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iEDeX Enrollment

  • More than 250 million Americans are enrolled in health insurance plans.
  • Many other states are working to identify opportunities to expand state-funded health care coverage.
  • The benefit enrollment and maintenance 834 is becoming the standard of choice for the Human Resource Department.
  • The state of MA passed a law requiring all residents to obtain health insurance.

iEDeX Enrollment leverages the power of technology to automate your enrollment process. It is a solution designed specifically for the health plans to streamline their enrollment procedure.iEDeX™enrollment is a seamless solution that can be integrated with your managed care information system to support automated enrollment processing.

iEDeX enrollment automatically examines inbound enrollment files to ensure that they meet 834 EDI industry standards. Standard documents are integrated into the payers proprietary managed care information system while erroneous documents are queued up for correction by internal IT staff.

In addition, the system provides an option to the employer to self correct erroneous data by generating and sending error alert emails to employers. Employers are provided web-portal access to correct errors and enroll new employees. The system has an intuitive user-interface for upfront correction of enrollment documents that don't meet EDI standards.

Why iEDeX™ Enrollment?

  • Employees who are satisfied with their employer's health plan communication are 5 times more likely to be satisfied with their health plan than employees who are not satisfied with their communications. (Watson Wyatt)
  • Self service open enrollment reduces inquiries by 75%. (Hunter Group).
  • 95% of HR and benefit managers consider automated enrollment, administration, communication, and supplier management of benefit programs a technology imperative. (RewardsPlus).
  • Using ANSI 834 standard for linking employer and payor networks to exchange enrollment information is estimated to save employers with 50 employees or more $2.0 to $4.1 billion per year (net of transaction costs), and save payors $110 to $220 million net per year (Workgroup for Electronic Data Interchange).
  • AT&T saved $15 million in first year of EDI enrollment and reported substantial decrease in claims paid to ineligible claimants (Healthcare Financial Management).
  • Regents of the University of California implemented HIPAA compliant enrollment that found and corrected $1million billing error (McLure-Moynihan Inc.).
  • Extensive, on-going communication among constituents is critical to the success of EDI implementation (Workgroup for Electronic Data Interchange).

Features

  • Ability to handle multiple product types for multiple payers.
  • Produces real-time quotes for different health insurance plans.
  • Accepts enrollment documents in employers proprietary formats.
  • Automatically enroll new members using information on paper or electronic forms.
  • Generates HIPAA complaint enrollment files in 834 standard.
  • Integrates the new member enrollment information to payers proprietary managed care information system.
  • Can be integrated with health plan's claims and billing system.
  • 24/7 customer support.

Values

  • Eliminates the cost and time associated with paper intensive enrollment procedures.
  • Reduction in errors associated with manual enrollment.
  • State of the art technology that identifies and alerts about error trends.

Improve employer/sponsor relations

  • Eliminates the errors and time-lags in benefit administration.
  • Reduces costs associated with claim rejections.
  • Upfront correction of new member enrollment data.
  • Empowers employers by providing them with web-portal access to self-correct enrollment errors.
  • Pro-actively market superior administrative capabilities to prospective and current employer groups.

Improve enrollee relations

  • Lower claims expense and improved customer service.

Strengthen provider relations

  • Minimize claim rejection rates.
  • Expedite transaction processing cycles.
  • Increase auto-adjudication rates by identifying and correcting enrollment errors.