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Dedicated Platform to Manage Specialty/Carve-Out

EZ-Suite Provides the Sophisticated Platform to Manage Delegated Risk 

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. 



Citra empowers Specialty/Carve-Out Organizations to:

  • Maximize electronic data interchange, accelerated time to value and flexibility for expansion
  • Control complex processes involving benefit plans, provider contracts, and member populations
  • Manage Specialty/Carve-Out populations and the required reporting 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 via 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 Specialty/Carve-Out core eligibility, claims, benefit and authorization platform. 


Accountable Care Organizations

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Self-Insured Employers

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Independent Practice Associations

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Integrated Delivery Systems

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Management Services Organizations

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Third Party Administrators

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Medicare Advantage

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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.

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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.

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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.

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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.

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Provider Portal

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

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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.

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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.

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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.

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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.

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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.

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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

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