AveCare

AveCare is a healthcare financial technology solution offered by Zelis Healthcare. According to the vendor, it aims to modernize and streamline the payment and claims management processes for healthcare payers and providers. AveCare caters to businesses of all sizes, including health plans, third-party administrators (TPAs), medical and dental insurance carriers, property and casualty carriers, and Blues plans. Professionals and industries in the healthcare sector rely on AveCare to optimize their financial performance and improve the efficiency, accuracy, and transparency of healthcare payments.

Key Features

According to the vendor, AveCare offers the following key features:

Seamless Claims Management: AveCare streamlines the entire claims lifecycle, from submission to adjudication, aiming to reduce administrative complexities and improve accuracy.

Automated Payment Optimization: AveCare leverages advanced algorithms and data analytics to automate payment optimization, with the goal of identifying cost-saving opportunities and reducing payment errors for improved financial performance.

Real-time Payment Tracking: AveCare provides real-time payment tracking capabilities, aiming to enhance transparency and visibility into the payment process for timely follow-up and issue resolution.

Network Optimization: AveCare includes network optimization features that help healthcare payers and providers build, optimize, and maintain high-performing provider networks, aiming to ensure cost-effective and quality care.

Compliance with Regulatory Requirements: AveCare is designed to ensure compliance with healthcare industry regulations such as the No Surprises Act (NSA) and Transparency in Coverage (TiC) regulations, according to the vendor.

Efficient Provider Communication: AveCare facilitates secure and streamlined communication channels between healthcare payers and providers, aiming to enable the exchange of necessary information and reduce delays.

Intelligent Analytics and Reporting: AveCare provides intelligent analytics and reporting capabilities, aiming to offer actionable insights into financial performance, claims trends, payment patterns, and other key metrics. This is intended to enable data-driven decision-making and operational optimization.

Enhanced Member Engagement: According to the vendor, AveCare empowers members with personalized care selection, cost estimation, and care navigation features, aiming to enable informed decisions and cost-effective care options.

Streamlined Enrollment and Communication: AveCare aims to simplify the enrollment process with automated communications, aiming to reduce administrative burdens. It also facilitates secure and efficient communication with members, aiming to enhance satisfaction and engagement.

Integrated Platform: AveCare is designed as an integrated platform that consolidates various healthcare financial processes into a single solution. According to the vendor, it brings together claims management, payment optimization, provider network management, and member engagement functionalities, aiming to provide a comprehensive and cohesive solution for healthcare payers and providers.