Optimize Revenue, Minimize Compliance Risk

medicare enrollment eligibility
Reduce your costs and maintain compliance by automating your member eligibility verification using the CMS-endorsed and recommended BEQ process. Automate your letter generation, election adjudication (up to 98% adjudication rates) and TRR processing.

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Features

      • Accept MA-PD, MA and PDP enrollment data
      • Export enrollment/disenrollment, correction and change transactions for submission to CMS
      • In-load weekly/monthly Election Transaction Reply Files (TRR)
      • Export BEQ files for submission to CMS
      • In-load BEQ reply files from CMS
      • Export approved/eligible members to core claims system
      • Utilize manual entry of election form data
      • Import data files containing election transactions
      • Utilize the flexible rules engine to edit election data for errors and work flow
      • Manage exceptions by creating work items placed in work queues
      • Allow examiners the ability to review/document and create correspondence and correct election data
      • Build correspondence packages from stored Word document template libraries
      • Automatically initiate correspondence manually or from the rules engine
      • Export CMS ready files for BEQ submissions, enroll/dis-enroll and corrections files
      • Export enrolled members into a core claims system
      • Export queued correspondence for electronic print and fulfillment