Value-Added Services for the Medical Community & Their Employees

Medical Personnel

HealthSmart’s innovative solutions set us apart from the competition. We understand the complexities and challenges that today’s hospitals are confronted with, as both employer and provider. We have the depth and experience to provide great service and client-centric solutions that work:

  • Customizable Benefit Administration Solution
  • Single Administrative Platform
  • Reduced Dependence on Major Carriers
  • Tiered Domestic Networks
  • Payment/EOB Suppression
  • Predictive Population Management & Wellness Solutions
  • Provider Specific PBM Solutions
  • Online Member Service Tools
  • Dedicated Claim & Account Management Team

Our wide range of competitive products and services appeal to both large and small medical centers. When risk pools are combined, group members enjoy the economies of scale that were once only afforded to larger organizations.


Customized Programs & Community Alliances Bring Added Benefits

We tailor health benefit programs to seamlessly integrate with and support the local hospital’s services. Our ability to develop customized plans with services that include health, wellness, network, pharmacy and care management makes it possible to work closely with hospitals and businesses to uniquely strengthen local relationships and serve the whole community.

Virtually Unlimited Plan Design Options

Our system’s flexible plan-building component allows us to accommodate a variety of benefit programs. Features of our state-of-the-art system include:

  • Benefit Plan Flexibility
  • Fully Automated Edits
  • Real-time Online Processing
  • System Security
  • Fully-integrated Provider Management
  • EDI Capabilities
  • HIPAA Compliant
  • Check Supression
  • Ability to Tier Benefits & Networks
  • Domestic Fee Schedule Loading
  • Cashless Processing Capabilities

Experienced & Professional

Our commitment is to provide the highest level of customer service during the settlement of members’ claims.

  • Dedicated “Hospital Service Team” That Are Carefully Selected & Monitored for Quality
  • Member Access to Web-based eServices & Toll Free Number
  • Employer Service Representatives (ESRs) Are Assigned to Each Client
  • Customer/Member Service Representatives Provide Personalized Service With Consistently Positive Outcomes
  • Claims Examiners Are Extensively Trained & Experienced in:
    • Investigating Eligibility
    • Coordination of Benefits
    • Unreasonable Charges & Exclusions
    • Medical Terminology & Practices
    • Claim System Application
    • Client Specific Benefits