Technology Services

To provide health care administrators with assistance at every stage of care, ILS utilizes an integrated, cloud-based technology platform.  Our proprietary platform captures patient data from physicians, behavioral health specialists, pharmacists, long-term care providers, and others to create a full picture of the member’s health. The intuitive software identifies those most at risk by facilitating collaboration among care managers, health plan staff, and providers.

The data is distributed across the enterprise in real time. That provides enhanced capabilities for program identification, gaps in care documentation, care planning, and the identification of any undesirable outcomes.

Our technology platform automates and integrates core functions using a shared platform. Consolidated data may be leveraged to provide information to various stakeholders. Data includes:

  • Enrollee enrollment and reconciliation
  • Provider credentialing and network management
  • Benefit and contract management
  • Predictive modeling / risk stratification
  • Case management
  • Service authorization and referral management
  • Claims processing
  • Coordination of benefits and third-party liability detection
  • Fraud and abuse detection
Technology Services
  • Capitation and risk fund management
  • Consumer directed care support
  • Customer service
  • Electronic data interchange

The system supports the integration of data feeds from third-party systems to include: membership enrollment files; historical medical, pharmacy, and laboratory claims; and providers.