Health Plans

Success in the healthcare arena is all about using the right tools to create the systems and experiences that facilitate proactive, healthy choices in ordinary people. We succeed when quality of life goes up – for our customers and for their customers. That’s what we do better than anyone else in the world.

Health Plans with an edge in the consumer driven market are constantly becoming more effective and more efficient. Reach and impact are growing, and processes are becoming lean and financially streamlined. Lagging behind means not only lower quality healthcare for your end customer – it means not being able to afford to stay in the game.

Healthx is a provider of business solutions, not merely a technology or web solutions. Healthx works with hundreds of healthcare companies to develop best practices and long-term partnerships. We continuously enhance our products and services to ensure that our partners remain in the leadership position in their markets. Our third party health and wellness solutions, disease management solutions and FSA, HSA and HRA solutions are delivered to you pre-integrated into the Healthx Web platform.

Now is a great time to review your current portal and connectivity strategies. Healthx has a strong history of building on existing strategies and reducing costs—while at the same time improving usage among your members and providers. Healthx provides a turn-key approach to portals that are customized to your organization and easy to implement and use. As part of every implementation, we work with you to define your system requirements and the best approach for delivering a robust set of services to all of your constituents, all the way down to helping you introduce your new set of services to your Providers, Employer Groups and members.

Healthx provides a suite of technology solutions that allow a healthcare Payer to provide:

Eligibility and Claim Management of PHI

  • Secure interactions between members, employers, brokers and providers
  • Dynamic presentation of benefits information based on user roles
  • Direct access to other sites with a single login
  • Web self-service to all constituents - members, employers, HR, providers
  • Eligibility and claim status by web, phone/IVR
  • Claims - submission and status check
  • HIPAA compliant management of PHI
  • Automated report distribution and document presentation
  • On-line Plan Documents dynamically presented based on configurable criteria
  • On-line customer service to all constituents
  • Pre-certification and Prior Authorization for providers
  • Multi channel messaging and information management
  • Total web branding specific for each constituent

Disease Management Solutions

  • 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
  • Effective way of driving behavior, i.e. flu shot and mammogram reminders
  • A simple approach to communication