image_core_adminGOVERNMENT SERVICES SOLUTIONS

image_core_adminGOVERNMENT SERVICES SOLUTIONS

Compliance and optimization.

The Centers for Medicare & Medicaid Services (CMS) requirements create both compliance challenges and opportunities for differentiation for forward-thinking health plans. ikaSystems provides the tools to improve Star ratings, optimize revenue, and decrease total costs. Our solutions automate the complete range of enrollment and reconciliation transactions with CMS and adhere to CMS Chapter 2 requirements. Our highly effective government services solutions have enabled health plans to make transformational improvements—decreasing operational costs by as much as 50%.

These solutions automate processes for government services plans—including sales, claims, payment reconciliation, and correspondence—with flexible, easy-to-configure systems at a low total cost of ownership. Our powerful, cost-effective tools drive operational and administrative efficiencies that help you grow revenue, lower costs, and adhere to changing CMS regulations to retain good standing.

ikaMedicareGateway

An enrollment and reconciliation solution that automates complex data exchanges with CMS and enables quick, accurate, and compliant transactions.


ikaMedicareGateway Fundamentals

A tailored enrollment and reconciliation solution for health plans with fewer than 20,000 Medicare lives that offers a pre-configured set of the core functions available in ikaMedicareGateway and enables smaller health plans to compete effectively.


Consumer Web Portal

An add-on module to ikaMedicareGateway that streamlines the online enrollment process to both lower administrative overhead and increase customer satisfaction.


Payment Reconciliation

An add-on module to ikaMedicareGateway that automates payment and account processing for improved efficiency, faster discrepancy resolution, and enhanced management reporting.


ikaClaims for Medicare

A fully configured claims system that enables health plans to match Medicare pricing, benefits, and clinical editing rules to lower administrative costs through rapid, efficient claims administration.


ikaCRM for Medicare

A solution that integrates Medicare sales processes with a complete array of automated functions—including lead management, lead distribution, campaign and event management, and literature fulfillment—for maximum efficiency.


ikaCorrespondence

A flexible, cost-effective solution that doesn’t require a vendor for managing letter templates and creating correspondence that meets multiple CMS member requirements for enrollment and reconciliation.


RAPS/EDPS

Solutions for ensuring compliance with Medicare guidelines and receiving accurate payments by automating the submission of claim and chart review data to CMS.