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HEALTHsuite Mercato

Name: HEALTHsuite Mercato
Rating: 4.5 (2 reviews)

By RAM Technologies

778 Interested

Highlights : About HEALTHsuite Mercato

CMS letters, ID cards and fulfillment packages

Enrollment of Medicaid members

UM & med. management

About HEALTHsuite Mercato

HEALTHsuite Mercato is a health payers administrative platform that was designed to simplify Medicare and Medicaid healthcare administration. The software is fully integrated, highly flexible and provides a rules-based, plan-configurable automation system for every business need. HEALTHsuite Mercato’s user-friendly interface improves the logical flow between user and system, and its design is based on HIPAA standards. HEALTHsuite Mercato allows users to streamline every aspect of Medicaid administration, including member enrollment, recipient categories, PCP auto assignment, individual beneficiaries, and individual Medicaid cases. When it comes to Medicare administration, users are able to focus less on administration and compliance and focus more on member care. HEALTHsuite Mercato offers CMS application, data verification, revenue reconciliation, various fee schedule files and more. HEALTHsuite Mercato also allows users to streamline the Medicaid financial alignment initiative (FAI) program. The solution makes dual eligible beneficiaries enrollment possible with the integrated care system. HEALTHsuite Mercato also supports diverse open provider networks, administers long term services, and coordinates medical and non-medical service.

Specifications

24/7 Support

Yes

Business Size

Mid-Market

Deployments

Cloud

Language Support

English

Platforms

Product Details

Features

Member management

Group administration

Eligibility / enrollment

Benefit administration

Provider reimbursement

UM & med. management

Claims adjudication

Encounter processing

Overpayment recovery

Customer service

Medicaid administration

Enrollment of Medicaid members

PCP auto assignment

Supports individual beneficiaries

CMS application / interface processing

CMS letters, ID cards and fulfillment packages

Multi-cultural / Multi language

Rules based processing

Benefits

HEALTHsuite Mercato's automated workflow feature helps to maximize employee productivity with flexible rules-based processing.

The software provides full electronic data interchange (EDI) capabilities, and integration with trading partners and employers.

With HEALTHsuite Mercato, users are able to manage care teams, as well as coordinate medical and non-medical services.

The solution helps users to effectively streamline benefits administration for Medicare and Medicaid dual eligible recipients.

HEALTHsuite Mercato offers cost containment tools and the integration of prospective payment systems.

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