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 release of the HEALTHsuite Advantage™ core administrative processing system (Version 23.00). With this most recent update, HEALTHsuite Advantage provides many new capabilities for healthcare payers including support for California Proposition 56.
California voters passed Proposition 56 to increase access to health care for low-income individuals. The California Healthcare Research and Prevention Tobacco Tax Act (Proposition 56) raised the tax rate on tobacco products to fund specific health care programs within the Department of Health Care Services (DHCS) and Medi-Cal. These programs include the Family Planning, Access, Care and Treatment program; developmental and trauma screenings; women’s health services; physician and dental services; non-emergency medical transportation; and more.
The latest release of HEALTHsuite Advantage supports Proposition 56 by allowing health plans to apply supplemental payments for specified cases that qualify under the Act. HEALTHsuite Advantage can now allocate supplemental pricing to designated service lines that reflect the supplemental payments mandated by this new requirement. To accomplish this, HEALTHsuite Advantage utilizes a Supplemental Fee Schedule to process payments for the specified procedure codes. The plan can then control which claims the Proposition 56 functionality is applied to using a variety of rules made available specifically for this processing.
“We are constantly striving to provide the most comprehensive solutions for our clients, health plans administering government sponsored healthcare programs, and to deliver new capabilities to meet their needs,” stated Christopher P. Minton, Executive Vice President of RAM Technologies. “This addition is a prime example of that mission, where our strategy team identified the need upfront and our development shop proactively closed the gap, delivering a new enhancement to our clients.”
RAM Technologies, Inc. provides both technology (SaaS) and Business Process as a Service (BPaaS) for health plans serving the Medicare Advantage, Special Needs and Managed Medicaid markets. RAM’s core administrative solution, HEALTHsuite Advantage, represents the next evolution in administration for government sponsored healthcare programs. 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, both small and large, with a wealth of expertise in government sponsored healthcare, a benefit that has 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:
RAM Technologies is a leading provider of enterprise software solutions for healthcare payers. For over 42 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, Managed Medicaid and Special Needs plans. RAM Technologies provides the premier solutions for the administration of Government sponsored healthcare and has merited a top spot in the Philadelphia Business Journal’s “List of Top Software Developers” for fourteen 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.