The AdminaHealth Billing Suite

Turn Your Bill Consolidation, Benefit Reconciliation, and Payment Management on Auto

The AdminaHealth Billing Suite automates benefits reconciliation, bill consolidation, and payment management across the landscape of employee benefits. Even the most complex client requirements or plan architecture can be managed through the AdminaHealth Billing Suite.

Use some or all of the capabilities of the AdminaHealth Billing Suite to ensure fast, accurate, and headache-free billing management. Then utilize the data to make better business decisions.

AdminaHealth Billing Suite

With the AdminaHealth® Billing Suite you will:

  • Streamline one of the largest expenses of your business
  • Save time with automation – ditch the spreadsheets
  • Find simplicity – a central place to manage all your bills
  • Reduce errors through AI algorithms and automation
  • Have confidence in accurate billing

How It Works

Rules Engine graphic

Rules Engine

Connect to the AdminaHealth® Billing Suite through an Enrollment Feed via your current system or file. The AdminaHealth Billing Suite includes a Rules-based engine. In addition to enforcing state and federal mandates, pricing, and contractual agreements, customers can define their own rules to meet their specific requirements.

After going through the Rules Engine, you can use your data for the following:

So many bills to keep track of for many different carriers and other benefits vendors! Our Billing Suite consolidates it down to one bill, one payment.

Bill consolidation graphic

  • Receive one bill consolidating all your benefit costs
  • Break down your single bill for chargebacks by subsidiary, department, P&L, or even employee
  • Fully customize your billing to satisfy all unique billing situations
  • Offer employees as many benefits as you wish without worrying about additional billing management burdens
No more comparing mountains of paper against each other! Reconcile payments, evidence of insurability, payroll, nearly anything and everything else you can imagine!

Reconciliation graphic
  • Ensure you pay the right amount to each provider, for each benefit, reconciled against your enrollment
  • Avoid premium overpayments
  • Reconcile against additional feeds, like payroll, to ensure accurate deductions and confirm evidence of insurability for life plans
  • Support all three payment requirements: self-bill, list-bill with short pay, and list-bill without short pay
  • Automatically report self-bill enrollment information to the provider as needed: eliminate filling out, signing, and sending in forms or manually entering information on websites

Vendor Reporting provides you a single pane of glass view to information such as enrollments, payments, and exceptions to all vendors while communicating exceptions and self-bill reporting directly to the vendors and carriers, automatically and accurately.

Making payments just got easier. Approval processes and electronic execution of transactions mean you don’t have to chase anyone down for signatures, and you don’t have to mail out your payments.

Payment management graphic
  • Authorize one payment for the amounts due all providers
  • Break down payments by subsidiary, department, or P&L, effectively automating internal chargebacks
  • Remit payments to each vendor accurately and on time through the Federal Banking System
  • See all your benefits-related financial transactions in one place, in real time, on the consolidated benefits ledger

Data science and analytics graphicYour data, plus our AI algorithms and reporting, enable you and your client to make better business decisions.

  • Find knowledge in the data: what it all means and how it can help you make better decisions for your clients
  • Receive actionable insights into your benefit offerings and utilization from AdminaHealth Data Science & Analytics to improve decision making

Dependent eligibility graphicEnsure that enrolled dependents are eligible for coverage and avoid having to make expensive and difficult amendments and changes later. Every new dependent is automatically checked for eligibility in the enrollment feed, ensuring you remain in compliance and are not paying for ineligible dependents.

Broker & Consultant Highlights:

AdminaHealth® provides you and your clients with the tools necessary to manage, audit, reconcile and transact payments for all fixed and variable expenses related to health and voluntary benefits. Our platform is comprehensive, yet flexible, allowing our bill consolidation and premium reconciliation to be easily applied to both fully-insured and self-funded groups.

Bill Consolidation and Premium Reconciliation

Your clients receive one fully-customized bill consolidating all benefit costs, apportioned for chargebacks by subsidiary, department, P&L, or employee. Sell additional benefits to your clients without worrying about additional billing management burdens.

