Simplify Healthcare
Member Level: GoldVendor Overview
Description of Services: Simplify Healthcare is focused on powering connected benefits and provider journeys on a foundation of clean and rich product, benefits, and provider data across the Payer ecosystem. Our end-to-end platform, Simplify Health Cloud™ — powers this connected journey for health plans. Simplify Health Cloud™ is a scalable, enterprise-grade, secure, configurable, and compliant platform aimed at maximizing existing investments in Core-Admin systems. 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 product, benefits, and provider data.
Benefits1™ — the single source of truth for product and benefits data that enables –a catalog for product and benefits data in a central repository, fulfilling all compliance and mandated document generation; and integration with selling, underwriting, and downstream systems.
Provider1™ — the master record for all provider data that enables –a flexible hierarchy for storing all critical data regarding providers and their relationships, critical provider management processes like onboarding, credentialing, contracting, reimbursement models, roster file management, and provider directories.
Service1™ — delivers an intelligent benefits inquiry experience that enables – a “single pane of glass” for customer service representatives to handle and resolve all benefits inquiries; combines NLP – Natural Language Processing and AI to deliver the most optimum responses to benefit inquiries to members, providers, employers, and brokers.
Claims1™ — delivers a foundation to integrate benefits data from product development and quote to claims and integrates provider data and fees/rates into the claims - that eliminates manual keying of benefits and provider configuration in the claims system leading to – claims accuracy, reduced claims recoveries and faster time to market.
Experience1™— delivers a dynamic data driven digital experience that enables – a rules-driven solution to send and display benefits and provider content to a Payer’s digital front door; personalized offerings of benefits and provider content to members based on rules and customer metadata.
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
Alliance members, log in to view this company's complete profile.
600 N Commons Drive
Suite 110
Aurora, IL 60504
844-720-6678
https://www.simplifyhealthcare.com/
Documents
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.
Recording: Automate Provider Lifecycle Management
Simplify Healthcare presents a solution that can address your No Surprises Act (NSA) needs by providing a master provider record and contract repository that can keep downstream systems updated.
Presentation: Automate Provider Lifecycle Management
Join this webinar as you will see a solution that can address your No Surprises Act (NSA) needs by providing a master provider record and contract repository that can keep downstream systems updated.
Presentation: Optimize Your Member Engagement
Hear how Clarity can help you create a strategic member engagement calendar to get the most value from the communications you send to members throughout the year.
Recording: The Future of Medicare Plan Management
During this video presentation attendees will discover the challenges and opportunities in the Medicare Advantage market for Payers in 2022 and beyond. Learn how Payers can leverage cutting-edge automation technology to grow their market share.