Health Plans - Softheon

Simplify Member Enrollment, Billing, and Renewal

With over 20 years of experience, Softheon delivers cost savings, compliance, and revenue growth opportunities for health plans.

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Why Softheon? Custom Built for Health Plans

We create flexible, adaptable, technology -driven solutions using 100% US-based staff that reduce administrative burdens health plans face.

Clients benefit from our reduced operating costs and economies of scale as Softheon combines Software-as-a-Service (SaaS) and Business Process-as-a-Service (BPaaS) to offer configurable solutions though a vertically integrated cloud solution.

Marketplace Administration Modules and Solutions

Softheon offers turnkey solutions that integrate with public and private marketplaces. Health plans benefit from simplifying member administration through cloud modules.

Softheon’s Role in the Health Plan Member Lifecycle

Where Softheon and Internal Health Plan Systems Meet

1. Plan Shopping

2. Enrollment &
Eligibility

3.Payment

4. Generate Invoice

5. Ongoing Communication
Billing Reconciliation

6. Enrolled in your health plan

7. Renewal

Who We Serve

Great Tools for Every Health Insurer Market Segment

ACA Plans

Keep your members engaged in a from enrollment to renewal experience on your white-labeled site with our Phase 3 Enhanced Direct Enrollment (EDE) solution.

Individual & Group Plans

Provide your members with access to healthcare, dental, and vision plans in an end-to-end, white-labeled shopping experience.

Medicaid

Effortlessly stay compliant with new and existing requirements, such as 1115 and 1332 waivers, through our configurable, vertically-integrated platform.

Medicare

Keep your members engaged through a fully integrated approach to enrolling in coverage and managing associated payments.

Interested in a discussion or demo around Softheon's solutions?

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