Enrollment Platform

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Enrollment Platform

Better Solutions to your Complex Challenges

Accelerate enrollment processing and fuel accuracy with a comprehensive, compliant solution.

Enrollment, claims processing, and billing are essential functions for any health plan. Accuracy and simplicity in these functions are vital to the success of your plan and the satisfaction of your customers. Your members rely on your plan to deliver the care and outcomes they need, and to make managing their healthcare easier. While your members may not see your back-office operations, enrollment, claims, billing and other business functions have a dramatic impact on member satisfaction. Complications in the execution of these core operational functions can create a long list of problems for your organization. Conversely, an efficient, user-friendly enrollment platform increases member satisfaction and drives down administrative costs to help you reach your business goals.

A scalable platform that grows with you

Support membership growth and optimize the open enrollment window with Advantasure’s automated and configurable enrollment platform built for government-sponsored healthcare programs.

Save time, reduce errors and boost productivity with our enrollment technology platform. It enables cost-saving flexibility and allows you to easily configure system updates for existing plans, products and membership; all in-house and without code changes. You’ll experience increased administrative efficiencies, greater adherence to CMS requirements and support for Star rating measures.

Platform Capabilities

  • Near instantaneous feedback on application completeness and validation
  • Real-time eligibility and entitlement verification
  • Identify, prioritize and correct enrollment discrepancies between your plan and CMS
  • Generate automated letters to facilitate meeting CMS timelines
  • Provide automated CMS file generation, transmission and processing
  • Improve CMS Star measures by maximizing enrollment, lowering disenrollment and enhancing customer satisfaction
  • Regular updates for CMS guideline compliance, including new Medicare Part C and Part D members

Client Performance Results

  • Achieved 99% new enrollment success rate
  • Reached 80% reduction in application processing time
We understand the revenue and cost drivers that impact your plan’s goals and day-to-day operations. Our solutions are built around delivering the technology platforms and managed services (link to services page) that meet and adapt to changing CMS requirements. Built for the government healthcare market, our solutions are backed by a team with deep expertise and experience in regulatory, plan, technology, government agency and other fields. Enrollment works as a stand-alone solution, and for increased performance, we’ve designed it to integrate with our billing, claims and other administrative technology platforms.

Extend Functionality: Add-on Solutions

  • Provider Portal
  • Member Portal
  • Correspondence
  • Inter-plan Teleprocessing Technology for Blues plans

Additional Features

  • Daily and monthly membership reconciliation
  • Reconcile CMS special status via automated daily maintenance/li>
  • Submit, monitor and archive CMS files via optional services
  • Expand enrollment with minimal impact on staff resources

Let’s talk about how we can boost your performance with enrollment and other administrative technology platform solutions.

Find Out How We Can Help You Drive Forward

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