Advalent Premium Billings: Revenue management system
End to end premium billing system - Invoicing, Payment and Payment Reconciliation

Advalent’s Financial Plus offers health plans a highly configurable, cloud-based solution to automate premium billings and payments. Advalent’s Platform-as-a-Service (PaaS) provides application management capabilities and hosting services for health plans that require flexibility and scalability to adapt to a changing market. The Premium Billing System brings invoice generation, payments and reconciliation for multiple lines of business under the same solution. Advalent’s utilization-based pricing allows health plans to bring together and oversee Medicare, Medicaid, Commercial, Self-funded groups, Administrative Services Only (ASO’s) and Health Exchange (HIX) lines of business for efficient revenue and payment management at predictable and lower costs.

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Invoicing

Advalent’s Financial Plus drives invoicing through highly configurable options. It accommodates split invoicing into multiple cycles. Advalent’s Financial Plus supports auto reconciliation of various shares including APTC, Tribal and Other shares. It also gives users the option to drive premium calculations on both 834/820 or system rules using rate tables.

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Payments

Advalent’s Financial Plus is configurable to accept payments from multiple channels. It defines posting rules and priorities for channels. It also has the capability for auto-posting with posting preferences by the payment channels.

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Reconciliation

Advalent’s Financial Plus payment reconciliation rules are automated including Accounts Receivables and Delinquency processes. It allows for configuring posting rules with override options to limit false positive delinquencies.

Invoicing

  1. Monthly Invoicing
  2. 834 Premium Consideration(Premium Amount , APTC Amount, Tribal / Other Amount, Total RES Amount)
  3. Automatic Retro Calculation(Adds, Terms, Plan Changes, Group and Sub Group Changes, APTC Changes, Tribal Changes, Rate Changes)
  4. Invoice Buckets Concepts (Member Share, APTC Share, Tribal Share)
  5. Proration and Delinquency rules

Payments

  1. Manual Check Payments
  2. Lockbox Payments
  3. Automatic Check Handling (ACH) / EFT Payments
  4. Credit Card Payments
  5. 820 Payments
  6. Dental / Vision / Rider Payments

Reconciliation, Delinquency and Reporting

  1. Resolve premium collection disputes and perform reconciliation
  2. Client delinquency and discrepancy notifications
  3. Pend, hold or deny claims automatically due to delinquency
  4. Release of claims when premium payment is received
  5. Manual & automated invoice adjustments
  6. Delinquency reports, A/R summary and detail reporting, A/R balance reporting, sales journal, cash receipts, beginning balance and verify balance reporting