HBM+’s Advantage is the most progressive system in the marketplace today. Our single system offers a patient-centric approach for our flexible, responsive delivery and maintenance of quality benefits management services.
All HBM+ online services - including our mobile applications and providerConnect, our health care provider-specific transactional website, as well as services - are driven by the Advantage system and will enhance the plan member and provider experience.
Capacity on demand, the elimination of legacy systems, reduction in system development and maintenance, and precise compliance with new legislation all contribute to your bottom line.
With an HBM+ solution, you will lower your administration costs, helping you to continue to remain competitive in your market.
At HBM+ developing customized solutions includes reflecting your brand as an integral part of the solution we build with you. Our goal is to seamlessly connect your clients with your organization – not ours.
We deliver business solutions that have the capability to feature your own corporate brand for any or all of these services and tools:
- ID cards
- Claim forms
- Online plan member services
- Mobile app for plan members
- Online administration services
- Reports
- Online provider services
Outsourcing back-office operations lets you take control of your administration expenses and focus on the things you do best – your core business. HBM+ offers an extensive range of solutions to support benefits administration and claims management for our clients:
- New business implementation and configuration
- Eligibility and billing
- Claims adjudication for drug, dental, extended health services and health care spending accounts
- Prior authorization services for prescription drug claims and other complex health services
- Call center services to support plan member and provider inquiries
- Fraud prevention and detection
The solutions we offer are based on our experience and expertise as a health benefits manager. By understanding your needs, we can develop a solution that will save costs and manage benefits in the most efficient way.
As a leader in benefits fraud prevention and detection, HBM+ offers Claim Watch: a comprehensive and multi-layered approach that tackles fraud and abuse head on. Recognizing the interdependency between fraud management, quality claim adjudication, and health care provider management, Claim Watch is an integral element of HBM+’s provider management solution and is supported by two other vital components:
- The providerConnect portal gives health care providers across Canada access to the National Provider Registry, secure services for direct deposit and online claiming, claim forms, administration guidelines, and more
- The National Provider Registry is a centralized database of over 400,000 registered health and dental providers authorized to submit claims and/or bill participating carriers directly. It’s updated daily with the provider-specific information required to properly adjudicate claims and to authenticate and certify each health care provider
HBM+ boasts extensive expertise in providing health benefits management and technology solutions to the private and public sectors in Canada.
Our knowledge comes from our people. We hire and retain experienced specialists to develop and maintain our clients’ customized solutions, providing value to your organization and maximizing your success. Here’s what they bring to the table:
- Solid and proven technology
- Implementation and project management
- Account management
- Pharmacy benefits management
- Health benefits management
- Client service
- Fraud, abuse, and waste management
