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SHMS Payer Platform Reviews & Product Details

Strategic Healthcare Management Systems (SHMS) enables health plans of all sizes reduce administrative overhead. SHMS has segment-specific products for healthcare payer organizations (claims/contracting/adjudication, provider networks, enrollment/member management, risk adjustment, etc.) as well as powerful EDI tools to support automated electronic interaction between vendors.

Seller

Strategic Healthcare Management Systems

Product Description

Strategic Healthcare Management Systems (SHMS) enables health plans of all sizes reduce administrative overhead. SHMS has segment-specific products for healthcare payer organizations (claims/contracting/adjudication, provider networks, enrollment/member management, risk adjustment, etc.) as well as powerful EDI tools to support automated electronic interaction between vendors.

Overview by

Sunil Joshi

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SHMS Payer Platform Reviews (2)

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Scott G.

Chairman Of The Board

Mid-Market (51-1000 emp.)

12/8/2023

"SHMS - The optimal system for MAPD start ups and mid level organizations"

5/5

What do you like best about SHMS Payer Platform?

SHMS is a healthcare technology vendor that offers a fully integrated compliance and operation system for small to medium sized managed care organizations primarily focused on MAPD.

The SHMS system handles member enrollment processes, grievance & appeals, provider data management, contract management, claims adjudication, risk management data submissions EDS, medical management, member services, capitation, ODAG/CDAG & operational reporting and analytics and much more. Implementation and Change Management with SHMS was fantastic and the technical environments are current and scalable.

My partners and I utilized this system as the foundation of our HealthSun Health Plans Operations that was tightly integrated into over 30 medical clinics, several stand alone pharmacies. Additionally, we used their system for MMM-FL MAPD Operations.

Great system for new and up and coming MAPD organizations with all the hooks already built in to CMS and Regulatory Agencies. Review collected by and hosted on G2.com.

What do you dislike about SHMS Payer Platform?

An overall flexible and agile system that enables customers to hit the ground running quickly. Very knowledagble staff both technically and industry perspective that works closely with the client. There is very little to dislike about the SHMS. Review collected by and hosted on G2.com.

What problems is SHMS Payer Platform solving and how is that benefiting you?

SHMS is designed as an end to end business platform serving all areas of an MAPD organization. The beauty of an SHMS system is the tight integration of its modules by business function. From an enterprise technology platform perspective the SHMS systems covers a vast set of the organizations system, operational and regulatory requirements. The SHMS system is built on a state of the art platform that is scalable as your organization grows. There are very few peripheral systems required to meet the ever demanding needs for administering a compliant CMS program. Review collected by and hosted on G2.com.

DM

Diana M.

Tech Project Manager

Enterprise (> 1000 emp.)

12/6/2023

"High Adaptability and Responsiveness for Pivoting Business Needs"

5/5

What do you like best about SHMS Payer Platform?

I've been working one on one with this platform for over 8 years. As a project manager in a constantly changing environment, SHMS is able to adapt and respond immediately to our business need. Whether it be a CMS requirement, or a process improvement enhancement, SHMS is to provide fast turnaround and real time responsiveness. We are able to collaborate to meet timelines and work with their team to meet goals as an organization.

The system itself is very user friendly. The vendor is available for support. The readiness for implementation of enhancements is top notch. Review collected by and hosted on G2.com.

What do you dislike about SHMS Payer Platform?

If we ever do run into roadblocks, the vendor has always been available to provide support as needed. No dislikes about this. Review collected by and hosted on G2.com.