Enrollment Management Edifecs Header

Managed Medicaid

Every state’s managed Medicaid enrollment works a little differently, and your enrollment system needs to be able to handle these state-specific nuances. Many organizations develop their own systems and workflows to account for these variances, but doing so comes with a host of potential challenges—not to mention increased maintenance costs.

The Edifecs Enrollment Hub simplifies and streamlines these processes, providing the visibility, automation, and expertise organizations need to achieve operational excellence.

Ready to Excel in Managed Medicaid

Connect with us to learn how the Edifecs Enrollment Hub can help your organization get the results you’ve been looking for.

Member Enrollment Management 1
  • Manage multiple member transactions in the same file
  • Reduce errors and operational costs while increasing scalability
  • Configure to match any state’s specifications

One hub for all your inbound data

Reduce complexity and increase visibility with a centralized hub for all state Medicaid intake data.

Enrollment Management Solution 2
  • Streamline identification of missing and disenrolled members
  • Optimize quality of data transmitted to downstream systems
  • Reduce IT and administrative costs

Ensure high-quality data streams

Avoid the knock-on effects of bad data with up-front discrepancy identification.

Enrollment Management Solution 3
  • Identify discrepancies in capitation, premium percentages and discounts
  • Aurately track and report over- and underpayments
  • Automatically close transactions and reopen when adjustments are paid

Improve financial reconciliation

Minimize financial risk with automated reconciliation of member transactions.

Enrollment Management Solution 4
  • Correct errors and reprocess transactions in real time
  • Automate error routing for manual review
  • Gain real-time visibility into transaction fallout

Simplify error tracking & resolution

Intelligent workflows automate identification, routing, and resolution of enrollment errors.

News & Insights

Enrollment Management for Managed Medicaid
As Medicaid expands and enrollment grows, ensuring profitability and compliance is not viable without technology designed for state-specific nuances.
Learn More  ❯
Optimized Medicaid ACO Enrollment in Massachusetts
Edifecs comprehensive enrollment management solution are built-in validations and integrated workflow processes to increase data integrity by enabling visibility and validation upfront in the enrollment process.
Learn More  ❯
Medicaid Enrollment Management
As Medicaid enrollment and spending continue to rise, managed Medicaid health plans (MCOs) continue to seek ways to address rising costs, which can begin at the earliest part of the value chain; the enrollment process itself
Learn More  ❯
View All Resources