Annual Enrollment Period
- Improved Operational Efficiency
- High Membership Retention
- Enhanced Regulatory Compliance
- Reduced Cost to Serve
- Improved Member Experience
- High Manpower Utilization
The Annual Enrollment Period (AEP) is the busiest time for a Medicare Advantage Health Plans. Due to the limited time window and the competition to engage and enroll members, health plans witness a seasonal peak in the demand for sales and enrollment staff, tapering down by the end of the year or first quarter. During the AEP, health plans face resource constraints, application errors backlogs, error-prone manual activities and increased member grievances.
Wipro assists during AEP (and beyond) with its In-house Member Enrollment and Member Management services. It helps to quickly ramp up teams and address the increased demands of AEP season.
Wipro hires, trains, and manages enrollment representatives, who work as an extension of internal team of health plan. It supports end-to-end Membership business process spanning Eligibility, Enrollment, Billing, Reconciliation and Member Customer Service. As an extension to the existing team, Wipro's AEP Support services are offered with either AEP Staffing Model - AEP support leaving existing Client's Platform or Member360 AEP Module - AEP support leveraging Wipro hosted Member360 solutions.
With successful AEP management for last 6+ years, Wipro contributes to Financial Accuracy, Payment Accuracy & SLAs with 30% increase operational efficiency along with automated billing reconciliation.
Successful AEP Management for last 6+ years
Improved Service Levels
Increase in Operational Efficiency
Medicare Lives Supported
Health Plan AEP Challenges
High Cost
Operational Inefficiencies resulting to High operating expenses
Missed SLA
High volume influxes in AEP (about 60% spike over BAU volumes) resulting to misses in TAT
Manpower Shortage
Staff Hiring & Training Challenges
Non - Compliance
Bandwidth Constraint of skilled resources considering increased focus on meeting CMS compliance and reporting requirements
Reconciliation Errors
Oversight in Financial and Membership reconciliation for complex enrollment resulting to errors
Member Dissatisfaction
Low Member satisfaction and experience
Wipro Solution
AEP Staffing Model
Our dedicated Business Intelligence Team supports staffing analysis based on historical data unique to each client, placing the right staffing span for each client. Sudden spikes are managed with our signed-up factory model utilizing trained resources pooled and aligned for clients using common platform and states
Member360 AEP Module
Our deep and long-standing relationship with CMS for 30+ years as a trusted contractor has enabled us to offer an integrated automation solution in Wipro's Member360 platform by receiving MBD and being the largest submitter of enrollment volume, including RAPS and EDPS.
25%
Reduced
Operational Costs
40%
Reduced Errors
during AEP
Wipro Value Drivers
End-to-end Membership BPO Services Eligibility, Enrollment, Billing, Sales / Broker Management and Member Customer Service
Medicare Enrollment Products & Services Academy & COE to enable ready-to-be-deployed staff
Global Shared Services Delivery Model with cross-trained Membership Staff
Core-Flex Staffing Model to address Seasonality and provide staffing and operational flexibility
Existing relationship & governance framework to drive continuous value
Enhanced focus on regulatory compliance & reporting