RAM Technologies, Inc. (RAM), the perennial leader in enterprise software solutions and services for Medicare Advantage and Managed Medicaid health plans, is pleased to announce the latest update to the HEALTHsuite Advantage core administrative platform. With this latest release (22.02), RAM has added support for many new functions including the CMS mandated Incarceration and Not Lawfully Present Update.
“We are constantly striving to provide the most comprehensive, fully integrated, end-to-end solution for health plans administering Medicare Advantage,” stated Christopher P. Minton, Executive Vice President of RAM Technologies. “This most recent addition to the platform accommodates a compliance requirement that is applicable to Medicare payers. We have updated HEALTHsuite Advantage to comply with this regulation well in advance of the deadline, and will continue to do so for future CMS mandates, providing our clients with the premier technology platform for their administrative and compliance needs.”
The CMS planned Software release of June 26th, 2022, will include an update to the Enrollment and Disenrollment transactions based on Incarceration and Not Lawfully Present statuses. This latest enhancement to HEALTHsuite Advantage, provides functionality to support this requirement including updates to the way Batch Eligibility Query (BEQ) rejections are routed within the system; allowing a member to fail an eligibility check based on being incarcerated or not lawfully present in the United States (US); and updating the member’s insured status and customer contract status for Transaction Reply Codes (TRCs) received on the Daily Transaction Reply Report (DTRR). The addition of these capabilities in advance of the CMS stated deadline, ensures RAM clients are ready for the new requirement.
RAM Technologies, Inc. provides both technology (SaaS) and business process solutions (BPaaS) to health plans serving the Medicare Advantage and Managed Medicaid markets. RAM’s core administrative solution, HEALTHsuite Advantage, represents the next evolution in Medicare and Managed Medicaid administration. HEALTHsuite Advantage deploys rapidly in a pre-configured state. This innovative approach slashes implementation durations, eliminates risk and reduces total cost of ownership. HEALTHsuite Advantage’s robust features and functions include all of the essential core system capabilities, including benefit administration, enrollment, billing, reconciliation, provider data management, provider contracting and reimbursement, utilization management, encounter and claims administration, fulfillment, customer service and more including fully integrated workflow and bi-directional integration with CMS – a must for Medicare Advantage and Managed Medicaid organizations.
RAM Health Services, RAM’s internal BPaaS offering, provides health plans with the option to outsource all or select portions of their operations. This increased level of engagement affords plans, small and large, with a wealth of expertise in government sponsored healthcare programs, a benefit that had traditionally been available only to larger organizations. For new market entrants, this offering is particularly attractive as it dramatically reduces time to market, alleviates hiring and HR issues and enhances health plan revenue.
About RAM Technologies, Inc.
RAM Technologies is a leading provider of enterprise software solutions for healthcare payers. For over 41 years RAM Technologies has led the way in the creation of comprehensive, end-to-end solutions (technology and services) for health plans administering Medicare Advantage (from Enrollment to Encounter Reporting). RAM Technologies provides the premier solutions for MA / SNP administration and has merited a top spot in the Philadelphia Business Journal’s “List of Top Software Developers” for twelve consecutive years, has been featured in Inc. Magazine’s List of Fastest Growing Private Companies for five years and has been named Most Promising Insurance Technology Solution Provider by CIO Review. To learn more about RAM Technologies call (877) 654-8810 or visit www.ramtechinc.com.
