Presbyterian Health Plan's implements ikaSystems' ikaEnterprise suite as a total solution for its individual business administration.

Presbyterian Health Plan (PHP) went live on April 2, 2007 after completing the first phase of its implementation of the ikaEnterprise solution suite for its individual business line. As a result PHP has effectively streamlined and automated a number processes including sales, underwriting, enrollment and customer service functions related to sales. The system's automated underwriting module enables PHP to sell to prospective members without any human hands touching the application - completely automating all processes from the initial quote to a HIPAA compliant 834 feed to its claims system.

"Carole Henry, PHP's underwriting chief, wanted a solution that would automate and relieve their underwriters of many manual tasks allowing them to focus on higher value risk analysis and account management aspects of underwriting. Our system allows them to focus on the functions that facilitate book-of-business management and more frequent reviews and what-if analyses," stated Ravi Ika, President and CEO of ikaSystems.

As part of the next phase PHP will implement ikaEnterprise's off-cycle changes, e-billing and commissions management modules. PHP will also incorporate ikaSystems' robust sales force automation module into the system, which will provide the necessary competitive advantage in a more retail oriented environment.

This is one of the many steps PHP is taking to achieve its strategic objectives to improve business agility in the sales, underwriting and administrative processes of its commercial business lines.

PHP's next steps will be to implement ikaEnterprise to streamline and automate the sales, underwriting and a majority of the administrative processes of its small and large group businesses, enabling it to automate a number of other important processes as well such as renewal rating and financial forecasting.

"PHP chose us after extensive due diligence because they were convinced that in addition to providing robust solutions we really understand health plan administration and how to incorporate business intelligence in a way that would enable them to effectively achieve their business objectives," adds Ika.

About Presbyterian Health Plan
Presbyterian Health Plan serves more than 400,000 commercial, Medicare and Medicaid members throughout New Mexico and is the state's largest health plan. PHP is part of Presbyterian Healthcare Services, a private, not-for-profit integrated delivery system and the state's largest provider of care. For more information, visit www.phs.org.