LISLE, Ill.--(EON: Enhanced Online News)--The Affordable Care Act (ACA), the most momentous change to the U.S. health care system since Medicare in 1965, becomes a tangible reality today with the start of open enrollment in ACA-mandated Health Insurance Marketplaces and Consumer Operated and Oriented Plans (CO-OPs). Healthation, a leading provider of cloud-based and on-premise core administrative systems for healthcare payers and administrators at the forefront of this change, announced today that many of these new marketplaces and CO-OPs utilize its core administrative and financial management system.
“These new health insurance marketplaces and CO-OPs rely on Healthation technology due to both our deep understanding of ACA requirements and our ability to enable direct-to-consumer servicing for health insurance plans”
Specifically, Healthation’s full core administrative system is being used by Health CO-OPs in Maine, Kentucky, Louisiana, Wisconsin, New Mexico, and Connecticut, and its sophisticated financial management components have been implemented by State-based Health Insurance Marketplaces (Exchanges) in Colorado, Kentucky, and Hawaii.
“These new health insurance marketplaces and CO-OPs rely on Healthation technology due to both our deep understanding of ACA requirements and our ability to enable direct-to-consumer servicing for health insurance plans,” said Healthation President and CEO Darin LeGrange. “In addition, Healthation’s ACA successes demonstrate that we can deliver our complete core system or any of its components in a timely and cost-effective manner for all kinds of payers and administrators, regardless of size or complexity.”
In addition to core financial management services such as invoice generation and aggregation, premium collection, processing, and disbursement, Healthation’s ACA-compliant system functionality includes:
- Fully automated 834 Enrollment Processing and effectuation
- Payment Processing via 820 and eLockbox including insufficient funds (NSF)
- Cost-Share Reduction Subsidy Processing
- Marketplace Carrier Invoice Processing
- Advance Payment of Tax Credit (APTC) Grace-Period Processing
- Per-Member Rating
- CAQH CORE Compliance
Healthation’s core system helps public marketplaces and CO-OPs achieve their charters as resources that enable individuals, families and small businesses to gain access to high-quality health insurance by reducing administrative cost and complexity while helping to increase constituent service and satisfaction levels.
About Healthation, Inc.
Healthation is a comprehensive, rules-based, and user-configurable core administrative system that offers a single, Web-based platform for all healthcare lines of business, including medical, dental, vision and pharmacy. Today, Healthation supports 29 customers representing nearly 25 million members. The company's offerings are available via a SaaS subscription model in either an ASP or client-hosted environment. For more information, please visit www.healthation.com or follow the company on Twitter @ twitter.com/healthation and LinkedIn @ linkd.in/Healthation.