Integration Plus™ (Integration+™) Product offers health plans a complete, end-end software as service solution to seamlessly integrate with various Health plan and Health Plan partners, alleviating the burden of managing data exchange and transformation between Health Plan claim processing platform, upstream and downstream applications. It is a fully managed, secure, cloud-based enterprise integration platform, accelerating application development, ecosystem deployment, and maintenance of cloud services, data, and B2B integration processes. Serving as a robust, enterprise-class middleware platform, it is built on open-source and Java-based technologies, supporting various integration protocols including SOAP, REST, files, FTP, SFTP, HTTP(S), and more. Integration Plus™ (Integration+™) supports Medicare, Medicaid, CHIP, FEP, Commercial, Fully Insured and Self-funded groups, Administrative Services Only (ASO’s) and Health Exchange (HIX) lines of business for medical and all specialties such as dental, vision and behavioral health, crafted to seamlessly integrate, scale, and adapt, providing an unparalleled solution for health plans looking to optimize their operations.
Integration Plus™ (Integration+™)
End to End Integration Solution
Pre-built Integrations
Out-of-the-box functional APIs to facilitate quick development and delivery of new digital solutions, reducing migration risks.
EDI Solution
Supports the exchange and transformation of messages, workflow configuration, testing, and monitoring of transactions. Effectively integrates with stakeholders, such as vendors, suppliers, distributors, partners, and marketplaces. Validates messages against customer business rules, ensuring data accuracy, and enriches data before forwarding to the sender. Enables real-time or scheduled data transfers, automating EDI processes to connect, transform, and route various document types between applications. Processes ANSI X12, DFF, and PFF standards, orchestrating data in these formats and accelerating stakeholder onboarding. Provides business intelligence on message transfers, empowering informed decision-making.
DataHub
Proprietary Payer Data model that combines all the Health Plan data in a data warehouse. Aids in faster data retrieval with relatively simple SQLs. Facilitates near real-time data transfer to all downstream systems. Enhances accurate data report generation and outbound extraction at any point in time.
Pulse
This feature maintains the balance and control of data in various business value streams.
Key Features
Integration Excellence
Seamlessly integrates Health Plan claim processing platform with inbound and outbound interfaces, fostering a cohesive and streamlined payer ecosystem.
Data Mapping and Transformation
Tools and capabilities to map data between different formats and structures, enabling seamless communication between systems with varying data schemas.
Real-time Web Service Calls
Handles real-time web service calls effortlessly using APIs, ensuring quick and accurate data exchange between systems.
Audit Trails and Reports
Maintains comprehensive audit trails and generates insightful reports for enhanced transparency and accountability.
Built-in Functional and Operational Capabilities
Offers built-in capabilities catering to all functional and operational needs, providing a comprehensive solution for the payer ecosystem.
Configurable and Customizable
Highly configurable and customizable to adapt to the unique requirements of different clients and lines of business.
Scalability and Performance
Horizontally and vertically scalable to accommodate future growth and evolving needs seamlessly.
Integrated Monitoring
Proactively identifies errors, inefficiencies, and bottlenecks through integrated monitoring, ensuring smooth and error-free operation.
Data Validations
Offers a configurable platform for WEDI SNIP Constraints, ensuring the creation of EDI files compliant with HIPAA.
HIPAA
Fully HIPAA compliant platform integrated to a Network Operations Center and Security Operations Center.