CDS Healthcare Payer Suite℠

Healthcare Payer Suite Header

Innovation is powering health care IT transformation. Are you ready for what’s next?

CDS Healthcare Payer Suite℠​ is a unified, real-time enterprise core administrative and claims management system. More than simply claims processing, this comprehensive platform helps payers modernize technology and processes to lower costs and enhance the member and provider experience.

CDS Healthcare Payer Suite’s value-based portals provide a 360-degree view of all program channels and facilitate the customized interactions needed to increase satisfaction and retention.

Real-time Processing, 360-Degree Program View

Claims Processing

  • Configurable benefit system
  • Multi-tier plans
  • Value-based benefit designs
  • Real-time settlement and liability determination
  • Paperless EOB processing

Membership and Billing

  • One-click enrollment
  • On demand bill generation
  • Instant premium collection and posting
  • Easy navigation for entering, retrieving and inquiring about data

Population Health Management

  • Reduce health care expenditures
  • Integrated mobile and web wellness campaign
  • Real-time, plug-and-play link with external platforms

Member and Provider Portals

  • Customized dashboards
  • Self-service functionality on secure website and mobile app
  • Real-time access to eligibility, claim status, authorization status, customer service and other services
  • Electronic Data Interchange gateway

Reporting

  • Easy access to accurate information
  • Single source of truth for operational data
  • Easy import to external data warehouses
  • Ability to leverage existing data analytics with minimal disruption

Customer Service

  • 360 degree view allows for customized interaction and increased retention
  • Cloud virtual call center integration
  • Computer Telephony Integration
  • Multi-media document generation

Secure Hosting

  • Secure HIPAA, PCI and HITECH hosting
  • One of the largest health care data centers in the United States
  • Multi-layered security structure

Included in Gartner’s “Market Guide for U.S. Healthcare Payers’ Core Administration Processing Solutions” as a representative vendor.

CDS Healthcare Payer Suite Benefits

  • End-to-end core administrative processing
  • Real-time processing in all channels
  • Single source data repository
  • Phased and flexible implementation approach
  • Fully compliant and secure environment
  • Data as a Service

Supported Reimbursement Models

  • Fee-for-Service (FFS) to capitation
  • Value-based benefit designs
  • Integrated deductibles
  • "N" tiered hospital