eQHealth Solutions is an innovative population health management company that provides comprehensive technology and service solutions supporting utilization management and care management programs. eQHealth provides third-party administrators (TPAs) and self-insured employer groups with leading-edge population health management technology that can be coupled with utilization management and care management services. eQHealth’s population health management solutions are focused on the ability to proactively manage and optimize member health while significantly improving the financial well-being of the organization. TPAs and self-insured employer groups will benefit from eQHealth’s HITRUST and CMS-certified technology platform, eQSuite®, that promotes clinical integration between disparate stakeholders providing a comprehensive 360-degree view of member health, including social and economic factors. eQSuite® Population Health Management Technology proactively identifies high-risk, high-cost members and populations with its extensive predictive modeling and machine learning capabilities. The system helps guide members to the right care at the right time utilizing integrated evidence-based assessment tools and embedded clinical guidelines. eQSuite® Business Intelligence and Healthcare Analytics Technology delivers hands on access to properly interpreted information providing actionable information supporting advanced predictive modeling & risk stratification initiatives.
https://www.eqhs.com/ebixpartnership
Primary Sales Contact:
Carol Brown
cbrown@eqhs.com
The Phia Group, LLC is an experienced provider of healthcare cost containment techniques offering comprehensive subrogation and overpayment recovery, consulting services, plan document drafting, claim negotiation, balance billing defense, and plan defense, all designed to control costs and protect plan assets. Our mission is to reduce the cost of healthcare through innovative technologies, legal expertise, and focused, flexible customer service. By providing the industry with best practices and staying true to a forward thinking methodology, The Phia Group boasts an all-encompassing cost containment program for the ever-changing healthcare industry.
Primary Sales Contact:
Scott Byerley
sbyerley@phiagroup.com
For third-party administrators, WEX Health provides the depth and breadth of functionality and deployment options that no other solution can offer. With WEX Health Cloud, TPAs gain a proven web-based technology platform that administers consumer-driven healthcare accounts including HSAs, HRAs, FSAs, VEBAs, COBRA, defined contribution, wellness, and transit plans. Combined with our web portals, debit cards and mobile app, consumers have multiple ways to access and spend their funds. The WEX Health Cloud platform currently helps over 390,000 employers and 32 million consumers better manage healthcare expenses.
https://www.wexinc.com/solutions/health-cloud/
Primary Sales Contact:
Emily Tate
etate@wexhealthinc.com
"Employers and employees are looking for ways to save on healthcare costs. You need to quickly help CFOs save on healthcare costs leveraging actionable insights, and promote appropriate healthcare providers to members e.g., telemedicine to risky members of the population. Not an easy challenge to overcome.
Zakipoint Health (ZPH) helps TPAs to integrate their customers' healthcare data into one place to radically change the way you show cost saving opportunities, and promote these opportunities to the right members at the right time e.g., use mail order medication instead of retail Rx, or telemedicine service instead of ER, preferred provider with lower costs and higher quality, or close a gap in care. And do it with a simple mobile experience that connects the member and drives change.
With us, employers are identifying 15% worth of cost savings and getting 50% higher usage of programs and incentives by members. Be ready for the change. Learn more about how you can solve this challenge here. "
https://portals.sharekits.com/
Primary Sales Contact:
Dipali Dey
dipali.dey@zakipointhealth.com
"Zelis is the healthcare industry’s leading claims cost and payments optimization platform with superior technology and solutions to price, pay and explain claims, all at enterprise scale on a claim-by-claim basis. Zelis leverages proprietary technology, robust analytics, extensive payment and provider networks, and innovative claim savings channels to deliver administrative and medical cost savings. Zelis was founded on a belief that there is a “better way” to determine the cost of a healthcare claim within a pre-payment environment, manage payment related data, and make the claim payment. Zelis has over 1,000 associates who serve more than 700 payor clients, including TPAs, Health plans, and self-insured employers, and more than 1.5 million providers, delivering more than $5B of claims savings, $50B of provider payments and 500 million payment data communications annually. Partner with Zelis today to ensure appropriate reimbursement of care and maximized savings."
