable Medicare and Medicare Advantage organizations to:

  • Enroll and reconcile members accurately and easily
  • Automatically verify data upon CMS response
  • Improve HEDIS/STAR ratings and other Quality ratings for high caliber care and clinical outcomes
  • Achieve and maintain compliance with new government regulations
  • Deliver transparency of information for superior plan and member customer experience
  • Lower administrative costs significantly by automating workflows
  • Leverage voluminous clinical, administrative, and operational data aggregated from multiple disparate sources
Special Needs-2

Special Needs Organizations
(I-SNP, IE-SNP, D-SNP and C-SNP)

With over 150,000 members served through our customers, HealthAxis is the leading provider of next-generation technology, comprehensive third-party administrative services, and robust solutions focused specifically on the special needs market.  We understand the requirements of this complex population and deliver unique tools and capabilities to help our customers thrive. We proudly serve some of the fastest-growing independent SNPs in the market.

Our solutions enable Special Needs Plans to:

  • Efficiently track provider performance
  • Pay facility capitation
  • Identify SNP eligible members
  • Create and modify dashboards for high needs members
  • Manage multiple chronic conditions
  • Integrate with EHR systems

Self-funded & Commercial Health Plans

The reality of a shifting marketplace demands solutions that are as adaptable and integrated as they are functional. That is why HealthAxis aims to provide a future-proof technology to our customers, thereby ensuring they retain the edge needed to stay competitive and effective. Our technology enables self-funded employers and commercial health plans to remain flexible while providing quality customer service and reducing overall risk. Highly customizable and automated, our system configuration capabilities provide flexibility in establishing various benefit and wellness plans.

Our solutions enable Self-funded and Commercial Health Plans to:

  • Build new products in a short period of time and quickly launch new lines of business in response to new market opportunities
  • Easily configure and manage multiple various benefit plans unique to small, mid-size, and large employer groups
  • Respond to new payment reform models, including value-based reimbursements and benefits
  • Lower administrative cost by automating key processes and workflows
  • Be flexible and integrate multiple vendors and benefit programs
  • Enhance the quality of care and clinical outcomes, resulting in better metrics and higher reimbursements
  • Deliver superior customer service by providing real-time, 24/7 access to critical information
  • Ensure regulatory compliance with changing regulations

Specialty - Vision & Dental

Our solutions are agile with the ability to quickly change to meet payer and consumer requests as well as adjust to growth and market conditions. With our user-friendly interfaces and modifiable systems, dental and vision benefits administrators can originate and manage unique plans and complex fee structures with unlimited modifications. Many manual and error-prone processes can be eliminated, allowing more time to focus on the members.

Correctional Healthcare

HealthAxis offers a fully integrative solution for payers in correctional healthcare. Our trusted platform offers automation to increase efficiency while streamlining manual workflows and administrative processes. We understand the complexity of managing correctional healthcare services and scheduling on and off-site appointment for inmates. At the start, we engage with your team evaluating your processes and assisting with implementing rules based on your specialized circumstances. Our customizable configurations allow your organizations to rapidly incorporate all your systems while ensuring your real-time data is secure and well managed.

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