Simplify Complex Pricing Situations

• Comprehensive and flexible capabilities for constructing various pricing models
• Automates pricing for multiple lines of business at a lower cost of ownership
• Out-of-box capabilities for ASO: admin fees, stop loss, level funding arrangements
• Out-of-box capabilities for calculating premiums and fees based on qualifying events like member addition, termination, etc., that are based on state level or federal business rules
• Parameter-based pricing variations
• Adjusts the price on specific products and tailors offers based on the potential customer relationship

Increase Productivity with Accurate Billing and Accounting

• Supports multi-currency, real time/batch/event based accurate invoicing
• Ad-hoc as well as scheduled billing with flexible bill cycles: monthly, quarterly, annual
• Enables maintaining complex billing hierarchies for large groups and national accounts
• Consolidates billing for variety of health plans and enables a simplified experience across multiples lines of business/groups or individuals
• Bill review process based on business rules
• Segments bills and increases productivity with high level of automation and error-free outcomes
• Supports complex transactions with centralized control for systematic refunds and adjustments
• Provides rules-driven billing approach to enable true business agility and revenue recognition

Streamline and Centralize Processes

• Supports centralized processing and monitoring for consolidated multiple enrollment channels and a 360-degree customer view
• Out-of-box integrations with enrollment systems through inbound web services; file upload interface utility for real-time as well as batch bulk updates
• Improves efficiency with unified processing and monitoring
• Improves productivity and customer service with visibility of the entire customer relationship

Achieve Unified and Responsive Payments

• Reduces operational cost and improves straight-through processing
• Supports real-time payment settlement and seamless processing
• Improves customer experience and helps achieve faster reconciliation
• Reconciliation and discrepancy management
• Payment application based on rules
• Provides capabilities for managing delinquency, discrepancy, and notifications to reduce risk
• Supports standard messaging and a variety of payment methods

Develop Insight-Driven Approach

• Enables informed decision making with high fidelity insights
• Provides out-of-the-box analyses, including metrics, charts, and reports
• Allows for consistent, real-time dynamic billing and pricing decisions

Gain Superior Customer Experience

• Helps create multidimensional customer group hierarchies and applies pricing rules and billing preferences at any level of the hierarchy
• Provides visibility into billing data and enhances predictive decision-making