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.
 

A Solution Designed 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.

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 enrolled 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 can encourage members to seek care and manage their chronic conditions.

*results may vary by payer plan and member demographics

On Demand Webinar: Modernize Dual Enrollment with AI and Behavioral Science

Learn how this innovative new approach to dual eligibility identification and engagement can optimize enrollments to help increase your Medicaid add-on net revenue while aimed at improving your members’ quality of life.

Infographic: Fusing artificial and human intelligence to optimize dual enrollments

Understand how AI and behavioral science come together to improve dual eligible advocacy.

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

$3.3B

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
$4.4B
Part B premium savings achieved for our clients’ dual enrolled members to date

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Additional Resources

FACT SHEET
Proactively Renew Dual Eligibles for Medicaid

Learn how Recert Complete® uses state-specific knowledge, empathetic advocates, and AI to successfully keep your members dual-enrolled.

Download Fact Sheet

FACT SHEET
Meet Member Needs to Drive Improved Health Outcomes

Community Advocate supports risk, quality, and retention initiatives by addressing social determinants of health through community program enrollment.

Download Fact Sheet

WEBINAR
Modernize Dual Enrollment with AI and Behavioral Science

Learn how this innovative new approach to dual eligibility identification and engagement can optimize enrollments to help increase your Medicaid add-on net revenue while aimed at improving your members’ quality of life.

Watch Recorded Webinar

INFOGRAPHIC
Advance the Dual Eligible Member Enrollment Experience

Using AI and behavioral science we’re helping to earn your members trust by optimizing their journey to dual enrollment.

Download Infographic

INFOGRAPHIC
Artificial & Human Intelligence Modernize Dual Eligible Advocacy

Learn how artificial and human intelligence modernizes dual eligible advocacy to optimize dual enrollments.

Download Infographic

BROCHURE
Dual Enrollment & Recertification Optimization

Leverage our end-to-end identification and enrollment process designed to deliver and maintain more dual-enrolled members.

Download Brochure

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