Payers Overview

Healthx technology platform connects Payers to Providers, Brokers, Employers and Members


Our partner network and consultative competencies coupled with our world-class technologies make us the most flexible, responsive and formidable players in the ever-changing healthcare arena. Healthx partners with some of the most respected names in healthcare to offer solutions that facilitate better healthcare decisions for hundreds of Payers, thousands of Providers and Employer Groups, and millions of members nationwide.

Healthx offers a superior technology platform, which enables Payers to electronically connect customers or third-party vendors to Payer data at price points made affordable by the size of the community we represent. Members can access important benefits information 24/7, ask questions, enroll in benefits programs, submit requests for additional information, track FSA, HRA and HSA accounts, and participate in health and wellness programs online.

Healthx Web platform services streamline customer and trading partner interactions across multiple touch-points, including telephone, fax, Internet, and Interactive Voice Response (IVR). Healthx Web enables you to customize and target your online presence via specific web portals for employers, members and providers. Healthx Phone combines Interactive Voice Response (IVR) and fax back technologies to assist providers as they request information via the phone keypad. The system provides either a verbal playback or faxback of eligibility, accumulator and claims status.

Healthx Portals are Highly Configurable and Brandable:

  • Customized, branded portals for Providers, Brokers, Employers and Members
  • Ability to manage and configure site to fit your business needs
  • Online interactive Explanation of Benefits
  • Online claims status and EOB’s
  • Online HSA, HRA and FSA Statements with links to EOB’s
  • Online request for HSA, HRA and FSA disbursements
  • Online secure customer service question and response system
  • Online eligibility look-up for all benefits
  • Enrollment and life event change management for all benefits
  • Dynamic links to plan documents, networks and PBM’s
  • Integration with Consumer Health and Education Tools
  • Email notifications of new claims or customer service answers
  • All services delivered via a secure, fully managed ASP model
  • Online purchasing of Over the Counter items and Durable Medical Equipment
  • Methodology to help drive usage from all constituents
  • All services delivered via a secure, fully managed ASP model

Targeted Messaging

  • Online claims views including e-mail notification of new EOB’s
  • Email notifications of new claims or customer service answers
  • Online secure customer service question and response system
  • Email notification for key events to drive high system usage
  • Automated email notification
  • Broadcast announcements

Reports

  • Secure, online distribution of monthly reports or premium billing
  • Detailed online usage reports by service and client

Disease Management and Predictive Modeling

  • Advanced Reporting and Predictive Modeling
  • Comprehensive Chronic Disease Management
  • Provider Profiling and Intervention

Pre-integrated Consumer Directed healthcare tools

  • Interactive health & wellness awareness programs
  • Web-based personalized Wellness Programs
  • Hospital, Pharma and Physician comparison tools
  • Treatment & Coverage Advisors
  • Illustrated information on surgeries, conditions and tests
  • Reward programs for members

Paperless enrollment & eligibility management

  • High degree of configurability
  • Improving the eligibility management process

Phone/IVR technology

  • Convenient self-service for providers
  • A simple way to reduce provider inquiries to customer service reps

Multi-purse / purpose benefits card

  • Automated employee spending account management
  • Greater FSA, HSA and HRA participation
  • Increased employer satisfaction

National Pharmacy Alliance

  • PBM and consulting services
  • Lower-priced, completely transparent pricing model
  • Significant savings

Convenient online retail services

  • Discounted prices on over-the-counter items
  • Convenient purchasing of durable medical equipment
  • Free shipping on most orders

Automated Outbound call programs

  • Greater response from members as compared to traditional mail campaigns

We continue to explore, develop and identify technologies that streamline the business processes for our clients and empower members with the best tools to make more informed healthcare decisions. Our communication and technology solutions are utilized by hundreds of payers, thousands of Providers and Employer Groups and over 15 million members nationwide. Our solutions create consumer directed capabilities superior to larger payers today and in the future. We give our payers the ability to customize healthcare services down to the individual member level creating credible competitive advantages over larger payers.