Our user-friendly technology enables measurable outcomes for all our stakeholders.
We are a leading health and insurance technology company that leverages cutting-edge technology to deliver simplified and informed healthcare decisions to millions of lives connected by our technology, partnerships, and human touch. We constantly strive to make relevant and easy-to-use products and features for our members and our stakeholders like insurers, brokers, agents, and providers.
We foster a constant hustle within our teams to deliver high functioning, user-friendly products with novel features in the market. We invest in deep market research techniques and service delivery models to help our members and stakeholders throughout the process.
Our robust technology and industry expertise make us one of the leaders in the country’s health insurance and wellness sector.
Our Footprint
Member Benefits Platform
Our Member benefits platform, is a secure environment that allows members to review their coverage, download documents like benefit schedule and member guide, and gives them access to the provider finder and online claim submission process. The platform is private and secure.
- Member information is secure and only shared with people they specifically invite.
- Every case is mutually exclusive to one another.
- Available on browsers as well as on Apple App Store/Google Play.
- Available through integrations with key partner portals and apps.
Our outpatient benefits platform is a gateway to cashless, affordable, and accessible outpatient medical benefits. The outpatient platform is deeply integrated with the member benefits platform.
- Members can either use their personal email or work email to create an account.
- 2-way integration between outpatient and member benefits platforms. Members can either enable insurance/corporate wallet on the outpatient platform or use the member benefits platform to seamlessly access outpatient benefits.
- Members can share outpatient information with their family members.
- Outpatient is available for members and their extended family (spouse, child, parent, etc).
MAtrix platform accelerates payers' health insurance innovation journey. We offer an end-to-end core administration platform for small and large health plans to modernize their systems at scale and introduce new products quickly. The MAtrix Platform provides:
- Componentized and transparent applications for a better member experience
- It is a flexible and adaptable solution in the market today that helps payers ease maintenance of provider contracts, streamline the claims adjudication process, and provide exceptional service with centralized claims data.
MAtrix simplifies the claims processes for customers, employees, agents, and third parties with an innovative solution to address a common industry problem — improving claims service while reducing costs. Claims processing is one of the most crucial service activities health insurance companies perform. However, the complexity of managing a claims environment with multiple systems and manual hand-offs can create errors and delays that can cause irreparable harm.
- The platform helps organizations simplify the claims process for customers, employees, agents, and third parties.
- The platform provides an innovative solution to meet a common industry problem — improving claims service while reducing costs, ensure accurate and consistent claims decisions, improve service levels, and reduce backlogs.
- MAtrix is designed to provide claims management and processing support for various claims types in a single system.
MAestro
Like any modern competitive market, leveraging data analytics tools to make smarter decisions has become necessary for growth. And healthcare payers collect vast amounts of claims data from patients and providers. That data has tremendous potential to guide everything from health plans to marketing strategies.
New laws and regulations are transitioning providers to value-based care models. This change in care management shifts financial risk away from payers and towards providers. To do this, payers must extend their data analytics beyond simple internal reporting.
MAestro Drives Growth
- Identifies factors and trends that drive losses.
- Analyze historical and current claims data to ensure that providers are charging for the proper treatments.
- Improve investment by using payer data-backed evidence to demonstrate and defend the success of a program or strategy
MAestro Mitigates Risk
- Use advanced analytics to identify future high-cost patients by analyzing individual spending history, age, gender, and other predictors.
- Combat fraud by identifying patterns and trends in claims data to flag behaviors that potentially lead to fraud.
- Identify, track, and visualize key business metrics.
Medvantage is a technology platform that enables the prediction of costs and insurance coverage in a variety of healthcare situations. Medvantage is capable of delivering these predictions using the health insurance policy data of any insurer and any health insurance product across a wide range of hospitals.
Instant Cashless Discharge (ICD): Using this product, a patient can be discharged from the hospital without requiring an explicit claim approval. ICD does so by predicting the claim approval amount with a very high accuracy, thus eliminating the need to hold the patient waiting till claim processing gets completed.
Admission counseling: Counseling or guidance would be used by the hospitals to leverage the predictive capabilities of Medvantage platform to more accurately estimate the treatment costs for their patients and get ready prompts with recommendation for the appropriate treatment package. This will optimize out-of-pocket for the patients and reduce surprises of hospital bills by containing the out-of-pocket for patients.