Third Party Administrators

Third Party Administrators

A Third-Party Administrator’s ability to adapt to an ever-changing medical industry and marketplace may hinge upon whom they successfully partner with. HealthAxis Group aims to be just that— a consistent and reliable partner. Our end-to-end suite enhances TPAs’ abilities to provide optimal customer service through automated workflows and efficient administrative procedures. Innovative and full-service care will be easier for TPAs to achieve, and the possibility for our partners’ growth is rendered virtually limitless.

Our solutions enable Third Party Administrators 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
  • Improve service through enhanced self-service features
  • Match member portals to existing company web site look and feel for a seamless integration
  • Keep pace with rapidly evolving market-by-market changes within a single code base by using our sophisticated and intuitive Determinants™ Rules feature
  • Achieve auto adjudication rates of up to 100%, lowering staff ratios and making claims processors and workflow more productive
  • Effortlessly import and export  key data sets to support interoperability and analytics
  • Coordinate activities and share data among TPAs, covered members, and providers through a highly integrated platform
  • Shed costly and complex IT burdens using a hosted certified solution that conforms to cyber security and cloud hosting mandates
  • Automate high volume workflow in claims processing, and utilization management
  • Offer your clients advanced capabilities such as Care\Disease Management, Population Health and Analytics experience
  • Protect and secure all healthcare information under the HIPAA Privacy Legislation requirements

Remove your inefficiencies and optimize your performance
through these leading-edge solutions

Core Benefit Admin System

Technological optimization meets financial efficiency in this fully integrated system that is designed to streamline benefits administration, healthcare claims processing, and overall health plan management.

Web Based Self Service Portals

Regardless as to whether you’re a provider seeking to get organized, a member searching for enrollment solutions, or a user looking to increase the efficiency of patient-centric activity, we offer a reliable web portal that meets your needs.

Smart Front End Services

From advanced mailroom services to every facet of health claims management, products and services are balanced in our Smart Front-End® service which enables you to tailor your experience to your day-to-day needs.

Post Adjudication Services

The industry may be hard to keep up with, but with our Post Adjudication Services, you can defy modern limitations to ensure efficient and cost-effective health claims processing, resulting in faster claims settlements.

Business Process Outsourcing

We want you to focus on what matters most to you, which is why we offer BPO solutions that enable us to manage your business processes through our own internally managed system and strategic partnerships.