ikaSystems Corporation provides Web-based enterprise resource planning technology for process automation and intelligence management to support health insurers' commercial, and Medicare and Medicaid businesses. The company offers member portal, which supports administrative self-service; provider portal that automates processes, such as eligibility verification, claims submission, and authorization and referral submission and approval; employer portal, which includes online census/claims submissions, roster management, off-cycle transactions, electronic billing/reconciliation, and employer reporting functions for administrators; and admin portal that enables health plan administrative staff to complete transactions and manage health plan processes. It also provides ikaClaims, a claims administration and customer service system that delivers auto-adjudication rates; ikaBilling, a configurable premium billing solution, which allows health plans to set their rules for late payments and benefit revocation, and members and others to make payments online; ikaDWH, a database for claims, laboratory, pharmacy, encounter data, practice management, and electronic medical record information that supports standard and ad hoc report generation; and ikaCM and ikaDM, solutions that connect disease and case managers, physicians, and patients for information sharing and collaboration, as well as provides identification, stratification, enrollment, monitoring, alerting, and self-management tools. In addition, the company offers ikaProHEDIS+, a Web-based application that combines analytic and workflow tools to enable quality management; and ikaP4P, an real-time pay-for-performance application that allows health plans to define their
P4P programs, set up P4P parameters, and monitprograms. It serves companies in the commercial, government, telecommunications, insurance, and financial sectors. The company was founded in 1999 and is headquartered in Southborough, Massachusetts.
Blue Cross Blue Shield Association