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.Contact Us
A Solution Designed to Increase Your Dual Eligible Population
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.
Facilitate financial security for members, adding to their monthly income to create more secure personal circumstances.
Optimize revenue with enhanced risk adjusted payments and more consistent, reliable monthly CMS payments attributed to more dual eligible members.
Boost member satisfaction and loyalty by helping Medicare members receive the valuable added benefits they’re entitled to.
Support advanced industry ratings by making a positive impact on Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores and CMS Star ratings.
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
- 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.
- 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.
- 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.