WLT's Certified Business Partner Program
WLT is setting the standards for quality on behalf of its Clients. As such, WLT has adopted strict guidelines for its Certified Business Partner Program.
Certified Business Partners have agreed to go through a rigorous process of development, testing and quality assurance. This ensures that WLT Clients will be able to easily utilize WLT's Certified Partner's products and services directly from their WLT applications.
Many companies have approached WLT, offering to integrate their product(s) with the WLT applications. After careful consideration and discussion, WLT has come to the conclusion that there are only a few companies willing to put forth the effort and resources required. WLT's goal is to provide its Clients with the best tools available to encourage and facilitate growth within our industry by helping our Clients increase revenue while reducing their costs.
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WLT is proud to welcome Coalition America, Inc. as its 1st Certified Business Partner.
WLT Software of Florida, Inc. and Coalition America, Inc. (CAI) announce a new integrated product called “The EDI Connector”.
"The EDI Connector" is a solution that enables direct electronic communication from the Benefit Administrator (such as a TPA) to CAI. Specifically, the TPA can now use their WLT system to pull eligible out-of-network claims and transmit them via EDI directly to CAI for repricing. The bills are efficiently and quickly returned electronically to the Client for auto-adjudication. The process also provides key edits of the claims prior to sending to CAI resulting in improved workflow and a reduction in costs associated with “ineligible” claims.
Who is CAI?Coalition America, Inc. (CAI) is the leader in medical claim savings, specializing in reducing the cost of in-network and out-of-network medical bills for group health and workers' compensation plans. We accomplish this by providing access to over 100 preferred provider organizations (PPOs) nationwide, negotiations services, and leading edge technology to streamline your repricing and adjudication processes. As a result, we saved our clients over $795 million since our inception in 1995.
HistoryCAI was founded in March 1995 in Atlanta, Georgia by Scott and Sean Smith. CAI was created to provide a unique solution to the healthcare cost-containment challenges faced by employers, insurers, payors, HMOs, re-insurers and MGUs. Today, Coalition America works with over 300 clients representing more than 12,000 businesses nationwide.
Mission StatementTo be the leader in healthcare cost containment and claims transaction efficiency.
Core Values- Creativity & Innovation
- Customer Sensitivity
- Job Expertise
- Perseverance
- Positive Attitude
- Team Work
- For our employees, "the best place ever worked!"
- For our customers, "unsurpassed customer service!"
- For our community, "investing in a better tomorrow!"
- For our industry, "lead the market!"
- For our shareholders, "continuous profitable growth!"
- Significantly reduced medical costs
- Streamlined repricing and adjudication processes
- Access to over 100 PPOs nationwide
- Increased profitability
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Motivano
WLT is proud to welcome Motivano as a Certified Business Partner.
Motivano is the leading provider of electronic payment solutions for employee benefits and consumer-directed health care (CDHC) accounts. We service 170 third party administrators and health plans, as well as over 4,000 of their corporate clients. Many Fortune 100 and Fortune 500 companies and their employees look to Motivano's services to simplify and lessen the costs of their healthcare experience. A partial list of our clients includes; Citigroup, GlaxoSmithKline, Time Warner, Aon, Blue Cross of California, Wachovia Securities and many other quality driven organizations. Here are just a few reasons why so many Administrators and Employers are choosing the SmartFlex Debit Card:• True Auto-substantiation
• IRS Compliant Technology
• Automated online repayment of ineligible expenses
• Multi-purse and stacking accounts
• Real time balances
• SureTrak – a comprehensive web portal for account management
• Multiple Pharmacy options
• Overflow accounts for post tax funding
• Custom card design
• Flexibility for systems integration
• Access to all key industry software systems
• Secure Member Site, providing detailed transaction information
• Automated account funding system
• Marketing support
• Always have access to live agent
• Technical support
SmartFlex is a convenient prepaid Visa card that enables employees to pay for qualified healthcare, dependent care, transit, and parking expenses with pre-tax dollars, all while using just one card. Motivano's intuitive payment card technology debits the appropriate account, checks real-time balances, and helps prevent inappropriate use. www.motivano.com
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NMHC
WLT is proud to welcome National Medical Health Card Systems, Inc. (NMHC) as a Certified Business Partner.
National Medical Health Card Systems, Inc. (NMHC) is an established leader in managing prescription drug programs for HMOs, employers, local governments, union groups and third party administrators.
For over two decades, NMHC, headquartered in Port Washington, NY with service centers in Latham, NY and Little Rock, AR has been raising the bar by striving for innovation in technology, and unmatched clinical and service experience. The company's efforts have proven successful: ranked #6 on Fortune magazine's 2004 "America's 100 Fastest Growing Companies" list, a significant increase from its #27 ranking in 2003. This impressive standing - the only PBM in the top tier and one of just two PBMs in the entire listing - is a strong indication of the level of market acceptance for NMHC's groundbreaking Total Healthcare Solutions approach.
