Fast, turnkey HIX capabilities.
Health plans seeking to participate in a Health Insurance Exchange (HIX) require an extensive array of data management, workflow management, and reporting capabilities. ikaExchange delivers rich functionality via a highly configurable, easily maintained technology platform to help you meet the complex demands of the new HIX environment.
Complete Solution, Built-in Flexibility
ikaExchange provides the required functionality health plans need to participate in a federal, state-sponsored, or private HIX program. The flexible, scalable, and integrated platform can be easily configured to send, receive, and reconcile data—including product information, rates, membership, eligibility, and financial data. Plus it can calculate appropriate expected payments from multiple funding sources based on the rules of each individual exchange. More than just an EDI gateway, ikaExchange mirrors the system your plan uses to generate the information required by an Exchange, so you can leverage your IT investments for lower entry and maintenance costs.
As the Health Insurance Exchanges continue to evolve, ikaExchange allows you the flexibility to quickly and efficiently automate and adjust workflows and process changes, enabling you to remain positioned for success in this dynamic market.
The benefits speak for themselves
ikaExchange enables you to:
- Meet all HIX technology requirements your business needs today with a single, modular platform
- Be confident that your technology solution will be able to evolve as your business and the market evolves
- Benefit from Web-based enterprise data and workflow management platform; platform hosting; updates as needed; and full support for navigator, broker, employer, member, and state administrator roles
- Support AHBE and SHOP activities with automated, integrated plan management, enrollment, financial, reconciliation, reporting, EDI, and customer service functions
- Comply with federal, state, and organizational guidelines for creating, managing, and reporting HIX program metrics (payers)
- Create, submit, and approve submissions for Qualified Health Plan status
- Shorten time to market and lower cost of ownership by leveraging existing IT systems and resources and using an aggregator platform for all commercial and Exchange business channels
- Reduce burden on business units and minimize operational costs with a self-service tool set for external constituents, including EDI enrollment file processing and 834 file handling
- Access extensive and meaningful data reports and metrics reports
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