Insurers are facing significant challenges in today’s rapidly changing business environment.  Increased regulation resulting from the Affordable Care Act, fierce competition and consolidation are among many factors that are altering the competitive landscape.  Meeting these challenges with rigid legacy technologies can become lengthy and very costly.  It is crucial for Payers to operate with extra flexibility to adapt to these changes while avoiding “The Silo Mentality” with their IT systems.  The complexity and cost of maintaining redundant systems significantly weighs down your company as a whole.

Several factors contribute to the existence of multiple disparate systems within a single Payer’s organization.  One factor may be the result of acquisitions and mergers, where companies sometimes fall short integrating IT due to the upfront cost and cross training involved. Another factor may be differences among consumer markets.  For example, the functionality required for billing and collection for your Individual market customers will be vastly different than what is required for an ASC Group customer with differing funding/billing arrangements.  

The companies that commit to breaking down their Silo’s will be best positioned to embrace changes in the market place and generate competitive opportunities. Ideal and will help your organization create effective, integrated, long-term solutions that provide the flexibility, visibility and internal controls required to compete in this market.

Ideal ERP has extensive Healthcare expertise

Ideal ERP has a long and successful track record of partnering with major health insurance companies, helping them to better-leverage their existing ERP system to consolidate and standardize processes where it makes sense.  In addition, we are very effective at building custom solutions to fit the unique needs of the Healthcare industry.  Our experience includes:

  • Revenue Recognition (Coverage Period based)
  • Overpayment Recovery
  • Consolidated Provider and Consumer Billing
  • Inter Plan processing (Blue Card ITS)
  • ASO/ASC Billing/AR/Netting
  • Third Party Audit & Settlements
  • Statutory Accounting and Reporting
  • Federal Employee Program - FEPOC
  • Consolidated Reporting across Segments
  • Automated Cash Application
  • Automated Claim Adjustments
  • ACA Taxes & Medical Loss Ratio
  • Delinquency Tracking