Solution Bundle

Dual Enrollment Advocate™ & Recert Complete®

A consumer-centric solution for payers that want to optimize revenue and member satisfaction by helping members obtain and retain added benefits through dual eligible enrollment and recertification services.

 

Solutiondesigned to Increase Your Dual Enrolled Population

  • Enhance dual eligible identification with our industry-leading AI predictive model that pinpoints with up to 93%* accuracy those individuals with the highest likelihood to qualify for full or partial dual eligibility.
  • Optimize revenue with enhanced risk adjusted payments and more consistent, reliable monthly CMS payments attributed to more dual enrolled members.
  • Support advanced industry ratings by making a positive impact on Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores and CMS Star ratings.
  • Facilitate financial security for members, adding to their monthly income to create more secure personal circumstances.
  • Boost member satisfaction and loyalty by helping Medicare members receive the valuable added benefits they’re entitled to.
  • Help improve member health with added benefits that can encourage members to seek care and manage their chronic conditions.

*results may vary by payer plan and member demographics

End-to-End Dual Eligible Identification and Enrollment

  • Proactive identification

    • Use our industry leading artificial intelligence to predictively identify dual eligibles in your member population with more precision.
    • Apply the power of machine learning to more accurately identify the likelihood of full and partial dual eligible beneficiaries.
    • Live advocates proactively engage with members, once identified, to understand their situation and evaluate eligibility.
  • Easy enrollment

    • Experienced associates assist members with enrollment to help them complete and submit all necessary forms to appropriate state agencies.
    • Live advocates use tactics honed by behavioral science practices and real member feedback to help earn trust and facilitate the enrollment process.
    • Leverage scalable, cost-effective member outreach that can help to reduce member abrasion with our streamlined engagement and communications process.
    • Let us monitor Medicaid status data and advocate on behalf of members to submit appeals and help overturn denials with the support of our experienced government relations team.
  • Recertification

    • Help ensure Medicaid status is retained through our annual engagement with your dual enrolled members that guides them through the recertification process.
    • Allow us to monitor Medicaid status data to ensure we can help advise members regarding redetermination dates and any eligibility changes.
    • Let our team help manage eligibility dispute resolutions and provide monthly member reports to keep you informed.

Providing Measurable Value

3.3 B

Medicaid add-on net revenue to our clients to date (636,000+ dual enrollments and >1 million Medicaid recertifications completed) 1

1 Results based on historical data; results may vary by payer plan and member demographics

46.6 %

Increase in member retention (13.2 months) for Change Healthcare assisted duals, representing an average Medicaid add-on revenue increase of ~$13,000 per retained member

4.4 B

Part B premium savings achieved for our clients’ dual enrolled members to date

Our outcomes

View all insights

Resources and brochures

Infographic

Infographic: fusing artificial and human intelligence to optimize dual enrollments

Join Community discussions

Find and share knowledge, exchange ideas, and collaborate with peers and Change Healthcare experts to drive your solutions to success.

Contact Sales

Let's connect.