Value Proposition Significant new savings, administrative efficiency and key functionality for healthcare consumers, providers, and payors Today's complex health insurance products put a new level of financial obligation and administrative strain on insurance companies, providers and healthcare consumers. TriHealix streamlines the entire process by simultaneously moving healthcare and financial information from the point of care - to the insurance company - to the consumer's financial institution - and back. It enables combined benefit and claim adjudication, financial payment capability, healthcare data sharing and more for providers, payors and consumers. Features and benefits are tailored to each segment: Value for Consumers Value for Providers and Pharmacies Value for Payors: Health Plans, Administrators, Employers, PBMs Value for Consumers Convenience and safety: traditional health plan ID and payment cards are integrated into one, easy to use card. Multiple sources of funds are tied to a consumer's card including checking, credit, FSA or HSA accounts. With no financial account numbers printed on the card and its advanced PIN security, the TriHealix card is the safest transaction card today. Access to credit: consumers may apply for an optional line of credit to help finance deductibles and other out of pocket healthcare expenses. Maximized reimbursement: TriHealix technology is capable of automatically debiting from a consumer's multiple financial accounts to help maximize benefits and reduce out of pocket expenses at the point of care. Freedom from claim forms: by linking tax-advantaged accounts such as FSAs or HSAs, consumers benefit from electronic substantiation of qualified expenses and automatic debiting at the point of care, freeing them from paper reimbursement requests. Integrated statements: consumers receive a single, understandable statement of activity for all healthcare related transactions. The statement integrates medical and prescription drug claim details, includes accumulated benefit balances, provides transaction detail and account balance information for multiple financial accounts, and builds a personal health record. Value for Providers and Pharmacies Integrated destination gateway: a common entry point for both healthcare and financial transaction processing initiated by either the swipe of a card or submission of a claim. Electronic claim submission is enabled reducing claim costs and lowering settlement costs. Access to multiple sources of funds: providers will have access at the point of sale to multiple sources of funds which helps to maximize reimbursement with or without the swipe of a card. Funds include a consumer's insurance benefits as well as a variety of financial accounts such as checking, credit, and FSA or HSA accounts. Improved cash flow and reduced bad debt: the consumer financial authorization occurs inside the healthcare claim. Both payor and consumer responsibility are authorized with the submission of a single claim, collapsing front and back-office administration, improving reimbursement and reducing billing and collection efforts. Integrated reporting and statements: integrated reporting of pharmacy, healthcare and financial transactions is enabled, as well as electronic substantiation for tax-advantaged accounts. Providers receive a single statement reflecting both payor and consumer responsibility for quick and easy reconciliation. Value for Payors: Health Plans, Administrators, Employers and PBMs Integrated and dynamic ID cards: TriHealix creates the opportunity to replace traditional health ID cards with a fully customizable, integrated health ID and payment card. With its multi-purse capabilities, the TriHealix card integrates all consumer financial accounts - debit, credit, FSA, HSA, etc. Because the TriHealix card is dynamic, there is no need to reissue cards to members as benefits change or new accounts are added. The card's dynamic capabilities also ease the addition of new functionality as it is introduced over time. Multi-Purse management: a solution for payors to manage and sequence (i.e. direct prioritization of) multiple financial accounts and insurance benefits for its members using a highly configurable rules engine. A utility for a payor or a payor's account administrator is available to manage eligibility and substantiation rules to be applied to FSA/HSA claims processed through the TriHealix Platform. Auto-substantiation: automated, electronic substantiation of qualified pharmacy and medical expenses for tax-advantaged accounts (FSAs, HSAs) eliminates the need for consumers to make out of pocket payments and paper claims for reimbursements. Administrators gain efficiencies through reduced documentation requests and manual transaction analysis to verify purchase eligibility. Merchant services gateway: a robust gateway integrating healthcare and financial transactions with minimal impact to existing provider workflow. Combining both healthcare claim and financial transaction processing facilitates electronic claim submission and significantly reduces administrative costs for both payors and providers. Increased operating efficiencies: creates standardized connectivity between all parties to enable financial and non-financial transactions including eligibility and benefit adjudication. The TriHealix Platform integrates with other operating systems and links to Web-based portals to facilitate electronic claim submission and intelligently route transactions to the appropriate parties. Messaging and incentive platform: a rules-based platform capable of delivering personalized targeted messages, rewards and electronic coupons to consumers via the Web, e-mail or text message. Integrated statements: deliver an integrated statement to providers reflecting both payor and consumer payment for quick and easy reconciliation. Similarly, provide a truly integrated experience for consumers with an integrated consumer statement - a single, understandable record of all healthcare related activity. Business intelligence: TriHealix leverages its data warehouse and transaction repository for substantiation and reporting. © 2008 TriHealix, Inc. All Rights Reserved. | Terms of Use | Privacy Policy