Simplify Healthcare

Vendor Overview

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™

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™

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™

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™

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™
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
Suite 110
Aurora, IL 60504
844-720-6678
https://www.simplifyhealthcare.com/

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