January 23, 2008
Optimum Health goes live with ikaEnterprise in remarkable
implementation time frames
ikaSystems Corp. today announced
that the first phase of ikaEnterprise deployment was completed at
Optimum Health Care on January 1, 2008. The implementation of the
first phase of the project which included ikaClaims and the member
portal (online enrollment) began on November 15, 2007. Optimum
Health Care is an HMO in Florida and is contracted as a Coordinated
Care Plan (CCP) and a Medicare Advantage Prescription Drug (MA-PD)
by the Centers for Medicare and Medicaid.
Optimum Health was in need of an efficient MEDICARE ERP system and
it selected ikaSystem’s ikaEnterprise solution. The health plan
chose an ASP model where the hardware and software maintenance for
the solution is completely handled at ikaSystems' headquarters in
Southborough, MA. This enables Optimum employees and users to access
the portals and solutions with an Internet connection. Already, the
solutions' EDI transactions have streamlined processes and greatly
reduced the need for manual data entry. “Our portals will enable
Optimum Health Care to save on administrative costs and open the
doors to increased membership and revenue and we are looking forward
to being an integral part of this growth,” says Ravi Ika, President
and CEO of ikaSystems.
Optimum Health wanted to increase the claims adjudication rate and
realized that streamlining and automating the claims processes was
imperative to achieve this. With ikaClaims, benefit plans and
provider contracts are inserted online at a very high level of
granularity. This enables the system to auto adjudicate claims in
the 95% range. Similarly the Member Portal allows health plan
members to perform various functions in a self-service environment
including Enrollment, Plan Benefit Information, Claim Status,
Disease Management, Provider Search, Order ID Cards, Benefit
Limitation Status, Eligibility Verification, Customer Service,
Update Personal Information and Pharmacy Changes. Dan Polen, Chief
Operating Officer of Optimum Health Plan says “We are excited about
the fully automated, paperless process that will significantly
reduce the health plan's administrative costs and will allow for
fewer errors. We have already grown 200% in one year from 2 to 5
counties and we are confident that the deployment of other
ikaEnterprise portals will propel our growth further".
The remaining components of ikaEnterprise yet to be deployed include
a series of self-service portals and business and transactional
systems including profiling, and HEDIS® reporting, which will
implemented in the near future.
About Optimum Health Plan
Optimum health is a Health Maintenance Organization (HMO) in the
State of Florida that was awarded its Certificate of Authority by
the Florida Office of Insurance Regulation in September 2005. They
are contracted as a Coordinated Care Plan (CCP) and a Medicare
Advantage Prescription Drug (MA-PD) by the Centers for Medicare and
Medicaid (CMS) to enable them to service beneficiaries with a
Medicare Advantage Prescription Drug (MA-PD) product line beginning
January 1, 2007.
