MANAGED MEDICAID

Simplifying the Administration of Managed Medicaid

HEALTHsuite Mercato provides the flexibility and precision to streamline every aspect of your Medicaid administration. Following are some of the features available with HEALTHsuite Mercato:

  • Supports Enrollment of Medicaid Members and Verifies Data with State Medicaid Files
  • Captures Medicaid Recipient Categories
  • Supports PCP Auto Assignment
  • Supports Individual Beneficiaries
  • Links Individuals to Medicaid Cases
  • Identifies Medicaid Head of Household (HOH)
  • Supports Different Benefits for Each Individual
  • Sends Correspondence to HOH or Individuals
  • HOH Does Not Need to be a Medicaid Beneficiary
  • Supports Medicaid / Medicare Dual Eligible Processing (Wraparound or COB)
  • Maintains and Tracks Financial Responsibility for Government and Unlimited Third Party Subsidies
  • Supports loading of Medicaid Fee Schedules
  • Automated Workflow for Medical and Care Managers
  • Audit and Event Processing Workflow to Schedule and Track Pro-Active Activities and Episodes
  • Integration of Prospective Payment Systems and Cost Containment Tools
  • And more…
For complete information on HEALTHsuite Mercato's functionality to support Managed Medicaid health plans, contact us today.

Schedule a demonstration and see first hand how HEALTHsuite® Mercato can reduce the complexity and cost of your health plan operations.

RAM showed us a lot of interest, had great functionality, and RAM’s CEO actually came out to visit us. They were even willing to develop new functionality that we wanted. That level of service made us choose RAM.

Eben Yong

Director of MIS
Health Plan of San Mateo