ikaSystems, a premier provider of enterprise-level Web-based technologies for healthcare payer organizations, has released a new offering for the Medicare market. Available through a unique partnership with Government Works, a contractor with the Centers for Medicare & Medicaid Services (CMS), ikaMedicareGateway allows payers to significantly expedite and increase the accuracy of Medicare application processing, eligibility verification, and enrollment, membership and payment reconciliation through online functionality and real-time access to information from CMS’ MARx database. With this offering, ikaSystems now offers the industry’s most comprehensive solution for Medicare process automation and intelligence management.
“Whether they are looking to offer new Medicare benefit plans, rapidly expand existing plans or reduce administrative costs for large plans, payers have not had a comprehensive, sophisticated technology to replace and improve upon time-consuming and error-prone manual processes,” said Ravi Ika, president of ikaSystems. “With ikaMedicareGateway, as with all of our Medicare offerings, we have minimized the burden of compliance — particularly important during high-volume enrollment periods — through process automation, allowing payers to capitalize on explosive growth in the Medicare market while lowering administrative costs.”
At UPMC Health Plan of Pittsburgh, ikaMedicare Gateway combined with ikaPortals allowed the organization to expand its Medicare membership from 33,000 to 80,000 in 18 months without adding staff. The organization also achieved a four-fold increase in enrollment efficiency while improving accuracy. According to CIO Ed McCallister, “We could not have met our aggressive growth goals for our Medicare business without the business solution provided by ikaSystems.”
A hosted (ASP) solution, ikaMedicareGateway automates Medicare application processing, eligibility verification, and enrollment, membership and payment reconciliation. The process begins with an online application portal, which members, brokers or administrative staff can use to start the enrollment cycle. Through ikaMedicareGateway, instant eligibility queries and beneficiary look-ups are performed against the MARx database. Responses are immediate, both ensuring the accuracy of the information supplied and pulling data from the database to populate the rest of the application, saving time for administrative staff.
The quality of these initial processes creates error-free membership accretion files, significantly reducing rework and increasing cash flow by ensuring timely payment. In addition, ikaMedicareGateway users have seen enrollment, membership and payment reconciliation times reduced by an estimated 70 percent due to greater automation and accuracy, speeding the discovery of discrepancies and missing dollars. Finally, comprehensive data warehousing, reporting and efficiency features (e.g., automatic triggers) keep organizations fully informed and further increase their efficiency.
ikaMedicareGateway is a key component of ikaSystems’ comprehensive ikaEnterprise product suite for Medicare, which includes tools that automate the full spectrum of Medicare administrative processes, including marketing and sales management, claims administration, customer service, billing and commissions payment. Administrative tools in turn blend seamlessly with ikaEnterprise medical management applications, creating a connected, shared information platform for real-time collaboration. Because all ikaEnterprise applications are Web based, functionality is easily extended outside the health plan via ikaPortals, allowing members, providers and employers to take control of their own processes and share information. ikaSystems also supports organizations seeking to outsource administrative processes through partnership with a leading service provider.
About ikaSystems Corp.
ikaSystems is healthcare payers’ premier provider of Web-based ERP technology for process automation and intelligence management. ikaEnterprise, the company’s flagship product, automates all key processes in the payer business cycle, supporting commercial, Medicare and Medicaid lines of business. The system consists of five stand-alone, self-service Web portals for sales/broker, administrative, employer, member and provider use, each of which are tightly integrated with business intelligence and transactional systems for core claims adjudication, care management and proactive quality measurement and reporting. Using our agile, modular technology, organizations can move quickly to lower administrative and medical care expenses through greater automation and highly intelligent decision-making. To learn more, please visit www.ikasystems.com.
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