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A single app with the strength of many
Healthcare SuperApp
For starters, we like to think of ourselves as a SuperApp that unites the healthcare ecosystem to deliver a seamless, integrated, contextualized member experience. This means that consumers can easily find and compare providers to make informed decisions about their care while accessing previously siloed single-function apps in a multifunction environment.
Seamless Integration
Members no longer have to download, register and sign into multiple applications and portals. Our suite of proprietary ben admin features is woven into best-in-class curated healthcare tools that seamlessly integrate across member eligibility, plan benefit design, year-to-date accumulators, and more.
Promote Consumerism
Our mission goes beyond delivering a best-in-class healthcare SuperApp. What truly sets Hercules apart from other healthcare apps is our focus on consumerism. We believe that members should be able to shop for healthcare services just like they would for any other product or service. Our goal is to make the process of finding and selecting healthcare providers as easy and transparent as possible.
Drive Engagement
Hercules deploys two distinct methods to encourage members to engage in their healthcare whereby they can earn rewards by completing micro-learning quizzes, activities, and wellness challenges and shop for benefits that result in cash incentives through informed purchasing behaviors.
Engage your members and reward consumerism
Hercules Health employs strategies leading to habitual application utilization. Combined with cash incentives earned through intelligent healthcare shopping tied to quality and cost, Hercules Health is the leading healthcare engagement platform.
Gamification
Using gamification tactics, members earn rewards in the form of ‘Gems’ for engaging in predictable habit-forming activities such as tracking their physical activity, completing daily wellness educational micro-quizzes, and adopting healthy habits that improve their well-being. Gems can be redeemed for gift cards to 100s of recognized retail vendors.
Tangible Cash Incentives
Members earn cash funded to their medical savings accounts by shopping for the highest quality providers at the best cost for doctor visits, prescriptions, and other medical procedures. With cash rewards, members earn a percentage of their spending back in the form of a cash credit to their medical savings account to be used for future qualifying healthcare expenses.
Transparency in Coverage and No Surprises Act
The Transparency in Coverage (TiC) rulemaking and The No Surprises Act (NSA) comprise a set of rules and regulations that apply to self-funded health plan sponsors, payers, and providers. Payers must disclose the financial relationship between payers and providers, along with timely cost and quality of care information. Additionally, the NSA further prohibits payers from surprise billing patients for out-of-network services.
Price Discovery
The proprietary solution triangulates a network’s adjudicated claims against provider machine-readable files and a 4+ billion unique adjudicated claims database. The machine-learning system then produces line-item procedure costs delivering the industry’s most precise healthcare procedure cost results.
Comprehensive Compliance
Hercules Health delivers the industry’s best-in-class price transparency solution that is fully compliant with the Transparency in Coverage (TiC) and the No Surprises Act (NSA) rules and regulations.
Make sure you are compliant
| REQUIREMENTS | Penalty Enforcement Date | Hercules Health Capabilities |
|---|---|---|
| Three Machine-Readable Files (Publicly Accessible) | 1/1/23 | 1/1/2022 |
| Internet based self-service tool | 1/1/23 | 1/1/2022 |
| Mail, Fax & Telephone support | 1/1/23 | 1/1/2022 |
| All searchable items & services | 1/1/23 | 1/1/2022 |
| Advanced Explanation of Benefits (Pre-EOB before DOS) | 7/1/23 | 1/1/2022 |
| Search by Facility or Provider | 1/1/23 | 1/1/2022 |
| Show in-network negotiated rates | 7/1/23 | 1/1/2022 |
| Show out-of-pocket cost sharing | 1/1/23 | 1/1/2022 |
| Show accumulator balances at time of search | 1/1/23 | 1/1/2022 |
Designed for TPAs and their plan sponsor employers
No two TPAs or Plan Sponsors are alike. Each has its own set of requirements to optimize the support services for employees’ healthcare plans. Consolidating all healthcare information into a single, secure data platform, enables comprehensive data analysis leading to timely decision-making and quicker problem resolution.
TPAs
Designed from the ground up by engineering and development experts with 40+ years in the TPA business. The fully configurable, modular TPA platform ingests unstructured and structured data from any healthcare trading partner, transforming the data into actionable information for health plan members, plan sponsors, and TPAs.
Employers
The Hercules Health platform facilitates consumer-driven quality medical care delivery that optimizes outcomes and costs to both the member and the plan sponsor. The platform excels at performing data analysis across the siloed trading partners resulting in actionable insights that can help consumers make more informed choices about their care, improving the quality of care delivered while also optimizing costs.
Use Hercules to power your health organization
There’s nothing more important in healthcare than the seamless coordination and harmonization of data: members accessing their benefits to improve outcomes while lowering costs; employers providing benefits; providers storing information about their patients; payers processing and paying claims based on eligibility requirements set forth by policy or law… It sounds complicated but we’re here for you!
Core TPA platform interface
The core TPA platform interface is an extract, transform & load (ETL) tool which minimizes the need for significant time-consuming TPA resources by establishing automated bi-directional data feeds updated at agreed-upon periodic intervals once datasets have been defined and implemented during engineering design and test stages.
Modular & Configurable
Each module and corresponding functional component is completely configurable at the TPA, Plan Sponsor, and member levels. Plan Sponsors can elect specific functions at the member level. TPAs can configure the base platform for Price Transparency and machine-readable files only, or elect any combination of modules, functions, and ‘best-in-class’ pre-integrated services.
Documents
- ID Card
- Plan Design
- Member Document Upload
- HR/TPA Member Docs Request
Claims
- Explanation of Benefits
- Medical & Rx History
- Coverage History
- Accumulators
- Lab History
Search
- Find Procedure
- Provider Directory
Integrations
- Engagement Platform
- Messaging Service
- Service Ticket
- Track Module Usage
- Wearables
Services
- Medical Savings Accounts
- Telemedicine
- Behavioral Health
- Member Concierge
- Care Plan Support
Users
- Members
- Subscriber/Dependents
- Non-Covered User
- Configurable App by Plan Type
Support
- Chatbot
- Contact Information
Communications
- HR/TPA can request data from members
- HR/TPA post announcements
We’re proud to partner with some of the best names in health
Leveraging the best-in-class partners, we have created a one-of-a-kind SuperApp that offers users an unparalleled experience. From member concierge to member engagement, our app has it all.
Talon is the leading compliance solution for the Transparency in Coverage Rule and the No Surprises Act.
Optimity is the award winning member engagement platform that leverages rewards based activities, challenges, and micro learning quizzes to keep users coming back.
Rightway’s member concierge solution helps members optimize their healthcare benefits through guidance, education, advocacy, and coordination of care.
Request a demo and see what Hercules can do
Learn more about Hercules Health. Please complete the form linked below and we will be in touch to schedule a demo.