RAM Technologies, Inc., a leading developer of advanced health plan administrative systems, has added support for Medicare sequestration to the HEALTHsuite Mercato enterprise solution. Health plans utilizing HEALTHsuite Mercato now have fully automated capabilities to support the Medicare payment reduction requirement.
On March 8, 2013, the Centers for Medicare and Medicaid Services (CMS) published information about the Mandatory Payment Reductions in the Medicare Fee-for-Service (FFS) Program, also known as sequestration. Sequestration requires a 2 percent reduction in Medicare Part A and Part B provider payments under the Medicare Fee-for-Service (FFS) program. CMS also implemented the 2 percent sequestration reduction for Medicare Advantage plans as a reduction in the plan’s capitation payment from Medicare. HEALTHsuite Mercato supports this processing requirement and also provides health plans with the adaptability to meet this requirement in a fashion that best meets their needs; including allowing clients to alter the reduction percentage over time and support retroactive cancellation.
“We partnered with our Medicare clients to quickly understand how they intended to implement the Sequestration cuts and incorporated their requirements into our solution,” stated Robert A Tulio, President of RAM Technologies. “With HEALTHsuite Mercato health plans can specify which provider contracts and payment methodologies are subject to the reduction.”
“HEALTHsuite Mercato provides health plans with advanced capabilities to automate Medicare administration,” added Mr. Tulio. “This enhancement provides our clients with the flexibility to administer and automate this new regulation.”
“We are thrilled that RAM Technologies was able to respond so quickly to this requirement,” said Ron Robinson, Health Plan of San Mateo’s Director of Finance and Administration. “We thought we were going to be forced into some form of workaround or manual process to support the sequestration requirement, but with HEALTHsuite Mercato it is all taken care of.”
HEALTHsuite Mercato is an enterprise application that simplifies the administration of Medicare, Medicaid, Dual Eligible and commercial offerings. From auto-adjudication to workflow to fulfillment, the entire process has been transformed, yielding better results across the enterprise. Functions include member management (enrollment and eligibility processing), benefit administration, provider contracting and reimbursement, provider credentialing, utilization and medical management, care management, claim adjudication, encounter processing, overpayment recovery, subrogation, capitation, customer service and contact management, fulfillment, premium billing, management and operational reporting, electronic data interchange and more.
eHealthsuite is RAM’s innovative Internet portal product that facilitates on-demand access to information for the health plan’s members and providers, reducing the expense and time associated with customer service calls. eHealthsuite allows the health plan constituents to access their information in real-time, and to conduct transaction processing remotely through a secure Internet connection.
About RAM Technologies, Inc.
RAM Technologies (ramtechnologiesinc.com)is a leading provider of enterprise software for the healthcare industry. For over 32 years RAM Technologies has led the way in the creation of superior software solutions for health plans serving Medicaid, Medicare, Commercial, and Federal Employee Health Programs. RAM Technologies has been recognized on Inc. Magazine’s List of Fastest Growing Private Companies for the last four years and has also been featured in the Philadelphia Business Journal’s Lists of Top Technology Employers and Top Software Developers.