Business Issue:
The complex nature of enrollment data creates an ongoing business challenge. Accuracy of Enrollment data is critical to all functions including claims payment, customer service, and medical management. Erroneous enrollment information has a major downstream impact on administrative member services, claims payment, and provider services.
EZ Enroll Solution:
EZ Enroll was designed to automate the enrollment process as well as increase accuracy of information. The system provides an easy-to-use front end system to enter in enrollment information. It uses a rules-based engine that ensures all entries meet required information before importing into the plan's membership system.
The new enrollment files are automatically imported into EZ Enroll, run through the business rules engine to ensure all data is complete and accurate and then imported directly into the membership system. Additionally, EZ Enroll supports eligibility verification with CMS for Medicare and PDP enrollments. |
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