Health Insurance Exchange / Marketplaces (HIX)
To facilitate coverage expansion, the ACA establishes health insurance exchanges, or marketplaces, which allow individuals to choose among competitive plans. With the open enrolment in insurance products offered through the federal and state health marketplaces begins, individuals gain more control over how they spend their healthcare dollars. These new marketplaces will allow individuals with low to moderate income to purchase insurance eligible for government subsidies.
ICD-10 COMPLIANCE (REMEDIATION)
Healthcare organizations are being challenged to provide quality services and comply with regulatory requirements without losing eye on keeping costs in check. Integration between payers and providers is crucial in achieving this and this has traditionally been done using expensive EDI solutions and proprietary VANs (value added networks) for exchanging claims, enrolment, eligibility, and payment advice information.