Primary Sales Contact:
William G. Schneider, Sr.
William.Schneider@zelis.com
Focus: Health Care Cost Containment, Electronic Payment
Zelis Healthcare is an information technology company which utilizes an end-to-end technology platform to fulfill the claims cost management and payments needs of healthcare payers including large and medium-sized health plans, TPAs, Taft-Hartley Plans, providers and individuals. The company provides a comprehensive portfolio of network management, claims integrity, payment remittance solutions and analytical services for medical, dental and workers’ compensation claims to over 500 payer clients. Additionally, the company delivers electronic payments and explanation of payments to over 270,000 healthcare providers and serves individuals with provider lookup and medical referral services. By providing access, analytics and validating claim accuracy at every step of the continuum through our leading edge technology and high-touch approach, we uncover incremental value that significantly adds to your bottom line.
Focus: Enrollment Commmunication, Claims Communication (EOBs), Provider payments
For years, all of us at RedCard have been working to improve the way health plans and TPAs connect with members and providers. We’ve explored how to make the mountain of data more meaningful. How to make every piece of communication more useful. And how to make payments move faster.
Website: www.redcard.com
Focus: Health Care Cost Containment
Verscend Payment Accuracy is the industry’s only real-time, pre-pay, integrated claim accuracy and fraud detection solution scalable for any size of payer. A convergence of technology, data, and analytics, our solutions incorporate a unique element: expert clinical review, a process that drives increased accuracy of claims payment.
Website: www.verscend.com
Focus: Health Claims Repricing
A&G's proprietary platform for real-time claims repricing, advanced claims editing, error detection and fraud, waste, abuse prevention. A&G/PlutoX is partnered with LuminX and can work with all various file formats through secure internet connections.
PlutoXPay gives you full transparency and oversight of the payment process. The PlutoXPay system puts you in control of Payment Reconciliation, Banking, Provider Communications, EFTs, checks, Virtual Card payments and interchange revenue. PlutoXpay also offers a patent-pending “virtual check” payment solution as well as an EFT Plus solution that solves your providers’ re-association issues.
Advanced Pharmacy Audit & Recovery Solutions
Website: www.aghealth123.com
Focus: Enrollment and Claims Communication, Payment Integrity, Electronic Payment
Change Healthcare is one of the largest independent healthcare technology companies in the United States, offering software and analytics, network solutions and technology-enabled services to help customers improve efficiency, reduce costs, increase cash flow, and more effectively manage complex workflows. Ebix has partnered with Change Healthcare to help customers achieve the following:
Website: www.changehealthcare.com
Focus: Health Claims Provider Clean Up, 1099 Processing
BASELoad & W9 Corrections is a provider data service vendor - laser focused on enhancing auto-adjudication rates by cleaning, validating, and fulfilling medical and dental provider information. During BASELoad’s near 20 years in the health industry, custom solutions have been created and perfected to achieve 99% provider matching accuracy with electronic claims. BASELoad’s main services include, but are not limited to, a full provider database clean-up, provider fulfillment data updates, EDI provider matching service (SureHit), as well as PPO provider and fee schedule updates. Over the years, BASELoad has performed countless claims systems conversions, repricing utilities, routing, web portal lookups and many client specific custom programs.
W9 Corrections, BASELoad’s daughter company, is the original inventor of the complete outsourcing solution for the 1099 process, established in 2010. Simply send W9 Corrections your IRS file, and W9 Corrections will manage the entire lengthy and tiresome process from start to finish, inclusive of W9 mailings, B Notices, 2nd B Notices. W9 Corrections will establish the legal name/Tax ID combination, by bouncing the file against W9 Corrections internal database comprises of millions of confirmed legal Tin/Name Combinations. While using W9 Corrections, clients success rate is 99%, with no client ever receiving a fine from the IRS.
