EZ-CAP is part of a comprehensive software platform used by payer and provider organizations managing delegated risk or fee-for-service relationships.
Eligibility & Member Management
All pertinent member data in one spot, including ability to set QuickAlerts for member-relevant info throughout modules, configurable User Defined Fields for customizing data capture and workflow, full utilities for PCP, PCF, plan affiliation & enrollment, member opt in/out privacy options for all communications, etc.
Benefits Management
Functioning as a highly configurable single source of truth for benefit plans, EZ-CAP streamlines administration and maintenance across multiple lines of business through unique user configurable categories, providing flexibility to configure your ever-changing business, allowing you to grow faster.
Provider Management
EZ-Suite utilizes a Single Provider ID to manage multiple contracts for Provider. Leverage Box 32 to determine the location for Payment and supports Geo-Adjust Payment based on Carrier or Locality. Store electronic copies of the signed Provider Agreement affiliated to Provider utilizing the integrated document management, manage multiple addresses and manage configurable plan affiliation.
Fee Schedules
Take fee schedules to the next level. Adjust data based on geographical location by utilizing box 32 and implementing automation, allowing providers to have multiple contracts and service locations under one Provider ID.
Capitation Payment
Powerful capitation provides flexibility in determining how to pay capitation:
• Age
• Gender
• Condition Code
• Primary Care Physician (PCP)
• Primary Care Facility (PCF)
• Contact Capitation
• % of Premium
• Risk-Adjusted
• Tiered Physician MembershipSpecialty capitation can be paid based on specialty pool, line of business, health plan, health plan/option, service area or combinations.
Retro-activity can be configured to meet your business rules.
Claims Administration
Experience operational efficiency with a customizable configuration of auto-adjudication including the utilization of user-defined, labeled and formatted fields. File off of 837 and push to payment or create a workflow with a specific data element.
Bundled Payments
Increase incentive payments by utilizing customization built to support the Bundled Payments for Care Improvement (BPCI) Initiative. We have the answers that will make this process simple and allow you to continue to focus on the quality care provided to the patient.
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.
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.
This internet portal facilitates timely, cost-effective sharing of clinical and administrative information between a healthcare organization, network providers, and health plans.
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.
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.
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.
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.
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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Support855.339.4889 |
