PowerMHS

PowerMHS is a fully-integrated information system for health plan administration, including large health insurance carriers and Blue Cross and Blue Shield plans. Benchmarked to support six million members, PowerMHS is a multi-company, multi-option, multi-fund system, created to handle complex benefit structures, complicated provider reimbursement arrangements, integrated utilization management and intelligent claims processing.

Achieve Operational Efficiency with Superior Information Technology
PowerMHS is a fully-integrated, highly flexible, scalable, industry-proven health plan administration system that is benchmarked to support six million members. PowerMHS delivers reduced administrative costs for you and improved service for your members, groups, providers and other trading partners. Working with leading health plans across the industry, DST Health Solutions developed PowerMHS to meet the needs of large healthcare payers and the managed care market.

The Right Solution for Your Health Plan Enterprise
PowerMHS is designed to handle large volumes efficiently and to interface easily to other enterprise systems. PowerMHS delivers intelligent claims processing and web-enabled applications.

• Flexibility is the key to PowerMHS efficiency. User-defined options and setup allow health plans to achieve high levels of auto-adjudication and customize the system for unique processing needs.
• Intelligent design and an efficient graphical user interface (GUI) make PowerMHS easy to use and support.
• Integration with Web applications promotes customer self-service producing operational cost savings.
• HIPAA-ready provisions, including EDI transactions and customizable security, increase regulatory compliance and administrative simplification.
• APIs and other integration functionality provide a framework for your administration system to connect seamlessly with legacy and best-of-breed applications.

PowerMHS Delivers the Functionality Needed by Large Health Insurance Carriers and Blue Cross and Blue Shield Association Plans
PowerMHS enhances worker productivity, allowing you to accomplish more work with less administrative staff. Our user support services make recruiting, training and deploying staff easier, increasing your ability to secure and support new business more quickly and cost effectively. Major areas of functionality include:

• Member enrollment
• Member services
• Benefit administration
• Premium billing
• Provider management
• Provider reimbursement
• Utilization management
• Claims productivity
• Claims adjudication
• Financial management
• Reporting

DST Health Solutions delivers optional PowerMHS functionality that is specifically designed to support the information processing needs of Blues plans, including ITS Home/Host processing.

PowerMHS Technical Architecture
PowerMHS is available as an IBM iSeries host-based application which runs on the OS/400 operating system using a DB2/400 database with a TCP/IP communication protocol. PowerMHS utilizes a graphical user interface (GUI) product by Seagull Software called GUI/400.

For more about PowerMHS, contact us at inforequests@dsthealthsolutions.com.