Additional information for HEALTHsuite Mercato
Key features of HEALTHsuite Mercato
- Member management
- Group administration
- Eligibility / enrollment
- Benefit administration
- Premium billing
- Network management
- Provider contracting
- Provider credentialing
- Provider reimbursement
- Automated repricing
- UM & med. management
- Referrals
- Authorizations
- Pre-certifications
- Care management
- Claims adjudication
- Encounter processing
- Capitation
- Subrogation
- Overpayment recovery
- Customer service
- Fulfillment
- Data warehouse
- EDI interfaces
- Web portals
- HIPAA compliance
- Medicaid administration
- Enrollment of Medicaid members
- Verify data
- PCP auto assignment
- Supports individual beneficiaries
- Correspondence
- Cost containment tools
- CMS application / interface processing
- CMS letters, ID cards and fulfillment packages
- Multi-cultural / Multi language
- Rules based processing
- Automated workflow
- Dual eligible processing
View All FeaturesBenefits
HEALTHsuite Mercato's automated workflow feature helps to maximize employee productivity with flexible rules-based processing.
The software provides full electronic data interchange (EDI) capabilities, and integration with trading partners and employers.
With HEALTHsuite Mercato, users are able to manage care teams, as well as coordinate medical and non-medical services.
The solution helps users to effectively streamline benefits administration for Medicare and Medicaid dual eligible recipients.
HEALTHsuite Mercato offers cost containment tools and the integration of prospective payment systems.