Simplify Healthcare

Member Level: Silver

Vendor Overview

Description of Services: Simplify Healthcare powers connected benefits and provider journeys for Payers through a scalable, enterprise-grade, secure, compliant, and configurable cloud based software platform — Simplify Health Cloud™. Packaged on the Simplify Health Cloud™ — Benefits1™, Provider1™, Service1™, Claims1™, and Experience1™ provide Payers with discrete and precise solutions to complex problems and opportunities in delivering a rich set of products, benefits, and provider data. Simplify Healthcare also enables Payers to build enterprise solutions with speed and innovation on a configurable, secure, and low-code application development platform — Simplify App Fabric™.
Benefits1™ — Creates a single source of truth for product and benefits data with automated business rules and workflows to fulfill all compliance and mandated document generation requirements.
Provider1™ — Creates the master record for all provider data with automated rules and workflows to simplify provider management processes like contracting, onboarding, credentialing, reimbursement models, roster file management, and provider directories.
Service1™ — Enables customer service representatives to handle and resolve all benefits inquiries with an AI- and NLP-powered search engine to provide accurate responses to benefit inquiries from members, providers, employers, and brokers.
Claims1™ — Business rules and workflow-driven claims management platform that transforms benefits and provider data into a consumable format for the Core-Admin systems while enabling claims adjudication and configuration testing.
Experience1™— Rules-based master content management platform that pulls up-to-date benefits data from repositories to enable the generation, streaming, and personalization of content to members based on rules and customer metadata.

Simplify App Fabric™ — Configurable, low-code application platform that enables rapid, secure application development and zero-friction deployment within a Payer’s technology ecosystem.

Simplify Healthcare ranks No. 159 among 300 honorees on the list of FORTUNE America’s Most Innovative Companies, No. 96 on the 2023 Financial Times List of The Americas’ Fastest-Growing Companies, No. 132 on the 2023 Inc.5000 Regionals list of America’s fastest-growing private companies in the Midwest region, No. 199 on the 2022 Deloitte Technology Fast 500 list, No. 842 on the Inc. 5000 42nd Annual List of the Fastest-Growing Private Companies in America, No. 15 on the Crain’s 2022 Fast 50 list of the fastest-growing companies in Chicago, No. 135 on the 2022 Financial Times List of The Americas’ Fastest-Growing Companies, and has 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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Documents
6/18/2024

Simplify Healthcareâ??s Benefits1â?¢.Medicare Sustains Leadership with over 30% Nationwide Market Share in PBP Bid Management
Building on our success, we've maintained over 30% market share in PBP bid management for two years, reinforcing our pledge to enhance value for Medicare Advantage plans.

2/28/2024

Press Release: Simplify Healthcare and Forge partnership
Simplify Healthcare has partnered with Forge to integrate their expertise in benefit plan management and document generation with Forge's dynamic digital document factory, offering Healthcare Payers an Integrated Document Generation Experience that guarantees on-time creation, translation, and distribution of high-quality and compliant documents, with multiple quality checks and stress-free printing and fulfillment processes.

12/5/2023

Presentation: Provider Lifecycle Management — Contracts and Data — to Ensure Accurate Reimbursements and Directories
Discover how Payers can leverage cutting-edge technology to automate end-to-end provider lifecycle management and ensure accurate reimbursements.

12/5/2023

Recording: Provider Lifecycle Management — Contracts and Data — to Ensure Accurate Reimbursements and Directories
Discover how Payers can leverage cutting-edge technology to automate end-to-end provider lifecycle management and ensure accurate reimbursements.

11/8/2023

Presentation: Ushering into the new era with CMS PBP Modernization
Navigate the changing landscape of the Medicare Advantage marketplace and build a connected benefits journey for your stakeholders.

11/8/2023

Recording: Ushering into the new era with CMS PBP Modernization
Navigate the changing landscape of the Medicare Advantage marketplace and build a connected benefits journey for your stakeholders.

10/5/2023

Presentation: Improving the member experience: Delivering human understandable benefits explanations
Discover how Payers can improve the member experience by delivering an intelligent and outcomes-driven omnichannel benefits inquiry experience, powered by Connected Benefits Journey.

10/5/2023

Recording: Improving the member experience: Delivering Human Understandable benefits explanations
Discover how Payers can improve the member experience by delivering an intelligent and outcomes-driven omnichannel benefits inquiry experience, powered by Connected Benefits Journey.

9/8/2023

Recording: Drive technology investment ROI through connected benefits and provider journeys
Simplify Healthcare presents how they drive technology investment ROI through connected benefits and provider journeys at the September 5th Alliance Vendor Spotlight.

9/5/2023

Presentation: Drive technology investment ROI through connected benefits and provider journeys
Simplify Healthcare presents how they drive technology investment ROI through connected benefits and provider journeys at the September 5th Alliance Vendor Spotlight.