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 enrollment and recertification services.

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A Solution Designed to Increase Your Dual Eligible Population

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Enhance dual eligible identification with our industry-leading predictive model that pinpoints those individuals with the highest likelihood to qualify for full or partial dual eligibility.

dual-enrollment-recert-complete-facilitate-financial-security-members

Facilitate financial security for members, adding to their monthly income to create more secure personal circumstances.

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Optimize revenue with enhanced risk adjusted payments and more consistent, reliable monthly CMS payments attributed to more dual eligible members.

dual-enrollment-recert-complete-boost-member-satisfaction-loyalty

Boost member satisfaction and loyalty by helping Medicare members receive the valuable added benefits they’re entitled to.

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Support advanced industry ratings by making a positive impact on Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores and CMS Star ratings.

dual-enrollment-recert-complete-help-improve-member-health

Help improve member health with added benefits that will help encourage members to seek care and manage their chronic conditions.

End-to-End Identification and Enrollment

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Proactive identification

  • Identify members that have the highest likelihood for dual eligibility with our industry leading predictive model.
  • Gain access to our predictive model that draws information from our highly reliable data sources.
  • Tie back to full and partial dual enrollment with optimized Hierarchical Condition Category (HCC) coding.
  • Live advocates work with members, once identified, to understand their situation and determine eligibility.

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Easy enrollment

  • Assist members with enrollment from start to finish with our experienced advocates that help them to complete and submit all necessary forms to appropriate state agencies.
  • Monitor Medicaid status data and advocate on behalf of your members for appeals and overturn denials with our government relations team.
  • Incur charges only when members are approved for full or partial dual eligibility to ensure your members receive Medicaid status quickly.
  • Leverage scalable, cost-effective member outreach that can help to reduce member abrasion with our streamlined engagement and communications process.
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Recertification

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

 

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