Member Enrollment
Improve Provider Data Accuracy. Reduce Costs.
Mitigate Compliance Risk.
Member enrollment, the first step in the Member Servicing cycle, is a critical business process that is often fraught with numerous errors and irregularities, due to paper-based, manual processing. This leads to the process often becoming frustrating for the prospective member, and time consuming and costly for the payer.
Challenges Faced
- High turnaround time between submission and approval of an application
- Manage Open Enrollment period
- Significant error rates in application processing
- Inefficient use of staff with a significant amount of staff time wasted in managing administrative tasks
- Lack of a robust tracking mechanism to monitor each application through the enrollment life-cycle leading to high loss rates for applications
- Difficulty in managing applications tracking sheet and orphan documents
- Complex business logic for processing member enrollment business process
- Ineptness to effectively and efficiently handle exceptional cases
- Analytics for usage of different communication modes and viewership of marketing messages
Benefits
Quick turnaround time. Improve the time taken to adjudicate the claim
Improve Accuracy. Reduce errors through robust quality assurance processes and seasoned claims adjudicators
Strong Governance processes. Our robust governance processes ensure that you are always in control with detailed reports on claims inventory, and service level commitments.
Reduces costs associated with claims processing by as much as 30-40% through our deep global delivery model
