Products > Mcare Features

HealthSoft Mcare™ is a fully functional and integrated information system designed for the growing segment of new and emerging risk-bearing managed care organizations. Because of the number of plan variations and options with this ever-changing market, Mcare is designed for flexibility with the ability to benefit large group practices, Independent Practice Associations (IPAs), Management Services Organizations (MSOs), Physician Hospital Organizations (PHOs) and any other provider group that is contracting with one or more health plans to provide health care services to a specific population.

Organizations will find Mcare is one of the most cost-effective medical claims adjudication and processing systems in the market place developed to effectively manage health plan contracts, pay medical claims, process referrals, track individual eligibility, monitor individual or group medical benefits.

Mcare is completely HIPAA compliant and has the ability to electronically process all the ANSI standard transactions. By developing strong partnerships with leading healthcare IT vendors, HealthSoft brings a web-based presence so organizations can check eligibility, submit referrals, access referral info, submit claims and review statistics of claims through a web portal.

Mcare™ System Features and Functions

Network Provider Management
Flexible Health Plan Benefit Management and Administration
Membership Services
Capitation and Fee-For-Services
Referral Processing
Hospital Pre-Certification
Claims Adjudication
HIPAA Compliant
Compliant and Grievances
Provider CredentialingCase Management