HEALTHsuite® Mercato

The Premier Solution for Health Payers

Payers must rely on new technology and system advancements to allow them to do more with less. Keeping your edge and maintaining your ability to compete in a rapidly changing market requires forward thinking and flexibility. HEALTHsuite Mercato features the leading technology to transform your business and create a platform for success in today's healthcare environment. Featuring a superior design based on the HIPAA standards, HEALTHsuite Mercato is a rules-based, plan-configurable system that accommodates all of your business needs in a single, fully integrated solution.

A Fully Integrated Solution

Strategic alliances give us an edge to meet the demands of the ever-changing healthcare world.

Capabilities To Give You A Competitive Edge

  • 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

Available as an on-site solution, as a Software-as-a-Service (Cloud), or as a comprehensive technology and services offering (BPO).

Is Compliance With Hipaa A Challenge For Your Organization?

The HEALTHsuite Mercato repository leverages HEALTHsuite's advanced data model and eliminates the burden and cost of re-engineering existing systems to comply with HIPAA.

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Sharing Knowledge to Improve Healthcare Administration
The Social Determinants of Health: Understanding and Influencing Key Predictors of Health Outcomes

Social determinants of health (SDOH) represent the conditions in which we live, work and grow old. They shape our daily lives and greatly influence our health. Find out how payers are utilizing these factors to improve member health while reducing overall costs.

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We selected HEALTHsuite and RAM Technologies due to their depth and breadth of functionality and their ability to meet our needs.
Eben Yong

Director of MIS Health Plan of San Mateo