EncounterCure
For government programs managed care,
financial success depends on encounters.
EncounterCURE ensures accuracy so you never miss an encounter.
Navigating enrollment challenges should not be a costly grind. CureIS developed EnrollmentCURE to optimize the enrollment process, tackling problems such as incomplete or conflicting information within health plans sourced from diverse channels, including government and employer groups. It also identifies issues from unstable provider networks and unpublished benefit plans.
- Enrollment information loaded in the adjudication system is meticulously verified, ensuring adjudication is not performed on inaccurate data.
- We ensure accurate member, PCP and eligibility data is available for claims
- Capitation owed to the payments received is easily reconciled. Coverage configuration aligns members with the right benefit plans and PCPs, and matches capitation or premium payments to the selected plans.
Real-Time Data for Real-Time Decisions
EnrollmentCURE streamlines daily operations by promoting daily activity files that provide timely member data. This translates to accurate copays at the time of the visit, reducing the need to check eligibility outside of core systems.
Swift Implementation
The CureIS team brings years of expertise to enrollment processes. Proven workflows and an extensive menu of business rules and edits enable fast implementation. Changes can be implemented and tested within hours, instead of weeks or months.
Cost Effective Efficiency
EnrollmentCURE offers a robust set of features, including integration with unlimited data sources, system-agnostic adjudication, and automated processing. Controllable environmental challenges are addressed, lowering operating costs by eliminating downstream issues that result in reprocessing, appeals, or encounter denials.
CureIS is fully accountable for ensuring results.
Explore more solutions:
Achieve faster adjudication rates and reduce your
back-office workload with our automated claims
solutions.
Streamline enrollment processes and determine
eligibility accurately, consistently, and quickly.
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.