Javelina Health Benefits Administration

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Overview

The Javelina application suite is an enterprise solution that consists of 20+ fully integrated modules that operate in real-time and are easily integrated within a client's digital framework.

The application provides enterprise-wide support for clients in the healthcare payer market.

Key Features

Javelina is an enterprise application developed for the healthcare payer industry. Javelina provides a digital enabled enterprise-wide application supporting:

•Adjudication Setup

•Billing & Administration

•Claims Pricing

•Claims Adjudication

•Claims Payments •Client & Member Portal Access (CMPA) / Web Self-Service/MESA

•Correspondence

•Customer Relationship Management (CRM)

•Electronic Data Interchange (EDI)

•Enrollment

•Javelina Queuing System / Workflow (JQS)

•Master File Maintenance

•Plan Building

•Re-Insurance

•Actuate (Reporting)

•Image / Document Management

•Job Scheduling

Key Benefits

Mphasis clients have derived multiple benefits from the proposed solutions. These include:

• Increased automation

• Speed to market

• Lower cost of ownership

• Improved analytics

• personalized consumer experience.

In order to drive automation, the core application considers membership information a key component of the database and is shared across all functions. It can be electronically loaded in either a HIPAA 834 format or a Standard Import/Export format derived from the automated mailroom entered through the on-line self-service portals via REST Web services integration or managed utilizing the applications browser-based User Interface. Accuracy and Automation are achieved utilizing a variety of user-defined enrollment configuration, validation and translation rules are available to streamline eligibility additions and maintenance. This automation not only supports efficiency but allows key staff to focus on a strategic task and less on lower level administration.

Supporting consumer-driven processes such as pricing, quoting, member engagement, incentive management and retention require not only a digitally enabled core system but also a host of applied technologies that utilize analytics and advance user experience enable by a multi-channel delivery system. As a center of excellence, Mphasis provides strong capabilities enabling organizations to transition to fully digital operation and a Next Gen payer organization.

Product/Service details