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.
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.
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.
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.
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.
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.
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
|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 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.
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.
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.
- ID Card
- Plan Design
- Member Document Upload
- HR/TPA Member Docs Request
- Explanation of Benefits
- Medical & Rx History
- Coverage History
- Lab History
- Find Procedure
- Provider Directory
- Engagement Platform
- Messaging Service
- Service Ticket
- Track Module Usage
- Medical Savings Accounts
- Behavioral Health
- Member Concierge
- Care Plan Support
- Non-Covered User
- Configurable App by Plan Type
- Contact Information
- HR/TPA can request data from members
- HR/TPA post announcements
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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.