Simplify HealthcareMember Level: Silver
Description of Services: Simplify Healthcare is redefining how Payers, TPAs, and ASOs address the toughest operational challenges faced in today’s competitive marketplace to help them improve stakeholder experience and boost membership retention and growth. Simplify HealthCare's scalable end-to-end cloud-based platforms — Benefits1™, Service1™, Experience1™, Claims1™, and Provider1™ — are enabling Payers to Simplify Product, Benefits, and Provider Lifecycle Management.
Benefits1™ streamlines day-to-day business operations, automate filings, and streamline processes across actuarial, sales, customer service, core-admin (claims), and the digital front door (portals, chatbots, mobile apps) to drive stakeholder delight, membership retention and growth, and operational excellence.
Service1™ is designed for Payers to deliver human-understandable benefit explanations in a unified view that provides accurate, complete, and real-time answers to members, providers, employer groups, and brokers/agents’ benefit inquiries via call centers and digital engagement channels — portals, mobile apps, and chatbots.
Experience1™ is a highly configurable Master Content Management Platform that pulls benefits data from repositories to enable real-time data streaming to multiple portals and channels while ensuring data accuracy, consistency, and compliance.
Claims1™ enables code set level configuration of benefits to support claims adjudication, reusable claims adjudication testing, faster review of the automated claims configuration, compare reports for quick validation, and automated configuration via reusability, consistent business rules, and proliferated granular data to eliminate the need to learn the claims system data model and instead focus on innovative benefit design and provider relationships.
Provider1™ Platform automates provider data and contract lifecycle management for Payers. It streamlines provider data and contracting processes, ensures accurate data is loaded into downstream systems, and improves provider relations with transparency and self-service via our portal/widget. Our rapid data migration approach removes one of the biggest obstacles to embracing a new system, namely, that some organizations struggled for years to migrate provider data. By improving Provider lifecycle processes and extending into your Providers’ environments through our digital front door, Payer’s teams can ensure compliance with the No Surprises Act while giving your Providers a much better experience.
Simplify Healthcare is currently ranked No. 132 on the 2023 Inc.5000 Regionals list of the fastest-growing private companies in the Midwest region, ranked No. 199 on the 2022 Deloitte Technology Fast 500 list, ranked No. 842 on the Inc. 5000 42nd Annual List of the Fastest-Growing Private Companies in America, ranked No. 15 on the Crain’s 2022 Fast 50 list of the fastest-growing companies in Chicago, ranked No. 135 on the 2022 Financial Times List of The Americas’ Fastest-Growing Companies, and won the Big Innovation Award in 2022 and 2023 for its member and provider benefits inquiry platform (Service1™).
For more information, please visit simplifyhealthcare.com
Primary Service: Automation, Workflow and IT Services
Secondary Service: Automation, Workflow and IT Services
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600 N Commons Drive
Aurora, IL 60504
Recording: Automate Benefits Management for ACA QHPs
Simplify Healthcare will explore during this video presentation how Individual and Small Group Health Plans can automate benefits management for ACA QHPs, achieve 100% compliance with plan materials, and simplify State filings for 2024 by leveraging the Benefits1TM Digital Payer Platform.
Presentation: Automate Benefits Management for ACA QHPs
Simplify Healthcare will explore in this webinar presentation how Individual and Small Group Health Plans can automate benefits management for ACA QHPs, achieve 100% compliance with plan materials, and simplify State filings for 2024 by leveraging the Benefits1TM Digital Payer Platform
Presentation: Accelerate speed to market for MA plans
Simplify Healthcare will help you discover in this presentation how Payers can leverage the Benefits1TM Digital Payer Platform to improve speed to market for their MA plans and streamline day-to-day business operations to drive stakeholder delight, membership retention and growth, and operational excellence.
Recording: Accelerate speed to market for MA plans
Simplify Healthcare will help you discover in the video presentation how Payers can leverage the Benefits1TM Digital Payer Platform to improve speed to market for their MA plans and streamline day-to-day business operations to drive stakeholder delight, membership retention and growth, and operational excellence.
Presentation: Future of Benefits Plan Management
Simplify Healthcare will help you to discover how the Benefits Digital Payer Platform enables innovative product strategies that can have a measurable impact on new business and renewal revenue; AND provides an end-to-end operational foundation to catalog, configure, manage, integrate, record products, plans and benefits, and generate documents to materially reduce administrative costs.
The Provider Directory & Data Problem
eProviderSync is a rules-based, configurable SaaS solution that solves Payers' provider data management accuracy problems through confirmation, management, and syncing of provider information across applications. It is an end-to-end provider data management solution that enables Payers to solve specific pain points at the application level.
The Future of Medicare Plan Management
The momentum behind Medicare Advantage is only growing as more baby boomers age into eligibility, and experts don't expect the energy around the program to slow down any time soon. Going into 2022 and beyond, the strategic positioning of Medicare Health Plans will increasingly depend upon competitive plan benefit design, targeted geographic and population enrollment expansions, and strong plan performance credibility.
Recording: Reduce Call Handle Times for Benefit Inquiries
In this video recording presentation, discover how you can reduce call handle times, improve FCRs, and accurately answer benefit inquiries to improve Star ratings using eServiceSync, a unique AI and NLP-based automation solution.
Simplify Commercial Benefit Plan Management
eBenefitSyncTM is a SaaS-based turnkey modular Large Group benefit plan management solution for Healthcare Payers and Third Party Administrators (TPAs), and Administrative Service Organizations (ASOs). It eliminates errors and inefficiencies in Excel grids-driven traditional benefit plan management by creating a single source of truth for all benefit data, auto-generating documents, and streamlining processes right from quotes to claims processing.
Presentation: Reduce Call Handle Times for Benefit Inquiries
Simplify Healthcare presents how you can reduce call handle times, improve FCRs, and accurately answer benefit inquiries to improve Star ratings using eServiceSync, a unique AI and NLP-based automation solution.