Health Care Technology
Company Overview of Softheon, Inc.
Softheon, Inc. provides healthcare business process optimization solutions for payer, provider, and government organizations. The company Exchange Connector, a Software as a Service platform for plan management, small business health options program, eligibility and enrollment, billing and financial management, member services, and appeals and grievances; and Care Connector for revenue cycle management, release of information, and utilization review. It also provides Business Connector that enables health plan issuers to address regulatory compliance challenges in pharmacy prior-authorization; new business, and underwriting and enrollment; claims pre-adjudication; claims post-adjudication; c...
1393 Veterans Memorial Highway
Hauppauge, NY 11788
Founded in 1994
Key Executives for Softheon, Inc.
Director of Professional Services
Director of Product Management
Compensation as of Fiscal Year 2012.
Softheon, Inc. Key Developments
Softheon, Inc. Announces Softheon Exchange Connector Cloud Platform Will Be Used to Connect Oregon's Health Co-Op to Oregon's Health Exchange, Cover Oregon
May 20 13
Softheon, Inc. announced that Softheon Exchange Connector Cloud platform will be used to connect Oregon's Health CO-OP to Oregon's Health Exchange, Cover Oregon. Cover Oregon is a new central marketplace where Oregon individuals and employers will be able to shop for health insurance plans and access financial assistance to help pay for coverage. Starting in the fall of 2013, Cover Oregon will serve as a one-stop resource that makes it easy to find the plan for any individuals' unique needs. CareOregon, which provides administrative services to partner health plans such as the CO-OP, contracted with Softheon for this platform. The Softheon Exchange Connector Cloud is designed for regional health plans that need to be operational by September 2013 with their Plan Management, Eligibility & Enrollment, SHOP, Premium Billing and Customer Service solutions. Other Exchange Connector Cloud components include a real-time Rating Engine and Summary of Benefits & Coverage (SBC) distribution to help health plans create their own private sales channels. Above all, the Softheon Exchange Connector Cloud delivers a turn-key exchange integration solution through subscription, eliminating the need for health plans to make major operational or IT investments. Softheon's Exchange Connector Cloud is fully integrated BPM/ESB/SOA platform that handles the complexities of state and federal exchange processes and data interfaces. Softheon's solution enables payers to extend and leverage their existing business and technology investments, which minimizes the risks associated with participating in exchange marketplaces.
Softheon, Inc. Launches Exchange Plan Management Software as a Service (SaaS) Solution for Health Insurers
Dec 5 12
Softheon, Inc. announced that they have released an updated cloud-based Qualified Health Plan (QHP) Certification solution as part of their Exchange Connector Plan Management platform. The company is getting Health Plans prepared for PPACA and helping them to connect with both Federally Facilitated Exchanges (FFE) and State-based Exchanges (SBE). Within the company's Plan Management solution, its QHP module supports interfaces between the health plan and the exchanges it operates in. Whether integrating with HIOS, SERFF, or any other communication protocol, Softheon ultimately provides a single interaction point for health plans during the certification, re-certification, decertification, appeals, and ongoing compliance monitoring processes. Along with their QHP and SBC solutions, Softheon's Exchange Connector(TM) platform also includes: A Small Business Health Options (SHOP) solution that provides real-time integration with respective exchange business areas to assist qualified small employers in enrolling employees in health insurance plans. An Eligibility & Enrollment solution that can significantly reduce the administrative burden that the health plans will experience during enrollment, thus allowing them to focus on customer care. A Billing & Financial Management solution that allows insured enrollees, federal agencies and health plan issuers to receive invoices and make payments, and provides a complete and transparent solution for all financial activities associated with the exchange. A Member Services solution that provides members with an easier purchasing experience, and enables health plan issuers to act as the first point of contact by offering easy access health coverage information and member services across multiple channels and mechanisms.
Computer Sciences Corporation and Softheon, Inc. Announce Collaboration to Deliver Cloud-Based Business Process Management Solutions for Health Plans
Jan 17 12
Computer Sciences Corporation and Softheon, Inc. announced a new software distribution agreement that will help healthcare professionals optimize efficiency and increase productivity. Computer Sciences Corporation will implement and provide the Softheon framework of business administration modules in a cloud environment allowing health insurance plans to extend the capabilities of their current system in a usage-based, software as a service (SaaS) model. With Computer Sciences Corporation's deep knowledge of the healthcare IT space and significant consulting expertise, health plan professionals will benefit from the agility, flexibility and rapid deployment of Softheon, Inc.'s payer-optimized business process and content management services delivered from an on-premises cloud or a Computer Sciences Corporation off-premises private cloud. The collaboration will allow health insurance plans to significantly reduce manual processes, enable disparate systems to communicate with one another based on standard Service Oriented Architecture (SOA) protocols and achieve rapid return on investment through a SaaS model.
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