Spend less time on technology, more time on experience.

Focus on member and provider experience with operational efficiency, cost reduction, and quality of care. 

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Put Our Experience to Work for You.

25+ Years Supporting the Delegated Risk Market


Citra's EZ-Suite is the software solution for payers and health care organizations taking delegated risk that are in need of a complete end-to-end technology to manage operational and administrative processes. EZ-Suite is the only comprehensive software solution delivering a highly configurable, scalable and flexible platform supporting multiple lines of insurance business, including Medi-Cal, Medicaid, Medicare Advantage, Carve-Out and Commercial populations.

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Varying Models

It is challenging in today's market to manage an array of existing models while embracing the emerging value-based models. EZ-CAP has the flexibility to easily configure and maintain multiples lines of business in one seamless infrastructure. 

Intelligent Automation

A highly regulated environment can only be successful with smart automation for auto-adjudication and workflows. By maintaining history for every transaction with role-based security, this solution allows you to compete and lead in highly competitive markets while staying compliant. 

 

Integrated Efficiency 

This comprehensive set of integrated capabilities meets all critical risk-based needs from eligibility and benefits, DOFR, providers and contracts, unlimited array of payment and capitation models, care and utilization management, member and provider customer service, including provider portal and powerful graphical driven analytic support for HEDIS, HCC, RAF, etc.

 

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Capabilities within EZ-CAP

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 Membership

Specialty 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. 

 

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Accountable Care Organizations

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Self-Insured Employers

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Health
Plans

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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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Providers

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Third Party Administrators

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Commercial

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Duals

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Medi-Cal

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Medicaid

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Medicare Advantage

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PACE

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Specialty/Carve-Out

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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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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.

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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 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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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 

Discover what Citra has to offer. Schedule your demo.

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