Getting enrollment and eligibility right is the first step to world-class claims service.
EnrollmentCURE provides the means to consistently and accurately reflect eligibility.
Member enrollment and eligibility are critical to patient access, properly adjudicating claims, and provider reimbursement. However, getting it right requires more than just “loading a file.” CureIS knows that a deep understanding of benefits, enrollment data, health plan and carrier processes, along with the ability to compare inbound data against internal information, is required to reflect member eligibility consistently and accurately.
Our EnrollmentCURE solution leverages our enrollment expertise to ingest multiple sources of enrollment communication, mapping, validating, and comparing member and benefits data to your established information existing data using our rules engine. We essentially reconcile the enrollment information constantly, only updating your system with confirmed material. In addition, we can track all electronic correspondence against premium and capitation values to ensure payments match enrollment.
For carriers, we make it easy to consume group data, validate premiums and publish accurate enrollment and eligibility to your delegates.
Explore more solutions:
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Achieve faster adjudication rates and reduce your back-office workload with our automated claims solutions.
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Identify any and all missing encounters with enhanced tracking, management and reporting for Medicare, Medicaid, and other relevant parties.
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Reduce manual data management, accelerate workflows, and gain operational perspective for everything from preprocessing data to integrating new systems to accessing archived data, and more.