Payer Organizations

The Centricity Business Managed Care Application provides a robust work engine for health plans and payers, enabling these organizations to

• Define and maintain complex and changing benefit plan configurations
• Monitor and manage member eligibility information as well as benefit use and limitations
• Track and manage capitated payments to primary care, specialty and ancillary organizations
• Define complex contractual relationships with provider networks
• Produce timely and accurate claims payments
• Manage referral requests and track medical review decisions
• Proactively identify and manage members requiring clinical case management and report on episodes of care
• Monitor issues reported by members enabling more responsive and complete member feedback