Maximize your FACETS investment with our specialized blended-shore delivery model. Full lifecycle support from implementation to optimization.
Maximize your FACETS investment with our specialized blended-shore delivery model. Full lifecycle support from implementation to optimization. Our experienced healthcare team provides comprehensive FACETS services across implementation, integration, testing, and production support.
Full lifecycle FACETS support from implementation and upgrades to production support and outsourcing services.
Implementation & Upgrades
FACETS implementation and upgrades with full lifecycle support.
FACETS Implementation and Upgrades
Configuration, process, and workflow management
Application Integration and external interfaces
Integration & Services
Ability to download only the errors/error messages to spreadsheet, or download the batch log in its original format.
Real-time integration and FXI services
Enhancements and Extensions
Testing Services
Production support and batch operation
Blended-Shore Model
Our blended-shore model reduces costs and enables 24-hour support with faster delivery.
Reduces implementation and operational costs for our clients
Enables 24-hour support
Faster delivery
High quality due to both onshore and offsite quality inspections
Ability to expand and contract staffing based on current needs
Outsourcing Services
Comprehensive outsourcing services across provider management, configuration, pricing, enrolment, and claims.
Provider and Network Management – annual provider and network assignment along with agreements setup and UAT
Configuration and Benefits Management – new product rollout, configuration, and benefits validation
Pricing and Agreements – provider pricing, network configuration, agreement validation using custom reports and claim processing
Enrolment and Billing – enrolment process validation, annual rate validation, specimen billing, billing reconciliation, and broker commission processing
Claims Analytics and Recovery – ad hoc reporting, data presentation, overpayment recovery, and production incident validation
Developed the integration and SOA components for a large health plan using FACETS
Implemented the complete FACETS batch processing and error handling process using Tidal for a health plan on the west coast
Implemented the complete FEP program in FACETS
Implemented Prime PBM with real-time accumulator update to and from FACETS
Complete plan/product benefit testing for a large health plan
Automated the Fee Schedule load process for a large health plan
Implemented letter server for a health plan on the west coast
Automated the billing receipt and premium reconciliation process
Developed customized small and large group rating system and automated rate upload to FACETS
Product Benefit configuration and testing
NetworX Pricing configuration and FEE Schedule loading
Automated Enrollment
Claims and EXCD configuration and testing
ITS Claims Processing
Utilization Management
Formatted outputs, ID cards, Letters, and Invoice generation
External claims and accumulator updates
Accumulator Synchronization Process
Billing Receipt automation
Group rating systems automation and rate upload
PBM Integration both real-time and batch
Integrating external applications such as Claims Xtend, ClearCoverage, Care Advance, etc
Medicare Management / EAM implementation
FACETS Consumer-Directed Health (CDH)
EDI processing – 834, 835, 837, 820, 270/271, 276/277 transactions
HIPAA Gateway implementation
