Medi-Cal Complexities Managed

EZ-Suite Drives Efficiency for Medi-Cal Delegated Risk

Knowing that your core administrative platform provides the necessary level of compliance and accountability in claims and utilization management is key for IPAs and MSOs on behalf of their client organizations. The rapidly increasing administrative requirements in Medi-Cal managed care require a flexible platform you control through choice selected configurability. 

Together with our point solutions, EZ-Suite drives compliant, trusted core benefits and claims administration excellence. 

iStock-1013683412-web

 

Citra empowers Medi-Cal Organizations to:

  • Maximize electronic data interchange, accelerated time to value & flexibility for expansion
  • Control complex processes involving benefit plans, provider contracts, and member populations
  • Manage California specific Medi-Cal rules and compliance requirements
  • Leverage actionable analytics to identify and provide care to high-risk / high utilization members
  • Supports comprehensive data needs through collection of provider and member profiles, health plan benefit data, primary care encounters, specialists, authorizations, physician and hospital FFS claims, risk sharing arrangements, and industry standard codes required for end-to-end UM, QM, and claims processing
  • Flexibility as models change for calculation of member months with a variety of methodologies: % of Premium, Risk-Adjusted, Tiered Membership or the more traditional health plan benefit option, primary care physician, member condition, age and gender
  • Automates timely and accurate payment to capitated providers based on PMPM expenses
  • Drive high quality member and provider engagement
  • Support role-based user and security at the module, screen and field level
  • Enable Full security settings for login attempts, forced password changes, and minimum password requirements
  • Complete before and after editing; Audit Trail at the field level

Widely used and always trusted, EZ-Suite delivers the most comprehensive and tested Medi-Cal core eligibility, claims, benefit and authorization platform. 


aco-icon-NEW

Accountable Care Organizations

Learn More

 

self-insured-employer-icon-NEW

Self-Insured Employers

Learn More

 

health-plan-icon-correct-NEW

Health
Plans

Learn More

 

IPA-icon-NEW

Independent Practice Associations

Learn More

 

integrated-delivery-system-icon-NEW2

Integrated Delivery Systems

Learn More

 

MSO-icon

Management Services Organizations

Learn More

 

Provider-icon_NEW2

Providers

Learn More

 

TPA-icon-NEW

Third Party Administrators

Learn More

 

LOB-ICONS-Commercial

Commercial

Learn More

 

LOB-ICONS-Duals-NEW

Duals

Learn More

 

LOB-ICONS-Medi-Cal

Medi-Cal

Learn More

 

LOB-ICONS-Medicaid

Medicaid

Learn More

 

LOB-ICONS-Medicare

Medicare Advantage

Learn More

 

LOB-ICONS-Pace-NEW

PACE

Learn More

 

LOB-ICONS-Speciality-NEW

Specialty/Carve-Out

Learn More

 

ez-cap

Core Administration

EZ-CAP is a comprehensive claims and benefit administration system, managing all functions  of a managed care organization in a single integrated platform.

Placeholder CTA

 

 

ez-care

Utilization/Case/Care Management

EZ-CARE is a dedicated care management module supporting our clients clinical teams’ focus on managing risk, quality of care, reducing costs, and improving patient/member experience. This complete, easy-to-use case management application is designed for the unique workflows of the nurses, doctors, case managers and healthcare administrators engaged in care management roles.

Placeholder CTA

 

 

ez-info-2

Analytics

EZ-INFO provides a complete, end-to-end population health platform for delegated IPAs, MSOs and Health Plans managing patients at risk. This solution combines everything from clinical and claims data to biometric and social information in a single location for actionable data, such as managing HCCs, HEDIS, STARS, etc., making program management simple, allowing you to effortlessly maximize revenue and reduce the future cost of care.

Placeholder CTA

 

 

ez-edi-new

Electronic Data Interchange

EZ-EDI offers the latest advancement in electronic data interchange (EDI) to easily retrieve information and perform transactions in real-time directly into EZ-CAP, without going through a clearing house.

Placeholder CTA

 

 

ez-net-new

Provider Portal

This internet portal facilitates timely, cost-effective sharing of clinical and administrative information between a healthcare organization, network providers, and health plans.

Placeholder CTA

 

 

ez-partner-new

Universal API

This application enables software vendors to interface existing systems with EZ-CAP. This Application Programming Interface (API) is an expert modification tool for developers to format request and response file transactions.

Placeholder CTA

 

 

citra-cloud-1

Cloud Services

Citra Cloud provides an advanced EZ-CAP cloud-based hosting service that gives you everything you need to run EZ-CAP, EZ-EDI, and EZ-NET. Achieve “plug-and-play” access to your application to safeguard your data and control costs.

Placeholder CTA

 

 

eligibility manager

Eligibility Management

Eligibility Manager is a uniquely configurable software solution that makes it easy for IPAs, MSOs, or any population health, delegated group or managed care organization to efficiently manage changes to healthcare member eligibility.

Placeholder CTA

 

 

cap check

Capitation Reconciliation

Cap Check is an essential tool for medical groups with capitated contracts to verify that they are receiving correct payments. By reconciling actual payments with expected payments on a member/month basis, you can verify whether you are being paid correctly, and make corrections when you are not.

Placeholder CTA

 

 

datatug

Eligibility Management

DataTug is a unique product that knows how to find the information you need quickly and accurately for any health plan. DataTug extracts required data automatically from health plan web sites and ANSI X12 270/271 and other data portals.

Placeholder CTA

 

 

We are Citra

"If you are listening with intent to your clients, you will be a fantastic vendor and a very successful company."

Scott Sanner, CEO 

Discover what Citra has to offer. Schedule your demo.

Schedule a Demo