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Certifi, Inc
IT Services and IT Consulting
Edina, Minnesota 901 followers
Premium Billing for Group, Individual, Medicare & Medicaid
About us
Certifi is an industry-leading, on-shore, software & services company. Created in 2006 by health care benefit experts with deep domain experience in information management and business optimization services. The firm’s area of focus is squarely on financial management for health benefits exchange. Certifi has been selected by significant public and private entities to manage exchange financials and successfully processes well over 10 million billing & payment transactions monthly. Certifi was the first reform-ready consolidated billing solution for a state exchange and is still in production today in Utah’s Avenue H health care exchange.
- Website
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http://www.certifi.net
External link for Certifi, Inc
- Industry
- IT Services and IT Consulting
- Company size
- 11-50 employees
- Headquarters
- Edina, Minnesota
- Type
- Privately Held
- Founded
- 2006
- Specialties
- SaaS for Health Care Exchange Billing, Payment & Accounting, Health Care Administration Technology, and SaaS for Dependent Eligibility Auditing
Locations
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Primary
5050 Lincoln Dr
Suite 450
Edina, Minnesota 55436, US
Employees at Certifi, Inc
Updates
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A major milestone has been reached in the fight to lower drug costs! The Centers for Medicare & Medicaid Services (CMS) has announced the first-ever negotiated prices for 10 Medicare Part D drugs. These new prices, set to take effect in 2026, represent significant discounts compared to list prices. Key takeaways: - Negotiated prices range from 38% to 79% lower than list prices. - Medicare could save billions of dollars annually. - Beneficiaries will also see reduced out-of-pocket costs. Learn more: https://hubs.ly/Q02LYb9N0
HHS Releases Prices for Medicare Negotiated Drugs
managedhealthcareexecutive.com
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Governor Brian Kemp announced that Georgia has received federal approval to establish its own health insurance exchange. This move follows legislation passed last year authorizing the creation of a state-based exchange. What this means: - More Georgians could gain access to health insurance: A state-based exchange allows for greater customization of outreach efforts and resources, potentially increasing enrollment. - Potential cost savings for the state: Georgia might avoid federal exchange user fees and redirect those funds towards other healthcare initiatives. Learn more: https://hubs.ly/Q02LYk5F0
Gov. Kemp says Georgia has 'green light' for state health insurance exchange
11alive.com
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A new KFF report reveals that Medicare Advantage (MA) enrollment continues to skyrocket, with over half of eligible beneficiaries now enrolled in these plans. While this growth presents opportunities, it also raises concerns about market concentration and the overall cost of the program. Key findings include: - Significant variation in MA enrollment across states and counties - Dominance of a few major insurers in the MA market - Growing scrutiny over MA plan payments and the impact on beneficiaries Learn more: https://hubs.ly/Q02LY07r0
Attorneys: Humana settles whistleblower suit for $90M
fiercehealthcare.com
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Elevance Health has unveiled a new tool to assess and improve individual and community health: the Whole Health Index (WHI). This index measures health on a scale of 0-100, considering physical, behavioral, and social factors. By identifying key drivers of health, the WHI empowers healthcare organizations to develop targeted interventions and improve overall well-being. Elevance Health is now sharing WHI data with select employers in Missouri and Virginia, offering valuable insights into population health trends. Learn more: https://hubs.ly/Q02LY1RY0
Elevance Health's Whole Health Index Demonstrates Opportunity to Improve Health
elevancehealth.com
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Blue Cross and Blue Shield of Texas is celebrating a major milestone: Their Special Beginnings® Maternal and Infant Health Initiative has positively impacted nearly 50,000 Texans in just one year. This program focuses on improving maternal and infant health by: - Increasing access to care - Reducing care gaps - Educating and engaging communities Learn more: https://hubs.ly/Q02LYfmP0
BCBSTX's Maternal and Infant Health Initiative Serves Nearly 50,000 Texans in Year One
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Specialized tools often outperform bundled solutions. This applies to health plans too. Many settle for bundled enrollment and billing software, but dedicated solutions offer significant advantages. Enrollment and billing have distinct complexities. Enrollment software tackles user experience, data accuracy, plan comparison, and eligibility verification. Billing excels at handling transactions, invoicing, payments, and delinquencies. Learn why more health plans are turning to distinct enrollment and billing solutions rather than a combined solution: https://hubs.ly/Q02DW-W60
The Power of Separate Enrollment and Billing Software for Health Plans - Certifi
https://www.certifi.com
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Harvard Pilgrim Health Care is partnering with Good Measures to offer a personalized nutrition coaching program to eligible members! This program can help you: - Lose weight and prevent chronic diseases through personalized nutrition counseling and coaching. - Develop healthy eating habits with support from registered dietitians. - Track progress and set goals using the Good Measures app. - Access educational resources including online classes and recipes. Learn more: https://hubs.ly/Q02LYmHc0
Good Measures and Point32Health to Deliver Food as Medicine Program — Good Measures
goodmeasures.live
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Is your health plan struggling with manual, error-prone premium billing processes? It's time to unlock the potential of premium billing software! By automating repetitive tasks, improving accuracy, and offering enhanced payment options, premium billing software can significantly boost your health plan's efficiency and profitability. Discover how software can: - Save valuable time and resources - Increase revenue through accurate remittances and reduced write-offs - Improve member satisfaction and retention - Provide valuable insights for data-driven decision-making Learn more: https://hubs.ly/Q02LPdPF0
Understanding Premium Billing Software ROI: Cost Savings and Revenue Improvements - Certifi
https://www.certifi.com
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The Centers for Medicare & Medicaid Services (CMS) has introduced a new demonstration program aimed at stabilizing Medicare Part D premiums following significant changes introduced by the Inflation Reduction Act (IRA). The IRA introduced a $2,000 out-of-pocket spending cap for Medicare beneficiaries and limited Part D premium increases to 6% annually. These changes increased costs for Part D plans. CMS is offering a voluntary three-year program for standalone Part D plans to reduce the base beneficiary premium, limit premium increases, and share financial risk with the government. Most Part D plans are anticipated to participate in the demonstration, which could help stabilize premiums and limit beneficiary disruption. Some lawmakers have questioned the legality of the demonstration and its potential impact on the federal budget. Learn more: https://hubs.ly/Q02KXXLp0
CMS Unveils Premium Stabilization Demonstration to Curb Part D Premium Increases - Certifi
https://www.certifi.com