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Medicare Advantage

With the rapid expansion of the Medicare Advantage market, there are myriad opportunities for plans to expand their market share—that is, as long as they can successfully navigate the challenges of enrollment management.

To capitalize on these opportunities, health plans need to be efficient, scalable, and compliant. And with the Edifecs Enrollment Hub, they can be.

Gain a Competitive Advantage

There are opportunities in the Medicare Advantage market. Is your organization equipped to capitalize on them?

Member Enrollment Management 1
  • Automate generation of eligibility request and response files
  • Seamlessly reconcile ESRD, CMS, and subsidy data
  • Simplify Medicare Supplement (Medigap) administration

Boost your processing power

Automate, reconcile, and validate data for more efficient enrollment processing.

Enrollment Management Solution 2
  • Generate and preview member-, group-, and application-level letters
  • Simplify rejection letter creation
  • Improve status reporting for enrollments and disenrollments

Deliver fast, compliant correspondence

Reduce administrative burdens with automated letter generation.

Enrollment Management Solution 3
  • Integrate all membership systems
  • Provide enriched data for downstream systems
  • Transmit file-agnostic data to downstream partners

Facilitate downstream success

Give downstream partners the high-quality data they need to thrive.

Enrollment Management Solution 4
  • Streamline Transaction Reply Report (TRR) processing, validations, and workflows
  • Facilitate MARx file compliance with near-real-time MARx entitlement data
  • Provide tracking and updates for each submitted and received transaction

Stay compliant via CMS integrations

Robust reporting provides more actionable insights and enables regulatory compliance.

News & Insights

Medicare Advantage Enrollment Challenges Demolished. No Hammer Required
Hitting a Wall Trying to address CMS Regulations and MA Complexity with Homegrown or Repurposed Enrollment Technology?
Learn More  ❯
Enrollment Management for Medicare Advantage
Competition in Medicare Advantage is fierce for good reason, but that doesn’t mean new and existing participants can’t prosper. In fact, with the right systems in place, MAOs can lean on their competitive advantages and achieve heightened levels of profitability and member satisfaction.
Learn More  ❯
One Enrollment Hub to Manage All Your Channels
With dynamically changing regulations and legislation around coverage, subsidies, and penalties, health plans must optimize their enrollment operations to be able to respond quickly to such changes, and gain a competitive edge over those who are underprepared.
Learn More  ❯
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