News and Events
Meritain Partners With GTESS to Streamline Claims Processing
Fast-growth health care administrator taps Software as a Service (SaaS) provider of claims automation technology to earn competitive advantage for growing consumer-directed business
June 6, 2006 (Amherst, NY; Richardson, TX) Meritain Health, Inc., a leading independent provider of services for self-funded health plans, and GTESS Corporation, a leader in providing total pre-adjudication claims processing technology to the health care industry, today announced the signing of a five-year contract to automate and consolidate Meritain’s front-end claims operations. The partnership, reached after a competitive review, provides Meritain with a single integrated pre-adjudication technology solution that will process substantially all of its paper and EDI claims and related documents. The GTESS System™ will enhance the claim submission to improve payment accuracy and timeliness, while driving dramatic cost improvements due to the high level of automation produced by The GTESS System. Meritain purchased the full suite of applications available from GTESS, in addition to certain other professional service offerings. The GTESS System is leading edge technology that automates claim receipt, conversion of paper to EDI, claim editing and clean-up, and PPO network re-pricing. The GTESS technology replaces error-prone labor models that utilize offshore outsourcing solutions with a technology solution that is 100% U.S. based.
“Partnering with GTESS gives us a high quality and efficient set of technologies to support the high growth rates we have been experiencing as a result of our organic growth and acquisitions,” said Elliot Cooperstone, CEO of Meritain Health. “GTESS also allows us to focus on our core, high value processes of promoting behavior change among our members through effective consumer directed plan design and execution, in order to better control health care costs for our clients.”
“Meritain’s selection of GTESS as its Software as a Service (SaaS) provider of pre-adjudication technology is a testimony to their progressiveness,” said GTESS CEO and President Deb Gage. “More and more health plans and administrators are seeking alternative solutions to offshore outsourcing vendors who are returning cost increases of 15% or more each year and delivering variable quality. The GTESS System is a way to achieve much more cost effective and higher quality claims without the risks associated with offshore arbitrage models.”
“As Meritain continues its expansion, its new highly scalable front-end will not only handle increasing claim volumes at a low cost basis, it will also benefit from easily implemented applications and upgrades.”
About Meritain Health, Inc.
Meritain Health is one of the country's largest independent providers of services for self-funded health plans. Meritain Health serves over 500 self-funded clients nationally, with over 500,000 members in more than 30 major industries. The company provides plan administration, innovative wellness, medical management, disease management, network management, and cost management services. Meritain Health is also a pioneer in, and now the leading independent provider of, consumer-directed health plans. Meritain Health employs more than 750 people, with regional offices in Baltimore, MD; Boston, MA; Canton, OH; Cleveland, OH; Columbus, OH; Evansville, IN; Houston, TX; Indianapolis, IN; Memphis, TN; St. Louis, MO; as well as the company headquarters in Buffalo, NY.
About GTESS
GTESS Corporation provides health care payers and plans with total pre-adjudication processing technology called The GTESS System. A suite of integrated client-customized software applications, The GTESS System completes data conversion, claim cleaning, and claim edit resolution while providing transparent integration of data back to the client environment. Using web-deployed software, GTESS clients can replace expensive outsourcing resources with scalable, updatable technology, driving efficiencies and dramatically lowering costs.
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Ellen Donahue-Dalton
GTESS
401.398.7816
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