TPAs

Services for Govt. Sponsored Health Plans (GSHP) & Self-funded Health Plans (SFHP)

Services for Govt. Sponsored Health Plans (GSHP) & Self-funded Health Plans (SFHP)   A. PAS – Platform & Administrative Services Enrollment Services Eligibility Services Credentialing Services Premium Billing & Collection Services Claims Administration Services – Facility & Professional Medical Vision Dental Workers Comp Grievance & Appeals Encounter Data Submissions B. CMS – Care & Medical Management [...]

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Posted in BPO, Call Center Services, Claims, Claims Administration, HealthCare, Self Funded Plans, Third Party Administrator, Third Party Administrators (TPAs) in America | Comments Off

Health Plans, Self-funded Plans, RBMs, IPAs, MSOs and TPAs in America

Health Plans, Self-funded Plans, IPAs, MSOs and TPAs  in America  1199 NATIONAL BENEFIT FUND 3P ADMIN 8TH DISTRICT ELECTRIC A & I BENEFIT PLAN ADMINISTRATORS A.G.I.A INC. AAA CHICAGO AAG-AMERICAN ADMINISTRAVIE GROUP AARP – UHC OVATIONS INSURANCE SOLUTIONS ABC HEALTH PLAN ABRAZA ADVANTAGE HEALTH PLAN ACCESS MEDICARE ACCLAIM ACCLAIM REPRICING ACCOUNTABLE HEALTH PLAN – WISCONSIN ONLY [...]

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Posted in ACOs, BPO, Call Center Services, Claims, Claims Administration, Clinical Services, Document Management, Employee Benefits, Enrollment, Enrollment Services, Enrollment Services RFP, Finance and Accounting, Health Actuarial, Health Analytics, Health CO-OPs, Health Exchange, HealthCare, Healthcare Analytics & Business Intelligence, HealthCare Analytics and HealthCare Business Intelligence Companies in America, HealthTechnolgy.com, Medical Services, Medicare, PDP, Plexis, Portal, PPO Network, Premium Billing, Reports, Revenue Cycle Management Services, Self Funded Plans, Services by HealthTechnology.com, Third Party Administrator, Third Party Administrators (TPAs) in America | Comments Off

Plexis HealthCare Systems

Plexis HealthCare Systems Plexis Claim Systems provide Core Administrative Software for Healthcare (Payer) Market. The salient features include: Claims Processing Customer Service EDI Benefits Management Care Management Capitation Management Document Management Provider and Provider Network Management Workflow and Process Management Plexis covers the following in the Health Plan Market: Commercial IPAs MSO Managed Care Medicaid [...]

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Posted in Claims, Claims Administration, HealthCare, Plexis | Comments Off

More on Logical Claim Solutions (LCS)

Q: What is the average implementation length? A: 1 to 4.5 months from contract defined start date  Q: Who are its common customer types? A: LCS shines with the self-funded employer group opportunities TPAs, and carve-out TPAs (such as dental TPAs) for small to medium populations that do not require any extensive benefit configuration. Indian [...]

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Posted in Claims, Claims Administration | Comments Off

Third Party Admin (TPA) & Health Services (ASO) by Health Technology

Third Party Admin (TPA) & Health Services (ASO) by Health Technology TPA Management (TM) Claims Administration Customer Service Self-Funded Dental Admin Self-Funded Medical Admin Self-Funded Vision Admin Medical Management (MM) Dependent Eligibility Audits Disease Management Health Analytics Medical Cost Containment Prior Authorization (PA) Utilization Review (UR) Wellness Strategies Health Accounts Management (HAM) Flexible Spending Accounts [...]

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Posted in Medicare | Comments Off


425 Washington Blvd., Jersey City,
New Jersey 07302, USA

Phone: +1 201.258.4704 / 201.258.4704
Fax: +1 201.604.3480