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Medical

SKYGEN USA’s Enterprise System for medical offers automated technology to advance payers’ medical business.

SKYGENUSA Powering Healthcare for the Digital Age

Our platform allows for streamlined processing of medical authorizations and claims, from heart and joint care to transplant services involving continuous care. For payers transitioning from fee-based to value-based reimbursement programs, the Enterprise System for medical supports the full spectrum of payment models, including an episodes of care approach and bundled payments.

Enterprise System for Medical Primary Capabilities

  • Product and benefits administration design configuration and price management
  • Member eligibility determination and enrollment
  • Member engagement management and servicing
  • Premium invoicing, collections, and funds reconciliation and distribution
  • Claims editing, adjudication, processing and reconciliation
  • Provider network management and payment
  • Healthcare data analytics and reporting
  • Regulatory and compliance support