Softheon provides comprehensive enrollment, administration, and renewal support across various markets, including ACA Marketplace, Medicare Advantage, Small Group, and beyond.
Leading Carriers Use Softheon to Get and Keep More Members
Leave the Automation to Us - You Can Focus on Your Members
The market is becoming increasingly competitive, regulation is hard to keep up with, operational costs are skyrocketing, and members are demanding better experiences. Here are some challenges that your Blues plan might be experiencing and how Softheon can help.
Member Engagement and Satisfaction
In a highly competitive market, members are demanding a more personalized experience, and health plans just don’t have the resources to do that manually.
Softheon enhances member engagement by providing tools that facilitate personalized communication and tailored health solutions. Our platform can segment member data to deliver targeted messages and services, enhancing personal connections with members and improving satisfaction rates. Additionally, our user-friendly interfaces make it easier for members to access services, manage their health plans, and communicate with their provider.
Scalability Challenges
You need to adapt and scale your services to meet the demands of an expanding member base, especially in profitable lines of business like the ACA, Medicaid, and the emerging ICHRA market. The challenge lies in scaling efficiently while maintaininghigh standards of service quality.
Our technology is designed to scale effortlessly with the growth of your plan. Softheon provides one experience that can be tailored to your specific needs, allowing you to expand into new markets or regions without the usual growing pains. Our platforms support increased volumes of enrollments and data management without compromising performance or security.
Cost Management
Managing costs while trying to offer affordable plans and maintain profitability is a significant challenge. Health plans are prioritizing ways to reduce overheads and administrative expenses without compromising member services or staffing.
Softheon can help reduce costs through efficient resource management and automation. By automating routine, manual tasks, we enable your staff to engage more with members while reducing overhead.
A health plan identified that its manual approach to payments was negatively impacting growth. Inaccurate and late invoices, reconciliation delays, and a lack of oversight resulted in member abrasion.
Read how the Texas plan utilized a off-the-shelf (OTS) billing and payment solution to grow its membership exponentially.
Health plans have achieved major transformation with Softheon:
95%+
average effectuation rate
99%
reconciliation accuracy
2000%
growth in membership numbers
Simplify Operations Across Markets with Softheon's Cloud Solution
Here's how Softheon can help you achieve your definition of success
Over 20 years of experience is built into our automated and integrated business processes,including data automation and integration via AI, EDI and APIs with CMS and downstreampartners like CRM, ERP, and Finance systems. And because it’s in the Cloud, we continuouslyimprove our products and stay ahead of changing regulations, so you don’t have to.
Use data to impact plan performance and members' behavior with out-of-the-box reporting,advanced analytics, AI, and data integration. From plan design to operations, Softheon'sanalyticssolution unifies your data to give you actionable insights.
With self-service portals for members, brokers, and plan administrators, all Softheon users experience the same unified and simplified journey. Our intuitive shopping, enrollment, and management experience is consistent across markets, making it easy for members to transition between coverage types.
Interested in exploring new markets? Explore the alternative to group coverage with Softheon’s proven off-exchangesolution tailored for the ICHRA market. Our custom ICHRA interface simplifies plan selection,making it easy for employees to find the right coverage and for health plans to tap into newmembership opportunities.
Health Plan Leaders Trust Softheon
“Softheon’s expert knowledge of the ACA marketplace, coupled with their leading enrollment and billing technology has made the perfect partner during Hometown Health’s first open enrollment period on the exchange.”
David Hansen | CEO, Hometown Health
“[Softheon has] a fantastic solution and its performance has been great… the strength of the vendor relationship isn’t whether you have problems or not, it’s how you go about solving them and those issues.”
Paul Wingle | CVS/Aetna
Interested in a Quick Chat?
Book a quick introductory call with Marc Bryant, VP Healthcare Solutions to learn more about Softheon's capabilities.
Ready to transform your health plan operations and enhance member satisfaction? Connect with Softheon today to discover how we can tailor our solutions to meet your needs and drive your success.
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