CASE STUDY
Industry:
Health Insurance
Products / Services:
Member360, Revenue360, Premium Billing
Leading Medicare Advantage Start-up Plan Implementation
Client Background
Client is a leading healthcare company serving seniors. The company helps its 125K members to get best in class healthcare by partnering with top providers. It utilizes world-class technology to enable a simplified experience.
Client Requirements
The client’s objective was to enter the Medicare Advantage Prescription drug (MAPD) market. With the introduction of new Product Lines that are 100% CMS Compliant, the client expected exponential growth in MAPD market across Florida, Arizona markets.
100% Timely & Accurate Enrollment meeting all the CMS Compliance Timelines
BI Analytics for Enhanced Reporting and Metrics
Extended Support during Annual Enrollment Period
Solution Highlights
With the introduction of new product lines and customer’s exponential growth in MAPD market, our integrated solution helped them meet CMS compliance requirements. The solution provided an integrated platform for Eligibility & Enrollment, Premium Billing and Revenue Reconciliation.
Eligibility &
Enrollment
Receive, Process, and Reconcile Electronic Member Enrollment from Various Sources
Integrated
Solution
Successful Implementation of Integrated Solutions for Member360, Premium Billing, Revenue360
Multilingual
Outreach
Letters supported in multiple languages including English and Spanish