Member Enrollment Services

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


Contact Us for Member Enrollment Services

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