HEALTH INSURANCE PREMIUM BILLING AND PAYMENT

Innovation Made Easy.

Reduce Administrative Costs. Improve Member Satisfaction.

Nearly 50% of all complaint calls to payer call centers are billing related, driving up operational costs while driving down client satisfaction scores and client retention rates. Yet, up to 80% of payers have not yet fully automated their premium billing platforms to improve billing accuracy.

Plus, customer expectations around billing accuracy, clarity and ease of payment will continue to grow as they have in other sectors. To be successful, payers need to exceed those expectations by utilizing modern technology to automate and improve every billing and payment touchpoint.

That’s where Certifi comes in. Our highly configurable cloud-native health insurance premium billing platform automates core billing functions. Plus our unique Perfect Balance™ design ensures the accuracy and reliability of every billing transaction, helping payers deliver a better customer experience on a  more efficient, accurate premium billing platform.

Upgrade Your Insurance Premium Billing Platform.

Configurable Billing Rules

Whether it’s a group list bill, an ASO bill, an individual bill or an employer self-bill, Certifi includes the tools you need to configure every bill type. You can set grace periods, tolerance thresholds, billing frequency, run and period dates and more. Our rules-based configuration simplifies the addition of new coverages and products.

Dynamic Rate Calculations

Our billing system calculates rates when billing transactions are created instead of relying on “stored” rates, improving accuracy. Plus, our Perfect Balance™ system improves the accuracy of retroactive billing by always storing matched transactions.

Invoice/Bill Creation

Whether it’s a paper invoice, a coupon book, an eBill and/or email notifications, our invoice and billing generation tools simplify billing. We can help you automate billing for core health coverages, specialty coverages like vision or life or other non-insurance coverages like wellness, saving time and reducing administrative costs.

Payment Portal

Payment Processing

Whatever payment method is required, Certifi has you covered. In addition to a payment portal accepting one-time and recurring payments, we can also accept paper checks via a lockbox and even have a retail cash payment network. Plus, we’re implementing artificial intelligence to match unrecognized payments with accounts, streamlining payment application.

Delinquency Management

Our rules-based delinquency management simplifies the creation of collections triggers – like days from last action, days from last delinquent date, a defined day in the month, etc. – with any number of actions. Plus, delinquency notifications can be configured to include any messaging you require.

Reporting

From summary management reports like premium history, monthly payments received, aging and suspense reports to detailed management reports like extensive reporting of payment activity, payment issues, declined payments and returned payments, Certifi delivers the information you need to make informed business decisions.

Future-proof Technology.

Modular

Our modular design makes it easy to replace your legacy billing system or current billing solution with our modern technology. We integrate with upstream enrollment or downstream accounting systems, making it easy to plug in a configurable, modern billing solution to replace your legacy or less advanced technology. Plus, our rules-based setup means you can configure our solution to meet future plan design requirements, without wasting your expensive programming resources.

Scalable

Certifi’s software is designed to scale by leveraging dynamic computing technology to efficiently increase processing capacity. Because our technology architecture relies on auto-scaling, we can easily meet peak demand for processing resources by automatically adding and removing capacity in real time.

Resilient

With Certifi, you’ll gain peace of mind knowing your data is always secure and accessible. Resiliency is achieved through simultaneous hosting in multiple availability zones and a geographically diverse backup environment.

Health insurance premium billing and payment that delivers happier customers and lowers administrative costs.

Why Perfect Balance Matters.™

A typical billing transaction can contain many components on the receivable and payable side. Our unique two-sided transaction structure ties those components together, delivering a unique two-sided transaction structure that is the key to providing consistent, reliable financial management.

Because transaction sets don’t close until both the funding and payment sides of the transaction complete, it forces balance and virtually eliminates reconciliation.

Charge Type Payment Method Bill To/Remit To Rate
Receivable Member Self-Pay Member $550.76
Payable ABC Health Plan $424.01
Payable ABC Dental Plan $68.55
Payable XYZ Broker $56.20

Improve the Member Experience.

In today’s competitive, consumer-driven healthcare environment, health insurers need to be responsive to their members and customers.

Certifi’s premium billing and payment tools help insurers deliver a better member experience. We deliver:

  • Accurate bills thanks to Perfect Balance™.
  • Access to self-directed tools showing billing and payment history.
  • Online one-time bill payment or recurring payments.
  • Cash pay at retail locations nationwide.

Seeing is Believing.

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