Capitation payments don’t have to be complex. Our platform is purpose-built to help payers, IPAs, and MSOs automate and optimize capitation payment processing, reconciliation, and reporting—from simple per-member payments to advanced, risk-adjusted models.
Automate PMPM, risk-adjusted, and delegated capitation payments with CapSwift. Support HCC-based rate adjustment, multi-tier delegation, encounter-linked reconciliation, and audit-ready reporting—across Medicare, Medicaid, Commercial, and Duals.
CapSwift supports full-spectrum capitation management including fixed PMPM payments, HCC-based risk adjustment, and complex delegated arrangements. Designed for payers, IPAs, and MSOs, it handles multi-tier flows, downstream allocations, and contract-driven reconciliation with precision.
Configurable capitation setup with automated risk scoring and audit-ready reporting.
Accurate reconciliation with variance tracking, utilization data, and payment controls.
Real-time performance monitoring and predictive analytics for contract and risk optimization.
Simplify and streamline capitation management with accuracy and transparency to support your value-based care goals. Request a demo today to learn how top payers and providers are modernizing capitation management with our platform.
Explore commonly asked questions to better understand our services, solutions, and how Nexillo supports your healthcare goals.
Yes. CapSwift integrates with HCC scores, risk stratification models, and other population health data to dynamically calculate accurate payments based on member acuity.
It supports tiered capitation, shared savings models, bonus calculations, withholds, and downstream provider payments, with complete transparency and custom rules.
BillSwift accepts ACH, credit/debit cards, checks, and lockbox payments. It also supports auto-pay, recurring billing, and walk-in payment processing.
Yes. CapSwift is HIPAA-compliant, secure, and scales from small provider networks to national health plans, supporting millions of members.
