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Risk Bearing Provider Organizations

The process of balancing risk management while meeting modern regulations and compliance standards does not have to halt or slow your management capability. HealthAxis offers a web-delivered solution aimed at consolidating both the process and performance of any business requirement— alleviating outdated operations and cumbersome processes. Our RBPO solution is not only customer-driven but is highly scalable and delivered on a per member per month basis.

Provider Services Include:
ACOs, IPAs, CINs, IDNs, Medical Providers

Our solutions enable Risk Bearing Provider organizations to:

  • Manage multiple markets and lines of business with vastly different rules or requirements within a single code-based system alleviating the need for employees to log into multiple systems and serve multiple clients
  • Achieve turnkey integration among Claim Adjudication, Enrollment Portal, Broker Portal, Member Portal and Care Manager
  • Review eligibility in real time through the Health Plan Enrollment Portal
  • Customize dashboards to manage daily task through workflow queue for claims, authorization and other departments
  • Satisfy the requirements for full delegation of financial risk
  • Manage and reconcile capitation and eligibility
  • Improve care planning and disease management
  • Easily configure complicated benefit plan, DOFR and fee schedules.
  • Resolve provider appeals and disputes
  • Scale services to any population size
  • Obtain seamless connectivity through our business partner for DRG/ARP DRG
  • Automate critical patient follow-up for appointment reminders, assessments, and other interventions
  • Alleviated the need to have additional onsite equipment and personnel management systems
  • Rapidly setup and configure systems with limited involvement from your IT resources
  • Increase automated claims payments
  • Comply with Meaningful Use requirements
  • Create comprehensive ad-hoc reporting
  • Effectively manage delegated risk
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