Solutions|Medicaid|Medicaid Management Solutions


Medicaid Management Solutions

Medicaid Management Solutions

Accelerate claims processing and increase accuracy while controlling costs

Our Medicaid Management Solutions are built on an intelligent, automated cloud platform that supports the entire claims payment life cycle. It can be purchased as individual modules or as part of a complete solution to orchestrate Medicaid business function workflows and manage tasks.

These powerful, collaborative and standardized services help you accurately measure and improve your Medicaid programs.

Care Management Service
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Provide effective care management for Medicaid to lower costs while improving outcomes for some of the most high-risk populations.
Claims, Encounters and Financials Service
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Adjust, adapt and accelerate the implementation of critical initiatives and policy changes with three critical modules - Claims, Encounters and Financials.
Drug Rebate Service
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Enable you to electronically send invoices to manufacturers and provides quick access to rebate information, as well as supports managing invoice disputes.
inSight Analytics
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Use automated reports and dashboards to provide valuable metrics about the delivery of healthcare services to Medicaid member populations, financials and more.
Managed Care Service
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Support electronic data exchange with managed care organizations and provide the capability to track their networks.
Pharmacy Service
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Accelerate pharmacy administrative and financial functions by automating and standardizing key processes and making it possible to configure policy changes in real time.
Program Integrity Service
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Employ analytics and peer comparisons across and within programs to identify fraud, waste and abuse issues.
Provider Service
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Streamline provider enrollments, screen new and existing providers, manage provider information for regulatory compliance monitoring and enable self-service for providers.
Third-Party Liability Service
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Track and manage healthcare coverage to avoid paying claims when other coverage is available and enable tracking of recovery cases.

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