Eligibility and Enrollment
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Streamlining and strengthening eligibility and enrollment processes in Federal and state healthcare programs reduces cost of care, promotes access to care, and improves the beneficiary experience. Through our unique blend of innovative technologies and state-of-the-art citizen engagement infrastructure, we give Federal and state healthcare authorities the ability to rapidly implement complex and ever-changing eligibility rules and the ability to engage eligible beneficiaries in clear and well-informed enrollment processes.
Our eSante EnGage360™ platform is a multichannel contact solution that builds on our proven customer assistance solutions to achieve program excellence in eligibility determination and health plan enrollment. We help customers improve plan selection rates among uninsured and underinsured populations through comprehensive education and outreach; omnichannel customer assistance, data-driven program optimization, enrollment support, and streamlined case management leveraging the following capabilities:
- Application processing focused on accuracy and timely completion, including software-assisted data validation
- Consumer education and outreach programs designed for specific state demographics and populations
- In-person enrollment assistance to help states reach, educate, and enroll prospective beneficiaries, including special populations
- Accessible, self-service options to help connect members with their healthcare options