Core Claims and Admin Systems

Our team has hands-on experience successfully implementing the leading claims and benefit administration systems, including HealthEdge, QNXT, Facets, DST and more, for payer organizations of all sizes.

In addition, we help clients continually identify opportunities to improve business performance and optimize their systems so they can maximize the value of their IT investments.

System Selection and Implementation Planning Services

Cumberland provides strategic system selection and implementation planning services to help payers find a solution that meets their needs.

Download

From Selection to Implementation
Cumberland provides a team of subject matter experts who specialize in areas such as claims processing, pricing, and benefits configuration. We work with health plans to complete each step of system selection and implementation, including:

  • Requirements Gathering

  • System Build

  • Testing

  • Training

  • Data Conversion/Management

  • Integration and Reporting

  • Support

  • Benefits and Pricing Configuration

  • System Maintenance


“Cumberland consultants not only excel at project management, but they are technical experts who understand the unique features of our QNXT system. We keep coming back to Cumberland because they are knowledgeable, flexible and thorough.” Bruce Gilbert, Director, TriHealth Benefit Solutions

Optimization: Maximize Your Investment
Cumberland consultants don’t just implement an IT system and walk away. We provide optimization services to help our clients realize a return on their IT investment and maximize efficiencies across their organizations.

Through optimization assessments, we provide payers with benchmarks so they can compare their performance with industry standards, and implement any necessary IT or operational changes.

We also work with payers to incorporate business intelligence/analytics and population health management programs into their IT strategy so they can better manage targeted patient populations.