Simplify Healthcare powers connected benefits and provider journeys for Payers through a scalable, enterprise-grade, secure, compliant, and configurable cloud based software platform — Simplify Health Cloud™. Packaged on the Simplify Health Cloud™ — Benefits1™, Provider1™, Service1™, Claims1™, and Experience1™ provide Payers with discrete and precise solutions to complex problems and opportunities in delivering a rich set of products, benefits, and provider data. Simplify Healthcare also enables Payers to build enterprise solutions with speed and innovation on a configurable, secure, and low-code application development platform — Simplify App Fabric™.
Benefits1™ — Creates a single source of truth for product and benefits data with automated business rules and workflows to fulfill all compliance and mandated document generation requirements.
Provider1™ — Creates the master record for all provider data with automated rules and workflows to simplify provider management processes like contracting, onboarding, credentialing, reimbursement models, roster file management, and provider directories.
Service1™ — Enables customer service representatives to handle and resolve all benefits inquiries with an AI- and NLP-powered search engine to provide accurate responses to benefit inquiries from members, providers, employers, and brokers.
Claims1™ — Business rules and workflow-driven claims management platform that transforms benefits and provider data into a consumable format for the Core-Admin systems while enabling claims adjudication and configuration testing.
Experience1™— Rules-based master content management platform that pulls up-to-date benefits data from repositories to enable the generation, streaming, and personalization of content to members based on rules and customer metadata.
Simplify App Fabric™ — Configurable, low-code application platform that enables rapid, secure application development and zero-friction deployment within a Payer’
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Industry
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Software Development
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Company size
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501-1,000 employees
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Headquarters
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Aurora, Illinois
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Type
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Privately Held
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Founded
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2008
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Specialties
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Healthcare IT, Payer Solutions, Benefit Systems, Benefit Data Synchronization, Value-based Payment, Reimbursement Solutions, Benefit Plan Management , Value-Based Reimbursement, Value-Based Reconciliation, Provider Data, Medicare Advantage, Provider Lifecycle Management, Digital Business Process Transformation, ANOC/EOC, CMS PBP, Provider Contract Management, Provider Directory, Medicare Compliance, ACA Compliance, SBCs and SOBs, Qualified Health Plans, Healthcare Contract Management, Medicaid Benefit Plan Management, CMS Compliance, Low-code application, Healthcare IT Consulting, Claims Management, Customer Service, Provider Credentialing, and Group Health Plans
