Health Plans Can Avoid Core Platform Replacement and Externalize Strategic Functions Including Product Design, Provider Management, Online Shopping, Membership and Billing
BIRMINGHAM, Ala., -- DST Health Solutions, LLC, today announced its new suite of health plan administration solutions that enable payers to improve primary business functions without needing to replace their core claims administration platforms. Utilizing this strategy, health plans can achieve many of the benefits of a new system, without the cost and time required to replace their legacy system.
"Health plans today face numerous challenges -- from market consolidation to increased competition and regulatory requirements," said Steve Sabino, president of DST Health Solutions. "With rapid change, health plans must be prepared to quickly adapt their operations to succeed. Our new suite of unique solutions enables health plans to rapidly configure new benefit structures, introduce new products, increase membership and leverage modern technology, while extending the life of their investment in core claims technology."
DST Health Solutions has developed four service-oriented architecture (SOA) solutions that address health plan product design; provider pricing and modeling; membership and billing; and online shopping (including quotes, enrollment and insurance card production).
ProductDesigner enables health plans to configure products and benefits quickly, as reusable objects, without having to make changes to their core claims system. ProductDesigner will allow health plans to make changes related to co-pays and coinsurance, for example, without having to create entirely new benefit plans. Additionally, ProductDesigner helps health plans increase member acquisition, boost renewals, improve plan design flexibility and accuracy, reduce claim-payment errors and accelerate auto-adjudication.
The Provider Management module gives health plans the ability to configure complex contracts without custom coding. Building upon its current provider management model, DST Health Solutions is transforming provider pricing with pricing models that enable health plans to model provider contracts in real-time and create reusable contract components. Users benefit from the ability to build contracts for both modeling and pricing, and therefore have the flexibility to move the contract directly to the production environment without risk of transcription errors.
In addition, Online Shopping is a unique solution for member acquisition that enables new customers to visit a health plan's website, enter their demographic information, deductible preferences and other data, and immediately receive a plan quote and new insurance card. Designed to provide the complete insurance shopping experience, Online Shopping enables customers to shop and purchase health plan services from any user interface.
Lastly, Membership and Billing is DST Health Solutions' new enterprise-wide module for enrollment information that allows health plans to efficiently capture necessary data and consolidate membership and billing processes into a single platform. Membership and Billing helps protect a health plan's investment in existing claims operations, while helping to maintain a flexible product portfolio, coverage selection and billing across disparate legacy systems. This externalized solution streamlines complex membership and billing processes for large groups, small groups, individual products and government programs such as Medicare and Medicaid. Membership and Billing accommodates government and private plan requirements, such as HIPAA and the Healthcare Effectiveness Data and Information Set (HEDIS®).
DST Health Solutions will demonstrate its new suite of health plan administration solutions at the AHIP Institute, June 15 - 17, at booth number 619.
About DST Health Solutions
DST Health Solutions, LLC delivers systems and services that help improve efficiency, reduce operational costs, increase speed to market, and facilitate medical cost management and price containment. Our clients include commercial health plans, consumer-directed plans, government plans (Medicare Advantage, Medicare Part D and Medicaid) and physician practices. DST Health Solutions' enterprise applications and outsourcing services include claims processing, member and provider management, benefit plan management, new product development, care management and medical management, and decision support/analytics. DST Health Solutions is a wholly-owned subsidiary of DST Systems, Inc. For more information about DST Health Solutions, contact 800.272.4799, email firstname.lastname@example.org or visit www.dsthealthsolutions.com.
CONTACT: Chris Goldman, Media Relations, +1-816-843-9087, for DST Health Solutions, LLC