Press Release
January 12, 2011
WellMed Goes Live with ikaClaims and ikaMedicareGateway
Operational Efficiency Lowers Costs and Improves Member and Patient Services
WellMed Medical Management, Inc., an award-winning senior-focused healthcare company headquartered in San Antonio, Texas, has completed a successful conversion of its core administrative operating system to ikaEnterprise, a comprehensive suite of software solutions for Medicare process automation and intelligence management. WellMed has closely partnered with ikaSystems, a premier provider of enterprise-level cloud computing technologies for healthcare payer organizations, in this strategic implementation, which is designed to increase administrative efficiency, improve controls and create scalability for growth across the WellMed organization.
WellMed and its affiliated companies serve nearly 100,000 patients and Medicare Advantage plan members, mostly Medicare-eligible seniors in Texas and Florida. Currently implemented are the ikaMedicareGateway and ikaClaims modules of ikaEnterprise. In just six months, WellMed has automated administration of Medicare medical claims with auto-adjudication rates exceeding 80 percent with the system’s configuration rules. WellMed is planning to implement additional components of the ikaEnterprise solution throughout 2011.
“We now have a system that is scalable so we can meet the demands of growth,” said Bill Connolly, senior vice president of operations for WellMed. “Easy user configurability also means that we can quickly and efficiently address member, provider and benefit changes and develop configuration programs that allow us to improve our business policy controls. The results are lower administrative costs and improved payment accuracy. At the same time, we’ve improved the service experience that members, providers and patients receive.”
ikaMedicareGateway automates enrollment processing and member/payment reconciliation, delivering greater accuracy and speed, reduced administrative costs, increased compliance conformance and higher levels of member satisfaction. The ikaClaims solution suite empowers health plans to turbo-charge their claims administration activities or to extend their existing IT investments by adding on high-performance functionality that allows for complex contract configuration, with integrated bundling and unbundling software commonly used in this industry.
“From its inception, ikaSystems’ guiding principle has been to ease every aspect of health plan operations — and ultimately to improve U.S. healthcare as a whole — through the effective use of state-of-the-art technology,” said Ravi Ika, chief executive officer of ikaSystems. “Making sure that plans can easily configure their own systems to adapt quickly to changing regulatory and other market requirements is a fundamental benefit of ikaEnterprise, shrinking implementation times dramatically while giving health plans the confidence that their systems will always support their business strategies.”
About WellMed Medical Management
WellMed Medical Management is a diversified healthcare company and health plan provider serving nearly 100,000 patients and Medicare Advantage plan members, mostly Medicare‐eligible seniors in Texas and Florida. WellMed is an industry leader in medical risk management, highly effective disease management and chronic care programs, healthcare delivery services, and more. WellMed is South Texas’ largest physician‐owned practice management company and medical group, specializing in senior health care since 1990. With more than 30 medical clinics in Texas and Florida, the vision of the healthcare company and insurance provider is to change the face of healthcare delivery for seniors. To learn more, please visit www.wellmedmedicalgroup.com.