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.
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Corporate Office430 Davis Drive, Suite 180 |
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Support855.339.4889 |
