Sophisticated information technology is at the heart of managing Specalty/Carve-Out risk. With a comprehensive set of capabilities from core claims and benefits administration to integrated care management, EZ-Suite enables our clients to handle all of their needs in-house and to align administration and care management for focused populations. Additionally, with our EZ-INFO analytics solution, Specialty/Carve-Out organizations can identify and leverage critical discreet information, identifying cases early that could potentially cost more money later.
Together with our point solutions, EZ-Suite drives compliant, trusted core benefits and claims administration and care management excellence.
Widely used and always trusted, EZ-Suite delivers the most comprehensive and tested Specialty/Carve-Out core eligibility, claims, benefit and authorization platform.
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.
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.
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.