Comprehensive Administrative and Care Management Functionality

The Member Portal is an ideal fit for health plans seeking to maximize member self-service. The ikaPortals framework delivers a secure, personalized experience to ensure that users are exposed to only the information to which they are entitled. Content management controls automatically keep content from displaying past its expiration date.

Enrollment Functionality

• Receive HIPAA-compliant emails for initial system login
• View the products and plans available for enrollment
• View, print and download individual quote and plan benefit summaries as well as detailed plan benefits and descriptions
• Compare quotes and benefit summaries side by side across all products, and print and download comparisons
• Choose to waive coverage completely (all products for self and/or dependents) or partially (some products for self and/or dependents)
• Initiate and complete (e.g., select primary care physicians [PCPs], e-sign) enrollment for self and dependents after making enrollment selections, including submission to the health plan

Self-Administration Functionality

• View personal information for self and dependents — e.g., contact information, PCP, employer — and update pertinent records
• Access plan documents for all enrolled products, including benefit summaries, explanations of benefits (EOBs) and plan updates
• Access and complete member surveys/polls
• Search, view and track benefits (eligibility, co-pays, deductibles, accumulators) for office visits and ER, urgent care, inpatient, outpatient, outpatient surgery and other services
• View claims information (based on health plan rules)
• Change password
• Request ID cards and print temporary ID cards for self and dependents
• Access links to external websites (e.g., a health plan’s Web site outside the portal solution, promotional campaigns, downloadable forms)
• Use secure messaging to communicate/interact with the health plan

Care Management Functionality

• Rate and view ratings for providers
• Access and complete health risk questionnaires (HRQs), receive simple and preliminary self-evaluation reports, and receive notifications and reminders for quality of care measures based on HRQ results
• Enter home-monitoring data (e.g., blood pressure, blood sugar, peak flow meter values) into a disease log to facilitate case management
• Receive periodic information, including notifications and reminders, regarding care gaps such as “measures due” or “measures done” during the HEDIS plan year based on member’s age, gender or disease conditions
• Receive easy-to-understand educational material focused on the member’s chronic condition(s)
• Maintain a personal health record (PHR), including:
• Personal information (e.g., contact information, which can be updated)
• Provider information (e.g., contact information, utilization index and quality index)
• Cost of care for all medical and pharmacy claims
• Disease log, a single repository of all clinical information that members can update (e.g., home-monitored blood sugar, blood pressure or peak flow meter values)
• Prescription log of all prescriptions, including any missed refills, brand vs. generic, dollars saved by changing from brand to generic, etc.
• Appointments (e.g., schedule appointments with case managers)
• Documentation and notes for closed-loop communication with providers and case managers
• Integrate with other electronic PHRs (e.g., Google Health)
• Access mobile healthcare services (according to health plan rules)