Softheon

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Softheon

Type of business	Private
Founded	2000
Area served	U.S.
Founder(s)	Eugene Sayan
Industry	Healthcare Technology
Website	https://www.softheon.com/
Current status	Active

Softheon Inc. (Softheon) is a United States technology company that provides a Medicaid Information Technology Architecture (“MITA”) aligned, Health Insurance Portability and Accountability Act (“HIPAA”), Payment Card Industry (“PCI”), National Institute of Standards and Technology (“NIST”) 800-53, Federal Information Processing Standards (“FIPS”) 140, and Minimum Acceptable Risk Standards for Exchanges (MARS-E), Version 2.0 aligned single-tenant Platform-as-a-Service (“PaaS”), Software-as-a-Service (“SaaS”), and Business Process-as-a-Service (“BPaaS”) cloud platform. The company works to solve complex health insurance distribution and service challenges for healthcare issuers, government agencies, brokers, employers, and consumers.

Softheon’s solutions transform the way state agencies, health plan issuers, brokers, and associations operate by delivering healthcare capabilities including: asset verification and identity proofing, individual, State-based, and SHOP Marketplaces, Special Enrollment Period (SEP) verification, Advance Premium Tax Credit (APTC) validation, Electronic Data Interchange (EDI) validation, electronic and paper-based payment processing, carrier reconciliation facilitation, and Federally Facilitated Marketplace (FFM) population analytics.

Integration with Healthcare.gov

In September 2019, the Centers for Medicare & Medicaid Services (CMS) approved Softheon as one of the leading Phase 3 Enhanced Direct Enrollment (EDE) vendors, which allows private companies to directly enroll consumers in Qualified Health Plans through the Health Insurance Marketplace without redirecting them to Healthcare.gov.

Recognition  

Softheon is a nationally recognized leader in its industry by Gartner, IDC, AHIP, ACAP, and HCEG. In 2018, Softheon was the 23rd fastest-growing company in the United States on Deloitte’s Technology Fast 500. In 2019, Softheon ranked as the 14th fastest-growing company on Crain’s New York Business Fast 50 list. Most recently, in 2020, Softheon ranked 1,595 on the Inc. 5000, a list of the fastest-growing private companies in America.

Founder and History

Softheon was founded by Eugene Sayan in 2000, an IBM veteran who led big data and process management initiatives for Fortune 1000 companies, to develop innovative solutions for healthcare payers, providers, and government agencies. The company played a critical role in building the nation’s first state health benefit exchange for Massachusetts Connector (RomneyCare). In 2008, Softheon was invited to design and implement the critical enrollment, premium billing, and CRM technology components of Massachusetts Health Connector Care. Softheon designed, developed, and set up the infrastructure, technology, tools, and services which resulted in a successful and efficient operation that exceeded Service Level Agreements set by the Health Connector.  

References

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