Monument Systems xpress™ Smart Series
Creating and Delivering Value to Health Plans
Monument Systems provides information technology for the managed care, Medicare, Medicaid, and commercial health plan markets.
Monument's state of the art enterprise system, xpress empowers health plans through information integration (administrative, clinical, and financial), integrated care management (embedded workflow, medical management, and clinical integration), and powerful financial management (enterprise reporting and analysis) through core administrative systems focused on process improvement.
Monument Systems solutions enable high visibility to manage financial performance, operational efficiency, and comprehensive member interaction.
Healthcare Reform is directed at cost containment and patient wellness. The challenge is for Health Plans to be empowered to deliver value and confidence to their members.
Monument Systems xpress™ Smart Series integrates your organization, your providers, and your members.
Information Integration-Roadmap to Wellness
xpress Smart Series provides rapid and efficient access to information and the ability to leverage health information for patients that creates opportunities for plans to improve care and direct patients to engage in wellness activities that will lower their future care costs and improve their ability to manage their individual care.
Care Management-Plan to Patient Collaboration
xpress Smart Series delivers the ability to harvest information for determining the best course of care for patients and to collaborate with patients on seeking appropriate care that delivers predictable treatment plans, tracks episodic care management and facilitates improved outcomes.
Workflow Automation-Streamlining Internal Operations
xpress Smart Series packages a unique suite of tools and technologies that implement an event driven environment that creates a workflow model to provide dynamic process improvement in customer service, inter-departmental collaboration, information management, process automation, and overall operational efficiency.
Monument Systems xpress™ Smart Series
A New Decade Solution that Helps You Deliver Health Care Reform.
Tangible Benefits
Monument Systems xpress™ supplies payers with complete integration of healthcare business processes through its enterprise workflow design. The solution's robust functionality delivers quantifiable value to payers through:
- Reduced medical loss ratios
- Improved quality of care
- Highest ratio of functionality per dollar
Robust Functionality
- Workflow >
- Monument Systems xpress™ features Workflow integration, throughout the entire system, to enhance efficiency and to support internal and external communications for your organization. The workflow functionality provides a means for managed care organizations to mirror and automate business operational flows and automatically route tasks directly to the appropriate users responsible for the task. Automated workflow ensures that issues for follow-up and other processing tasks move at an efficient pace and that they are completed in the prescribed order and timelines defined by the managed care organization.
- Enrollment/Benefits Management >
- Monument Systems xpress™ simplifies benefit plan administration with the ability to define and manage multiple services, products, lines of business and benefits within a single group. It also provides quick access to membership data, enrollment management and eligibility data, as well as information needed to perform premium billing and accounts receivable management. The system provides managed care organizations the ability to capture an unlimited amount of user defined member data events that may be required and specific to individual lines of business. ID cards can be produced in formats that allow for easy customization.
- Provider/Facility Contract Management >
- Monument Systems xpress™ helps managed care organizations manage complex provider and facility contractual arrangements including fee-for service and capitation models within the same provider contract. Single Providers, Provider Groups, and Provider Vendors, including multiple locations by each segment, are seamlessly organized within the system. Each can be related to multiple contractual arrangements, specialties, network affiliations and other demographics.
- Claims Processing >
- Automate your provider, facility, vision, and dental claims processing by utilizing administration automation that includes a comprehensive list of on-line edits and automated pricing. Your organization can significantly improve claims auto- adjudication rates for large volumes of claims which results in the reduction of manual labor and increases the speed and accuracy of claims payments for all lines of business.
- Medical Management >
- Monument Systems xpress™ provides flexible medical management capabilities through an integrated set of components to streamline the management of referrals, authorizations, pre-certifications as well as case, risk and grievance requirements. Automated workflow items can be used to automatically generate internal and external communications to your constituent's. Quick access to claims, benefit, provider and member data is an integrated part of the system to provide information quickly and easily during the management of care. High risk case indicators can be assigned to complex cases for quick and easy access. Integration with Workflow management allows for automated work queues, administrative monitoring, and identification and search features. Estimated costs can be automatically calculated for IBNR and financial management.
- Customer Service >
- Managed care organizations experience quick entry and access to information with Monument Systems xpress™. User defined reasons and actions along with the ability to attach claims, referrals, authorizations, events and notes provides customer service innovation for each unique call from your constituents. This innovation is further augmented with automated correspondence and reporting systems along with customer service scripting capabilities. Scripting provides you with the ability to implement best practices based on user defined information as it relates to the specific reasons and actions for a call. Advanced functionality provides immediate access to call history, member history, benefit history, enrollment history, and claims history that contributes to improved service and customer satisfaction quickly and easily.
- Extensive Reporting >
- Managed care organizations benefit from Monument Systems xpress™' reporting toolkit, which includes a full range of standard reports, ad-hoc reporting capability, role based report security and menu driven screens that allow you to manage report distribution by each functional area within Monument Systems xpress™. Automated reporting is integrated with system generated events allowing you to automate the selecting and running of reports based on user defined rules. Our Menu driven Job Queue and report schedulers allow you to run reports in advance to reduce administrative overhead.
- Electronic Commerce(EDI) >
- Monument Systems xpress™ offers managed care organizations with innovative Electronic Commerce solutions to meet today's changing standards through user defined rules, edits and transaction processing to reduce administrative overhead while expediting the exchange of information between you and your trading partners.
- Medicare Advantage >
- The Medicare Advantage module is designed to automate Medicare Advantage Part C and Part D-related processing, including enrollment reconciliation and RAPS processing while minimizing costs, eliminating the need for third party intervention, and processing demands for managed care organizations.