NMHCRX's success is a win for our clients. The company offers benefit providers a totally integrated program solution that includes:
- Internet pharmacy access and NMHCMAIL, a mail-service that is faster, cheaper, and more convenient.
- NMHCASCEND, our specialty pharmacy that proactively supports management conditions for the growth of biotechnology drugs.
- A national retail network of over 56,000 pharmacies.
- Our cutting-edge health information management services through NMHCINTEGRAIL, www.Integrail.com, that delivers comprehensive analyses of data.
- Complete clinical pharmacy intervention and management programs.
Clients choose to work with NMHC because of its ability to extend beyond standard service approaches and provide customer-focused pharmacy benefit programs. In some cases, NMHC has helped clients reduce the typical 15-20 % annual increases in pharmacy costs to as little as 1-4% by:
- Building customized pharmacy benefits programs for each client to address its unique needs, rather than applying a standard program template.
- Relying on clinical and service expertise to implement benefits programs quickly and effectively, thus reducing member issues.
- Predicting plan members at risk and recommending proactive strategies that benefit both the individual and the plan.
- Providing professional pharmacy services that reduce the costs of specialty drugs that are expensive yet medically essential.
- Offering an independent services approach without affiliation or allegiance to any drug or pharmaceutical company.
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Adminisource
WLT is proud to welcome AdminiSource as a Certified Business Partner.
AdminiSource provides a fully integrated and comprehensive system to effectively address the challenges inherent in the healthcare payment and remittance distribution process. AdminiSource has become the largest independent healthcare payment and remittance advice distribution company in the country.
The knowledge and expertise of AdminiSource dates back to 1989 when its executive management were providing systems and output support services as an internal supplier to Fortune 500 insurance and health carriers. In 1992, this team began providing outsourcing services commercially to the healthcare, insurance and financial industries as an enterprise of Anthem.
After a number of successful years, a group of five executives who are still involved in the daily operation of the company today, purchased a block of business managed by Anthem's Dallas facility and relabeled it as AdminiSource in 1998.
AdminiSource is a privately held corporation located in Carrollton, Texas and has become the premier print and mail outsourcing vendor for the healthcare industry in areas of quality, price, and customer service. AdminiSource services clients nationwide and produces payments for over 6,000,000 claims per month, distributing more than 300,000 transactions per day.
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United Claim Solutions
WLT is proud to welcome United Claim Solutions as a Certified Business Partner.
United Claim Solutions (UCS) was established to assist insurance companies and healthcare payors in reducing the cost of in-network and out-of-network medical claims. All of UCS’s services are delivered with the attention to detail necessary to maximize medical claim discounts. Our team examines every claim to determine a path that will enhance savings while limiting any chances for reversals of the discounts that some experienced from other out-of-network repricing organizations. We have the flexibility to create and customize our services to meet your specific needs.
All of our services are delivered in a seamless and efficient manner either through MediWeb or through your WLT system. Any WLT or MediWeb user can choose UCS as their preferred vendor. Once this is done, a user can have their WLT system pull eligible claims and transmit them via EDI to UCS for repricing and/or bill negotiation.
www.unitedclaim.com-Back-
PHX
WLT is proud to welcome PHX as a Certified Business Partner.
PHX delivers advanced cost management solutions for health plans. The company combines claim processing automation with professional services to deliver a centralized approach to cost management, increasing savings in both the near and long term while dramatically reducing errors and turnaround time. The firm’s solutions are used by a number of the industry's leading insurance companies, Health Maintenance Organizations (HMOs), and Third Party Administrators (TPAs). Services included in the PHX solution include bill review and audit, secondary repricing/claims negotiations, fraud and abuse detection, and health benefits trend analysis and reporting. All services are handled in-house for maximum privacy and legal and regulatory compliance. PHX also supplies full technology implementation, training and support for quick, seamless integration into any organization. Visit www.phx-online.com for more information.-Back-
WLT's Other Vendor Partners
A & G Healthcare Services, LLC
A&G Healthcare Services is a national leader in solutions for Primary and Secondary PPO networks. A&G features a National Travel Wrap Network -- Amera-Net, along with proprietary systems for BPO services including mailroom, scanning, imaging, OCR and HIPAA compliant EDI. www.aghealth123.com
BLI is a service bureau company that cleanses and converts network provider, facility, and fee schedule data into our client's software specifications. BLI can perform a full provider cleanup from current data residing on your system and in turn manage your network data monthly. This is accomplished through cross-reference tables built per client network entity. BLI has a unique duplicate provider detection algorithm. This algorithm flags duplicate providers, which are immediately deleted and never forward on to our clients. We currently work with more than 320 networks monthly and have processed in excess of 200,000,000 demographics and billions of CPT codes since conception. Our newest, innovative service "Sure Hit" gives our client the cutting edge in auto-adjudication by guaranteeing a 98% provider hit ratio on all EDI claims. www.baseload.com
Captiva Software (ADP Context)
Provides UCR database. www.captivasoftware.com
DenteMax
Provides a national dental PPO. www.dentemax.com
Eagle Business Solutions, LLC
Provides service for the Oracle database and supplemental Oracle consulting and support services. www.eaglebusinesssolutions.com
Health Care Insight
Provides services for detecting and preventing health care claim overpayments. www.hcinsight.com
Healthx, Inc.