Total Bill Reconciliation

Tell your clients with confidence that their bills are reconciled and they are paying the right amount to each of their vendors. Reconciliations are against enrollment as well as additional feeds, such as payroll, to ensure accurate deductions and confirm evidence of insurability for life plans. Our solution supports self-bill, list-bill with short pay, and list-bill without short pay.

Payment Management

Authorize one payment for the amounts due all providers, and break down by subsidiary, department, or P&L, effectively automating internal chargebacks. Remit payments to each vendor accurately and on time through the Federal Banking System. See all your benefits-related financial transactions in one place, in real time.

Self-Funded Plan Administration

Whether a client is currently self-funded or transitioning to self-funding, maximize resource efficiency with our plan administration. Meet operational accounting needs in relation to cost allocation, reporting, and cash-flow management. An automated approval process with notifications makes reviewing, approving, and transacting weekly and monthly expenses a breeze.

  • Reduce time and resources required to manage benefit costs while ensuring accuracy
  • Enhance efficiency with our “review and approve” process for actioning all financial transactions relating to health, voluntary benefit, and claims expenses
  • Streamline operational process from invoice received to transaction of payment
  • Reduce risk of overpayment for coverage in relation to group plan additions/adjustments

TPA & Carrier Highlights:

The AdminaHealth® platform enables TPAs and Claims Administrators to streamline all billing, reporting, and payment transactions. Our platform integrates with existing systems to simplify and centralize all benefit and financial administration, consolidate billing, and reconcile invoices with payment transactions through the federal banking system.

The invoicing and payment end of client management should be streamlined, automated, and low-touch. With AdminaHealth® tasks can be performed with as little or as much involvement as your organization requires. Save time and energy with a solution that complements your claims administration system and lets you focus on business priorities.

Swift Resolution

To client-driven billing adjustments

Bill Approval

And payment transactions via wire and ACH

Automate

Auto-generate broker commission reports and retroactive adjustments

Captive and Association Administrators

The AdminaHealth® platform assists in the implementation, administration, and financial management of Captive insurance products. Streamline administrative, reporting and payment processes with our comprehensive Captive management solution. Associations, school districts, and union Administrators can now easily bill each association member, yet create one bill inclusive of all association members.  

Maximize Capability

Efficiently administrate payment tasks for all insurance services

Simplify Billing

Payment and reporting with electronic payment transactions through wire, ACH, debit or credit

Automated Notifications

Approval for all transactions

Employer Highlights:

The AdminaHealth® platform provides a comprehensive, yet flexible solution to improve operational efficiency while gaining tighter controls and visibility into your health and benefit spend. Manage, reconcile, and transact payments for all fixed and variable expenses related to health and voluntary benefits.

Whether you are fully-insured and need a faster, easier way to perform monthly premium reconciliation, or are a self-insured organization with multiple subsidiaries and the need to charge back costs by product group or P&L, we can help.

Reduce Risk

Of leakage or overpayment for coverage in relation to group plan additions/adjustments

Minimize Time & Resources

Required to manage benefit costs while ensuring accuracy

Enhance Efficiency

With our “review and approve” process for actioning all financial transactions relating to health, voluntary benefit, and claims expenses

Client Use Case Examples

  • Self-funded clients: delivering value to self-funded plans for over five years now by easing the process of transitioning from fully insured to self-funded and automating the increased administrative burden
  • Fully insured clients: offering consolidated billing/automated reconciliation and payment management to large and small fully insured groups
  • Associations and Captives: removing complexity from the back-office administration and billing management of associations and captives
    • with an Association overall view and simultaneously a separate Association and Captive member view
    • Consolidated invoices and one-click payments
    • Club money from members – pay all vendors out with funds apportioned
  • HRO services
    • Fully automate bill consolidation for your clients. Remove the headache of semi-automated bill consolidation
    • Reduce costs, improve operational efficiencies, re-allocated resources
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