Solution Bundle

Dual Enrollment Advocate™ and Recert Complete®

Dual Enrollment Advocate™ and Recert Complete® is a consumer-centric solution bundle for payers who want to optimize revenue and member satisfaction by helping members obtain and retain added benefits through dual-eligible enrollment and recertification services.

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What’s included in Dual Enrollment Advocate and Recert Complete

  • Proactive identification

    • Industry-leading artificial intelligence to help predictively identify dual-eligible members in your population with precision
    • Apply the power of machine learning to identify the likelihood of full and partial dual-eligible beneficiaries more accurately
    • 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 necessary forms to the 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 reduce member abrasion with our streamlined engagement and communications process
    • We 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

Solutiondesigned to increase your dual-enrolled population

Dual Enrollment Advocate and Recert Complete - female provider on ipad with patients

Industry-leading AI to help enhance dual-eligible enrollment identification

Enhance dual-eligible enrollment identification with our industry-leading AI predictive model that pinpoints with up to 93%* accuracy those individuals with the highest likelihood of qualifying for full or partial dual eligibility. Plus, optimize revenue with enhanced, risk-adjusted payments and more consistent, reliable monthly CMS payments attributed to more dual-enrolled members.

*Results may vary by payer plan and member demographics.

Dual Enrollment Advocate and Recert Complete - provider using technology- Provider using digital tablet with female patient

Provide benefits to help improve member satisfaction

Help facilitate financial security for members, adding to their monthly income to create more secure personal circumstances. You can also boost member satisfaction and loyalty by helping Medicare members receive the valuable added benefits they’re entitled to.

Dual Enrollment Advocate and Recert Complete - provider using technology

Dual-eligible enrollment services to help improve ratings and scores

Help improve member health with added benefits that can encourage members to seek care and manage their chronic conditions. This helps support advanced industry ratings by making a positive impact on Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores and CMS Star ratings.

Providing Measurable Value

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3.3 B

Medicaid add-on net revenue to our clients to date (636,000+ dual enrollments and >one million Medicaid recertifications completed) 1
1 Results based on historical data; results may vary by payer plan and member demographics

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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

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4.4 B

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

Our outcomes

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Resources and Brochures
  • Infographic
    Blending AI and Behavioral Science to Improve Dual-Eligibility Advocacy

    In this infographic, learn how to increase dual-enrollment applications, helping members gain the added benefits they're entitled to.

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