3R EDGE Plus: Turnkey solution for HIX risk reporting
Enabling health plans to accurately submit files to HHS quickly and cost effectively.

Advalent 3R EDGE Plus allows you to accurately submit data files to HHS, ensuring your HIX plans are protected from adverse risk. It automatically converts enrollment, medical and pharmacy claims from client-specific data sources to HHS-defined XML files for HIX data submission. Dashboards and reports let you quickly understand your HHS submission, make required changes and resubmit them to improve your ACA risk adjustment and reinsurance reimbursement. It allows you to comply quickly with HHS requirements for risk-based data submission and achieve a complete and accurate risk score analysis.

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Configure-and-Forget

Payers unable to submit enrollment, claims and PBM data in the required XML formats, risk not knowing the impact of adverse selection on their business. With Advalent 3R EDGE Plus Configure-and-Forget solution, business users no longer have to spend time to stay HHS compliant as Advalent assumes the responsibility for keeping you compliant!

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Smart Workflows and Queues

Advalent 3R EDGE Plus makes managing submission workflows convenient, by identifying potential rejection records prior to submission. It allows for parallel risk adjustment, reinsurance identification and analytics along with automated void & replacement and error correction workflows.

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Extensible Platform

Advalent 3R EDGE Plus is built on a robust foundation designed to support multiple input & output formats and define multiple routing criteria. It can be extended easily to new lines of business with configuration changes, while supporting different sets of rules to be applied on the same data. This reduces the need for additional data loads and also defining custom rules.

Are you ready for the 3Rs

  1. Reinsurance: Provides funds to issuers that incur high costs for claims in individual markets (Section 1341)
  2. Risk Corridor: Limits issuer losses  for qualified health plans (QHP) after reinsurance and risk adjustment (Section 1342)
  3. Risk Adjustment: Balances the financial risk borne by health insurance issuers by transferring payments from issuers of lower-risk to higher-risk populations (Section 1343)

3R EDGE Plus Features

  1. Hosted, turnkey solution
  2. HHS compliant
  3. Fast & Easy deployment
  4. No capital investment (pay-as-you-go)
  5. Affordable, tiered pricing
  6. Intuitive dashboards
  7. Real-time notifications and reporting
  8. Multiple preconfigured reports
  9. Standard HHS reports

3R EDGE Plus Advantages

  1. Built-in formats and rules
  2. Configurable rules engine
  3. Native workflow engine
  4. Identifies potential rejection records prior to submission
  5. Firewalled and Encrypted
  6. Meets HHS and CMS compliance requirements
  7. Supports encounter submissions to CMS (Medicare) and State (Medicaid)