Please visit www.baseload.com and www.w9corrections.com for more information.
Focus: Claims Subrogation, Legal Support
Description: The Phia Group, LLC is an experienced provider of health care cost containment techniques offering comprehensive consulting services, legal expertise, plan document drafting, subrogation and overpayment recovery, claim negotiation, and plan defense designed to control costs and protect plan assets.
Website: www.phiagroup.com
Focus: Health Care Data and Pricing
For almost 20 years Context 4 Healthcare has provided Ebix customers with industry leading coding and UCR fee data. Our cloud based Payment Integrity, FWA and real-time Medicare pricing expand Ebix customer value with leading edge innovation. Immediate, actionable and defensible results make sure your plan is always protected. Context 4 Healthcare, your innovation partner since 1988.
Focus: Health Care Data and Pricing
FAIR Health is a national, independent, nonprofit organization dedicated to bringing transparency to healthcare costs and health insurance information through comprehensive data products, consumer resources and health systems research support. FAIR Health uses its database of billions of privately billed medical and dental healthcare claims to power an award-winning free consumer website available in English and Spanish and to create data products serving all healthcare stakeholders, including government officials, insurers, researchers, consumers, employers, brokers, hospitals, medical facilities, doctors and third-party administrators (TPAs). For more information, visit www.fairhealth.org.
Focus: Claims Processing, BPO Services
With industry-leading technology, proprietary systems and processes, secure and centralized data management, and highly trained and experienced staff, Firstsource offers the solutions to make that most essential of functions—establishing end-to-end operations, optimizing existing processes, and providing our own assistance and expertise for claims processing that helps our clients thrive.
Website: www.firstsourcehealthcare.com
Focus: ACA form delivery and IRS Reporting
HCM File ACA Reporting helps employers generate ACA reporting for forms 1094 and 1095 through and easy-to-use Web-based software solution. TPA’s and advisors can generate ACA reporting within minutes using HCM File’s intuitive reporting engine. HCM file will generate outputs for employee 1095-B and C and employer 1094-B and C forms as well as electronic filing to the IRS by combining data from various sources. Click here to learn about our client experience.
Website: www.healthcostmanager.com
Focus: Health Care Cost Containment
INETICO writes the rules on achieving optimal health with a variety of healthcare cost containment solutions. A United Claims Solutions Company, and nationally recognized industry leader that is URAC accredited in Case Management, Disease Management & Health Utilization Management. Innovative solutions include referenced based repricing, subrogation and more that have documented millions of dollars in savings.
Website: www.inetico.com
Focus: Health Care Data
OptumInsight, Inc. develops software and information products and provides advisory consulting service and business process outsourcing to participants in the health care industry. The company serves hospitals, physicians, commercial health plans, government agencies, life sciences companies, and other organizations that comprise the health care system work to reduce costs, meet compliance mandates, improve clinical performance, and adapt to the changing health system landscape. OptumInsight, Inc. serves physicians, hospitals.
Website: www.optum.com
Focus: Spending Account Administration
About WEX Health
We simplify the business of healthcare through WEX Health Cloud, a cloud-based healthcare financial management platform that drives efficiency for benefit administration technology, consumer engagement, and advanced billing and payments. Our partner organizations enable us to deliver our industry-leading and award-winning solution to 225,000 employers and more than 24 million consumers. Together we take the complexity out of defined contribution, HSAs, HRAs, FSAs, VEBAs, PRAs, premium billing, public and private health insurance exchanges, COBRA, wellness plans, and transit plans. Learn more at www.wexhealthinc.com, and follow WEX Health at @WEXHealthInc.
About BASELoad
BASELoad helps healthcare payers radically reduce costs and improve process through services, tools, and programs in matching, correcting, and utilizing medical provider data. We help with EDI Adjudication, 1099 Filings, Market Data, and more. We are dedicated to service, data, and process improvement. Learn more at https://baseload.com.
Contact:- sales@baseload.com