Our HMO Reconciliation

A summary of the feature

The HMO reconciliation feature is tailored towards helping hospitals cater to their
financial reconciliations with HMO providers. Due to unbalanced accounts and records,
hospitals lose millions of unclaimed funds to HMOs which happens on a month to month
basis. Many hospitals engage in capitation services with some HMO’s and
organizations without fully understanding if that agreement is healthy for them or not.
The Hyella system/software provides a two in one solution, allowing you to successfully
and permanently tackle issues that arise with HMO providers.

HMO feature users

Admin, HMO officers, billing officers, and healthcare providers in general.

Why should customers buy the HMIS in order to use the HMO Reconciliation feature?

Hyella, the future of hospital management, offers solutions that facilitate the ease of
daily operations, business functions of healthcare providers and help to curb
imbalances.
HMO providers, by virtue of their agreed partnership with various hospitals, assist the
patient when it comes to medical expenses, thereby relieving the burden on the patient.
The Hyella software erases the confusion that comes along with patients switching from
“private paying” to being HMO covered payments”, allowing the “Accounting” books to
be balanced rather than the manual, cumbersome, and tedious process of cross
referencing over a thousand patients with over 50 different HMOs to be able to do a
claim or raise a (claims form). With Hyella, manual reconciliation and backlogs in the
process will be a thing of the past. Reconciliation however, is not restricted to HMOs
alone, it could also be with corporate bodies, e.g health insurance for employees of a
particular company.Hyella gives you accurate real time data for your healthcare facility, making the
workflow seamless, easier, and more efficient. The fact is, patients keep coming in and
work must be done. So, as soon as a patient enters the facility, all processes are
documented and handled in order to prevent stress in the long run.