A One Stop Shop for Members to manage their coverage, search for benefits, find care, understand claims, and track prior authorizations. While it primarily focuses on enabling ease of self-service, thereby reducing operational workload for enterprises, it also simplifies and enhances interactions with Member Engagement teams.

Policy, Coverage(s), & Benefits

• Access detailed views of health (medical, dental, vision), life (basic and voluntary), and supplemental plan benefits
• Comprehensive policy and coverage dashboard
• Ability to manage and update member contact information

Finding Care & Cost Estimation

• Access care dashboard with options to find practitioners and facilities based on specialty, condition, or symptoms
• View practitioner and facility details, including location-based search with map view

Claims Management & Prior Authorizations

• View comprehensive claims dashboard for all coverages
• Access summary and detailed views of claims
• Initiate new claims for health, dental, life, disability, or accident coverage
• View submitted prior authorizations with search, sort, filter, and download capabilities

Notifications

• Manage notification settings for preferred channels and topics (claims, coverage changes, etc.)
• Receive notifications about member information and coverage change initiated by others

BrokerX is designed to simplify Client Acquisition, Management & Retention for Agencies & Agents.  It brings capabilities to manage the entire lifecycle of clients, covering pre-sales, sales, and post-sales at fingertips. Some of the most used and high-impact features include quoting and proposals, managing their book of business, accessing commission statements, and gaining ready access to insightful analytics.

Equip Your Brokers With End-To-End Client Management Capabilities

Book of Business

• View and manage complete list of business groups, including detailed overviews and dashboards

Sales Support

• Tools for quoting and managing sales-related information

Membership Management

• Access and manage member details (demographics, contacts, salary)
• Enroll new members, add dependents, and manage member coverages based on life events
• View and manage benefits, including the termination of members and dependents

Billing Management

• Consolidated financial overview for all billing accounts
• Manage invoices (view, sort, filter, download) and payment accounts, including posting payments for both list-billed and self-billed accounts
• Access historical payment data for billing accounts

Claims Access

• View submitted claims for both groups and members with robust filtering, search, and download capabilities

Reporting

• Access to payer-generated periodic reports

With the needs of employers in mind, the platform is designed to allow effortless management and oversight of employee benefits and usage. Employers can easily manage their group membership, including open enrollment, life change events, member profile information, understanding plan benefits, invoices, and plan performance.

Hassle Free Onboarding

• Access and manage member details (demographics, contacts, salary)
• Enroll new members, add dependents, and manage member coverages based on life events
• View and manage benefits, including the termination of members and dependents

Member & Policy Management

• View consolidated member data (demographics, contact, family, coverage, claims, and benefits)
• Enroll new employees, add dependents, terminate members or dependents, and manage qualified life event-based changes
• Manage beneficiary details for life and accident coverage

Comprehensive Dashboard

• Track outstanding payments, health claim financials, membership statistics, high claim policies, and open enrollment stats
• Receive notifications for pending bills, draft enrollments, and other actionable items

Billing Management

• View consolidated financials, past and outstanding invoices, and manage payment accounts (EFT)
• Post payments to client systems and verify new/edited payment accounts using external services

Documents & Content Management

• Access payer-issued documents and health claim forms with searchability

Programs & Campaigns

• Define and issue campaigns to members for communication andengagement

Reports

• Access pre-configured and on-demand reports, including demographics, open enrollment summaries, benefits cost, compliance, claims, and more
• View statistical data on stop-loss numbers and employee-level claims

Claims Access & Prior Authorization Management

• Access detailed views of submitted claims with search, sort, filter, and download options
• View and manage prior authorization submissions with search, sort, and download functionality

The platform is designed to cater to both in-network and out-of-network providers, enabling them to understand patients’ benefits, track claims status, payments, and appeals, as well as manage referrals and prior authorizations. It also integrates with the provider empanelment process, offering a comprehensive and unified digital experience for providers.

Claims & Prior Authorization Management

• View summary and detailed claims information, including prior authorizations
• Submit medical, dental, and vision claims online with AI-enabled features for streamlined submission
• Submit new prior authorization requests for medical and dental services.

Comprehensive Dashboard

• Quick access to check member eligibility and claim financial statistics based on historical data
• Notifications for claim and prior authorization updates
• Infographics displaying recent claims and prior authorizations

Member Eligibility & Benefits

• Search for members and access their eligibility and coverage details
• View details of past patients and their coverage benefits.

Payments & Financial Account

• View and manage direct deposit details
• Access historical claim payments for financial records

Notifications

• Receive updates on claims, prior authorizations, and network affiliation (empanelment) status

Reporting

• Access various payer-generated reports for performance and business tracking