Advancements in Vision Administration, Provider Data Management and Member Self Service Lead SKYGEN USA Enterprise System Enhancements

MENOMONEE FALLS, Wis., April 15, 2019 /PRNewswire/ -- In keeping with its dedication to delivering the leading benefits administration platform for vision and dental payers, as well as providing outstanding member and provider experiences, SKYGEN USA today announced new enhancements to its Enterprise System solution. The new capabilities include extended functionality for vision lab choice, support of multiple languages in member self service functionality, and intelligent provider data management to prevent duplicate provider records.

Provider vision program management
One of the early innovations SKYGEN USA brought to vision providers was the ability to send and manage orders directly through the Enterprise System platform rather than having to use a separate application. The company has now improved on that technology by enabling vision providers to choose where to send orders for materials, such as glasses and contact lenses.

Using the system's provider portal, vision providers now have the ability to select the lab of their choice based on factors such as quality, availability of materials, order turnaround times, cost and other parameters. This greater flexibility ensures providers are able to meet member needs while saving time during the ordering process.

"We have enhanced the Enterprise System eyewear materials ordering workflow to streamline the process and improve the provider experience," said Darrin Haehle, chief technology officer at SKYGEN USA. "By enabling providers to easily select the lab of their choice, they can increase their own efficiencies as well as provide more value to members."

SKYGEN USA has also enhanced providers' ability to check Medicaid member eligibility for eye examinations as well as materials such as eyeglasses. Providers can perform real time checks to instantly determine whether the visit and materials will be covered by Medicaid, and make an appropriate recommendation. Additionally, if exam or material benefits are not currently available, the Enterprise System will show the next date they are available.

Medicaid vision providers can also review data on members to determine which ones are overdue for services. They can proactively contact patients to encourage them to take advantage of their services, increasing patient flow (and revenue) while ensuring member needs are met.

Improving member experience with expanded member self-service capabilities

Self-service capabilities continue to grow in importance as a means for payers and members to communicate effectively. Yet in an increasingly diverse country, language barriers often pose a significant obstacle which can have a profound effect on ensuring members receive timely, appropriate, and efficient care. While this is true in any care setting, it is especially of concern among Medicaid dental and vision payers and managed care organizations (MCOs).

SKYGEN USA has addressed this issue by giving payers advanced capabilities for multiple language web portals. The Enterprise System now supports as many languages as payers require based on their market. Payers can load their translations into the portal template and members will be able to access all of the portal's features in the language they prefer, giving them the information they require while creating a better overall user experience.

Additionally, as part of SKYGEN USA's unwavering commitment to ensuring privacy and security for users, provider and patient portals require multi-factor authentication to confirm the user's identity.

Improved provider data accuracy with intelligent provider data management processing

Maintaining clean, accurate provider records is a major challenge for the healthcare industry. Duplicate records and other inaccurate data result in wasted time and resources for payers, as well as poor member and provider experiences. With a proprietary data model and intelligent provider data processing, SKYGEN USA has enhanced the Enterprise System's capacity to manage provider data and significantly reduce the issue of duplicate records.  

The Enterprise System's data model includes features that allow alternate variations of provider demographic information with a single provider record. With the data model creating the association between the core record and the variations, the Enterprise System's intelligent processing automatically matches these records during payer transaction requests instead of creating a "provider not found" scenario. The overall result is more accurate provider data, streamlined processes, and reduced manual work for payers and providers.

"One of our core beliefs is that dental and vision benefit administration should utilize technology that's built for dental and vision," said Craig Kasten, CEO and managing partner of SKYGEN USA. "We are constantly looking for ways to elevate dental and vision programs with innovative technology-enabled solutions that make life easier for payers, providers, and members. We do this by using the Enterprise System ourselves for day-to-day benefit management, and by listening to our clients. We are focused on powering connectivity in dental and vision, with technology that streamlines the flow of information between payers, providers, and members, and that helps drive better health while reducing costs."

About SKYGEN USA
SKYGEN USA powers healthcare transformation forward with innovative, next-generation technology-enabled solutions and data analytics that inspire stakeholders to challenge the status quo and create better alignment to drive efficiency, reduce costs, and elevate experiences for all throughout the digital age. It helps payers of all sizes and across all lines of business become the most efficient health plans in the country through a portfolio that includes Benefits Administration, Enterprise Technology, On-Demand Solutions, and Professional Services. SKYGEN USA powers the nation's largest healthcare insurers with clients operating in over 100 markets, serving 35 million member lives on its technology platform, and 10 million member lives through its outsourcing solutions. For more information, please visit www.skygenusa.com. 

SOURCE SKYGEN USA