Health Benefit Exchange (HBE) – Call Center Functionality & Services

Health Benefit Exchange (HBE) – Call Center Functionality & Services For Health Exchanges, Call Center will be the heart of delivering better service. The primary goals of the HBE Call Center will be to assist individuals and small employers in obtaining health insurance coverage and be able to respond to the following: The types of Qualified [...]

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Core Functions of State Health Exchange

Core Functions of State Health Exchange Deciphering Affordable Care Act (ACA) or ObamaCare, the core function of State Health Exchanges or Federal run Health Benefit Exchanges will include but not limited to: Adjudication of appeals of eligibility determinations Administration of premium tax credits and cost-sharing reductions Applications and notices Call center operations Certification, recertification, and [...]

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Health Exchanges – Enrollment & Eligibility

Health Exchanges – Enrollment & Eligibility Our 2-in1 Software and Services combo is ready for Health Exchanges as well as Qualified Health Plans (QHPs). We can help our clients to be ready for Oct 1 dead-line via following services: Enrollment Eligibility Credentialing Premium Billing Claims Call Center Support  – Member & Provider Services + Language [...]

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HealthCare Quality Improvement Organizations (QIO) and QIO Directory

HealthCare Quality Improvement Organizations (QIO) and QIO Directory What are QIOs? CMS contracts with one organization in each state, as well as the District of Columbia, Puerto Rico, and the U.S. Virgin Islands to serve as that state/jurisdiction’s Quality Improvement Organization (QIO) contractor. QIOs are private, mostly not-for-profit organizations, which are staffed by professionals, mostly [...]

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HealthCare Payer Services – PAS, CMS, AAS and RPS

HealthCare Payer Services – PAS, CMS, AAS and RPS Platform & Administration Services – PAS Ancillary Benefits Administration (AD&D) Claims Adjudication Claims Runoff Administration Claims Services Coordination of Benefits (COB) Eligibility Flex Plan Administration Identification Cards Issue employee materials Member Education/Communication Stop-Loss administration Summary Plan Descriptions (SPD) Care & Medical Management Services – CMS Case [...]

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Posted in BPO, Claims, Claims Administration, Clinical Services, Document Management, Finance and Accounting, Health Actuarial, HealthCare Analytics and HealthCare Business Intelligence Companies in America, HealthTechnolgy.com, Medicare, Premium Billing, Revenue Cycle Management Services, Self Funded Plans, Third Party Administrator, Third Party Administrators (TPAs) in America | Comments Off


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