HEALTHsuite Advantage is a comprehensive suite of integrated modules designed for superior Managed Medicaid plan administration, featuring eHealthsuite, our self-service portal for members and staff.

HEALTHsuite Advantage delivers precise state-specific reporting, flexible non-traditional service configuration, and thorough membership and financial reconciliation. It connects all correspondence to the right member, integrates records with any plan, and ensures seamless state compliance with proprietary data formats and ongoing updates. It also integrates with payment systems and cost containment tools.

Other key features include:

• Captures Medicaid recipient categories
• Supports PCP auto assignment
• Integrated and configurable workflows for both operations and medical management
• Supports Medicaid/Medicare Dual Eligible processing
• Maintains and tracks financial responsibility for government and unlimited third-party subsidies

Additionally, we provide our clients with state-specific features such as enrollment management, capitation payment reconciliation, encounter reporting, Medicaid fee schedules, and support for timely filing.

Our experienced team works closely with each client, and we assign a dedicated representative who keeps us updated on any business changes throughout our partnership. We utilize a state-specific readiness playbook for Medicaid implementations, customized to each state’s requirements and timelines. Our experts are adept at navigating state contract requirements and are well-versed in state companion guides. We handle system demos, staff interviews, and documentation reviews, while our platform accommodates all state-specific needs, including fee schedules, plan hierarchies, and capitation rates.