Healthx partners with payors to market and deploy a comprehensive suite of Web-based services for their employer clients. Healthx products turn slow, inefficient and expensive information processes (phone, fax and paper) into fast, effective and low-cost electronic processes delivered via digital networks including the Internet. In addition to basic on-line services such as enrollment, paid claims and eligibility look-up, Healthx provides cutting-edge services such as a customer service tool for time-stamping, routing and reporting of inquiries and responses, a document management system to eliminate out-dated, hard-copy forms and documents, sophisticated messaging tools, reinsurance reporting, preventative health links, and complete Web site branding and customization. www.healthx.com
Interactive Payer Network
Interactive Payer Network, InterPayNet, is a service organization operating as a hub for healthcare business-to-business electronic data interchange. InterPayNet assists payers, providers, and patients with the most efficient means of delivering information necessary for prompt settlement of healthcare bills. InterPayNet utilizes information processing technologies and assures the privacy, security, and integrity of the information it delivers. Through its extensive links to the major national and regional clearinghouses, and its well developed imaging, OCR, data verification, and repair and image reproduction technologies, InterPayNet provides a single source of HIPAA compliant electronic data in and out for all claims data at a substantial savings in time and money. www.interpaynet.com
Ingenix Health Intelligence
MDR Updates. www.ingenix.com
JMS and Associates, Inc.
JMS provides "Simple Solutions for Complex Problems" to the Health Care Payor Industry. Our solutions begin with receiving EDI and Paper Caims, Converting Paper to EDI, Claim Validation & Correction of Eligibility and Provider Data, Network Routing, Web Claim Viewer Systems, and Remote Adjudication Services. To find our more visit us at www.jmsassoc.com or call us at (248) 489-8888.
Liberty Data Products
Offers a complete line of continuous and laser forms and supplies for all office needs, including checks, statements, invoices, ID Cards, forms, and more. www.libertydp.com
National Marketing & Administration
Provides low-cost, high quality plan administration and claim adjudication services to medical and dental payers. www.nmatpa.com
Socrates, Inc.
SOCRATES, INC. is the only healthcare claims recovery firm that provides outsourcing services and software programs to health payors so that they achieve recovery rates that exceed industry norms with unparalleled case management from the WLT claims processing platform. The MY SOCRATES© software was developed by legal, claims recovery and programming experts. We have 15 years of health payor industry knowledge.
With over 15 years of experience, SOCRATES, INC. serves the healthcare payor industry and has a diverse customer portfolio, including health plans, third party administrators (TPAs), self-funded welfare benefit plans, Medicaid and Medicare products and governmental plans. Providers such as WellPoint®, Definity Health, Inc., John Deere Health, UnitedHealthcare®, Meritain Health, f/k/a North American Health Plans, along with a variety of BlueCross BlueShield licensed plans, have benefited from SOCRATES, INC’s outsourcing services and software. www.socratesinc.com
Tela Sourcing LLC
Tela is a BPO services provider based in the United States & India. We focus on providing BPO services to Health Payers, Health Plans, Third Party Administrators (TPAs) and other managed care vendors who are exploring the possibility of outsourcing business processes. Our focus is on the healthcare (payer) industry in the United States. Our primary service offering includes mailroom, scanning, claims data entry & claims adjudication outsourcing.
We have a very strong onshore as well as offshore management team with experience in offshore outsourcing as well as the healthcare industry. Our mission is to work with our clients in providing them with end-to-end and cost effective solutions across the entire healthcare value chain and enable them to draw competitive advantage in the marketplace. www.tela-usa.com
Provides flexible, dependable, and cost-effective solutions for the handling, printing, and distributing of claims communication. www.emdeon.com
Contact WLT
WLT Software2410 Northside Drive, Clearwater, FL 33761 USA
Phone: (727) 442-9296
Toll Free: (877) 807-4730
Fax: (727) 443-4936 email us for more information