Payers Gain NCQA Compliance With Release of AboveHealth(R) 3.2

DARIEN, Ill., July 22 Healthation's, next generationAboveHealth (AH) portal solution delivers a rules-based,claims-system-agnostic, real-time communication and administration to healthplans. AH allows payers to manage web-based communication and transactions forboth commercial and regulated lines of business in support of medical, dental,pharmacy, vision, life, and disability. AH offers highly customizable portalsfor Members, Employers, Providers, Health Plans, TPAs, and Brokers.AboveHealth(R) enables users to streamline processes, increase productivity,and support regulatory compliance in one single solution.

AboveHealth's Provider Directory is now updated to meet NCQA criteria,helping health plans to comply with NCQA accreditation standards. The NCQA, anon-profit organization focused on improving the quality of healthcare, hasrecently established standards and guidelines for managed care organizations(MCOs) in the areas of member rights and responsibilities as well asinformation and services available to members. Improvements to the ProviderDirectory include the ability for members to filter results to show only themember's LOB and Network(s); view the providers' specialties, certifications,and education; and view the facilities' accreditations; and search forhospital and group affiliation.

AboveHealth now features provider scorecards that make provider ratingstransparent for end users. President Bush's August 2006 executive ordermandates all health plans that administer benefits to Federal Employees mustadhere to the 4 Cornerstones of Transparency: increase transparency in qualityof care, increase transparency in pricing, encourage adoption of healthinformation technology (HIT) standards, and create positive incentives thatpromote quality and efficiency in health care. The provider scorecards onAboveHealth's Provider Detail pages supports health plans by allowing them todisplay the rating categories and scores that health plans generate from theirown system. Provider rating areas include Member Satisfaction, ClinicalQuality, and any other rating category the health plan determines. Both thecriteria to determine the scores and how the scores are displayed can betailored to meet the needs of the business plan, making the provider scorecardhighly configurable.

AboveHealth rolls out new Member Interventions feature. MemberInterventions is a tool providers use to view procedures that the health planrecommends be performed within a specific period of time. Health plans definethe 'measure' and the 'steps' to be considered by the member's physician andAboveHealth displays the resulting intervention request. When this feature isturned on, the intervention status appears at key locations on member basedpages, signaling whether or not the member has active interventions forconsideration. Clicking the status takes the provider or member to themember's Intervention List where all measures and steps in effect as of thecurrent or specified search date can be viewed.

About Healthation -- Darien, IL- based Healthation is a healthcare claimsprocessing and portal solutions software company helping health plans, thirdparty administrators and self insured employers improve business performancewith user-driven, rules-based, open architected, benefits management andtransaction processing solutions. Healthation's goal is to accelerate a retailtransformation in healthcare with a real-time, open exchange platform.Healthation offers two industry leading products to the payer industry. TheAboveHealth solution is a next generation claims-system agnostic, rules-basedportal and AcceleHealth(R), the industry's only web-based payer system builtto administer benefits in real-time across all lines of business under onemaster member record, including medical, dental, vision, pharmacy, life, andAD&D.

SOURCE Healthation