SKYGEN Enterprise System is the leading integrated SaaS benefits automation platform for commercial and government payers across dental and vision lines of business. It helps payers automate every aspect of benefits management, from claims payment, premium billing, and utilization management to regulatory compliance, fraud detection, and member and provider services. The platform is comprised of a relational database with more than 40 modules, each designed for a specific benefits administration process, highly automating payer benefits administration, supporting ongoing regulatory requirements, and aligning with industry standards. SKYGEN’s Enterprise System is intelligent, flexible, scalable, and secure—helping drive cost reduction and competitive advantage.

Features

• Serves both dental and vision markets
• Automated member enrollment
• Provider network and data management
• Multiple payment models, including value-based
• Rapid scalability across markets as needed
• Healthcare data analysis, real-time executive dashboards, and built-in standard reports
• Comprehensive, end-to-end provider data management supported by self-reported data from provider portal
• Continuous claim processing and daily payments
• Maintain consistent compliance
• Minimize coding errors
• Instant online claim estimator and EOBs
• Self-service clinical guidelines
• Flexible plans and stacked networks
• Integrated portal solution
• Customized platform for your needs
• Seamless transition for TPA solutions clients
• Exceeds industry quality standards, with error-free rates of 97% measured over a 12-month study

Benefits

• Automates every aspect of dental and vision benefits management
• Reduces costs and drives competitive advantage
• Enables rapid scaling and new product launches
• Improves access to quality care and provider satisfaction
• Enhances the overall healthcare experience for members
• Supports ongoing regulatory requirements and industry standards
• Provides real-time data and executive dashboards for better decision making
• Ensures consistent compliance and minimizes errors
• Delivers a seamless transition for TPA solutions clients