Health Insurance Exchange (HIX)

The Affordable Care Act, passed by the U.S. Congress in 2010, mandates that the states operate a marketplace for residents to buy affordable, private health insurance. These Health Insurance Exchanges (HIX) will provide an estimated 23 million Americans with affordable health insurance.

NebuLogic offers CRM Implementation Solutions for customer service centers. Our CRM solutions are the undisputed choice for providing excellent customer service.

NebuLogic’s HIX-CSC implementations provide you with:

  • Descriptions of benefit structures of the health plan’s products to the qualifying individuals/ families
  • Member eligibility lists
  • Existing information about network providers
  • Reimbursement arrangements with participating providers
  • Information to support the authorization process
  • Reports on utilization and quality management programs
  • Information on member and provider satisfaction with the health plan
  • Information on claims and claims processing
  • Premium billing and payment information for various purchasers
  • The results of performance measurements for various health plan departments
  • And much more – whatever your organization needs

Business Benefits:

  • A wide-ranging CSC solution
  • Integration with several external systems such as CTI, IVR, data sources, and portals
  • Single Sign on (SSO) among core systems
  • Fast implementation timelines, regardless of where on globe you operate
  • Scalable with ease of support and maintenance
  • Comprehensive reporting with profile-based dashboards and detailed analytics