Financial +™


Premium Billing & Revenue Reconcilation

Automate even the most complex billing processes

Financial Plus™/Financial+™ offers health plans a highly configurable, cloud-based solution to automate premium billings and payments. Our Platform-as-a-Service (PaaS) technology provides application management capabilities and hosting services for payers that require flexibility and scalability to adapt to a changing market. Financial Plus™/Financial+™ provides for invoice generation, payments and reconciliation for multiple lines of business all under one solution. It accommodates split invoicing into multiple cycles, auto-reconciliation of various shares (APTC, Tribal, and other shares), and gives users the option to drive premium calculations on both 834/820 or system rules using rate tables. Additionally, payers can perform revenue reconciliation, manage delinquencies and access a wide range of reports.

 

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.

Key Features

Automate Invoicing

  1. Monthly invoicing
  2. 834 premium consideration (Premium Amount , APTC Amount, Tribal / Other Amount, Total RES Amount)
  3. 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. Easily configure proration and delinquency rules
  6. Split invoicing into multiple cycles

Process Payments

  1. Manual Checks
  2. Lockbox
  3. Automatic Check Handling (ACH) / EFT
  4. Credit Card
  5. 820 Payments
  6. Dental / Vision / Rider
  7. Auto-posting and posting preferences by payment channels

Perform Reconciliation

  1. Automate A/R processes
  2. Resolve premium collection disputes
  3. Perform payment reconciliation
  4. Manual & automated invoice adjustments
  5. Configurable posting rules

Manage Deliquencies

  1. Automated delinquency processes
  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. Ability to limit false positive delinquencies

Produce Reports

  1. Delinquency reports
  2. A/R summary and detail reporting
  3. A/R balance reporting
  4. Sales journal
  5. Cash receipts
  6. Beginning balance and verify balance reporting