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Managed Care Organizations

The healthcare community is constantly evolving and restructuring itself to meet state regulations and health plan-specific challenges. That’s why HealthAxis Group believes adaptability is key in navigating the complexities of the managed care environment. Our goal is to keep payers and providers ahead of the change. We strive to ensure that Medicare, Medicaid/Medi-Cal, and “Dual Eligible” members are provided with care that is both quality and government-compliant, thus helping businesses remain competitive and dynamic. Our “latest generation” single/comprehensive/interoperable digital platform was specifically designed to help organizations increase operational efficiency, decrease operating costs and deliver unprecedented service.

Services Provided to:

  • Medicare
  • Medicaid/Medi-Cal
  • Complex Care
  • Speciality – Dental and Vision
  • Dual Eligible

Our solutions enable Medicare & Medicare Advantage organizations to:

  • Enroll and reconcile members accurately and easily
  • Automatically verify data upon CMS response (through Connect:Direct capability)
  • Receive the highest HEDIS/STAR ratings for high caliber care and clinical outcomes
  • Achieve and maintain compliance with new government regulations
  • Track and report on critical quality and compliance measures
  • Deliver transparency of information for superior customer experience
  • Lower administrative costs significantly by automating workflows
  • Leverage key data sources with seamless integration

Commercial and Private Health Plans

The reality of a shifting marketplace demands solutions that are as adaptable and integrated as they are functional. That is why HealthAxis Group aims to provide a future-proof technology to our customers, thereby ensuring they retain the edge they need to stay competitive and effective. Our technology enables commercial and private health plans to remain flexible while providing quality customer service and reducing overall risk. Both highly customizable and accurate, our standard integrations are configured in a way that allows organizations to rapidly incorporate all systems.

Services Provided to:

  • Commerical
  • Self-Funded Employers
  • Specialty –  Vision and Dental
  • Correctional Healthcare

Our solutions enable 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.
  • 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 Group 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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