STONY BROOK, N.Y., May 20, 2014 /PRNewswire/ -- Softheon, Inc., a proven leader in health insurance marketplace integration and business operations, has announced its recognition as of the leading Cloud Platform for Public & Private Exchanges – a prestigious distinction asserted by iMERGE Consulting, an independent research and consulting firm assisting States and Health Insurers with ACA challenges.
For ACA implementation and integration, Softheon MC2 received top rankings for integrated business process modeling and design for ACA compliant Qualifying Health Plans, Eligibility and Enrollment, Premium Billing and Payment processing, and Member Portal functional areas; runtime process management, analytics, and BPM-specific cloud deployment. For execution, it received top rankings for maturity, interoperability, and innovation. – For more information download the "10 Vital Questions to Ask When Negotiating for a Health Insurance Marketplace Solution from Technology Integration & Implementation Vendors, whitepaper released by iMERGE today.
iMERGE research stresses that the market littered with failed systems owed to poor architectures and lack of understanding of the exchange business operational issues, Health Insurers are becoming more inquisitive; asking Integration and Implementation vendors additional questions prior negotiating IT investments, such as those relating to Eligibility and Enrollment Plan Management, Premium Billing and Account Management. To evade common issues related to ACA Marketplace Platforms, Health Insurers must seek innovative Software as a Service solutions that fully understands the ACA environment and regulations.
According to Jim Minihan, iMERGE Analyst, "It [self-service Exchange Portals] must be a complete solution for Launching, Connecting and Operating within all Insurance Marketplaces – Consumers, Brokers, Exchanges, and Navigators. The system should offer Eligibility and Enrollment Plan Management, Premium Billing and Account Management- Softheon MC2 offers all these capabilities."
"We are grateful for the objective perspective iMERGE analysts have taken in their research, guiding Health Insurers on how to succeed in public and private exchanges" said Eugene Sayan, Softheon Founder and CEO. "It takes innovative thinking and leadership for an organization to transform in order to best serve within the consumer driven marketplaces. Our commitment to our health plans means we are a stakeholder in their success - it is an honor and privilege to be working with so many innovators as their trusted marketplace partner."
As of May 12, 2014, Health Insurers enrolled and effectuated of over 400,000 lives, through ACA Federal and State Based Marketplaces using the Softheon MC2 platform. Softheon MC2 is fully integrated with Federal and State Based Marketplaces, including California, Washington, Massachusetts, New York, and others. For both Public and Private Exchanges, the Softheon MC2 platform offers Plan Management, Eligibility & Enrollment including Direct Enrollment, SHOP, Premium Billing, Customer Service, and Edge Server solutions in cloud. This innovative integration platform provides Insurers the ability to have marketplace infrastructure and processes up and running in less than 90 days, with minimal risk and full PPACA regulatory compliance.
Softheon MC2 presently empowers over 40 regional health plans, with the ability to leverage their existing IT investments and core administrative systems, including TriZetto QNXT, DST Amisys, HealthEdge, ikaSystems and EPIC, to provide health insurance marketplace integration for private, state-based, and federally-facilitated marketplace exchanges. Softheon is uniquely qualified as the technology platform used by the nation's first full-service state health benefit exchange, since 2008. During the initial testing and implementation of marketplaces, Softheon participated in pilot federal and state programs, including the CMS Direct Enrollment connectivity and carrier wave testing, successfully effectuating marketplace members with multiple carrier core systems.
About iMERGE Consulting
iMERGE is a leading independent analyst firm providing management and technology consulting services to help clients save money and improve productivity. Its focus includes training, records management, electronic content management, business process improvement, document and data capture, collaboration and compliance advisory services. iMERGE helps clients improve project ROI, clearly define requirements and business case, evaluate software and deploy systems faster with offices throughout across North America.
Empowering the nation's first state health benefit exchange since 2008, Softheon's vision and strategic direction addresses healthcare payer, provider, and government agencies' goal of meeting Affordable Care Act (ACA) milestones. Softheon provides solutions for interacting with Federal and State Health Insurance Exchange (HIX) Marketplaces, while measurably reducing administrative costs, improving member and provider satisfaction, as well as addressing regulatory compliance challenges in all managed care administrative processes.
Softheon's Marketplace Connector Cloud (MC2) has been trusted by over 40 health plans as an accelerated federal, state, and private exchange integration platform. Softheon MC2 is a Software-as-a-Service (SaaS) solution where insurers pay a one-time activation and ongoing PMPM fees for exchange members only, while eliminating most, if not all, risks associated with ACA compliance of 2014 enrollment and other mandates.
To find out more about the Softheon, visit www.softheon.com.