Benefit Enrollment Automation

Reduce cost, increase operational performance, and streamline member benefit enrollment maintenance processes with employers, payers and carve-outs.

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Remain competitive in the marketplace by easily offering complementary plans with specialty providers.

Efficient and accurate enrollment is critical to verifying eligibility information, checking benefit details, coordinating care with plan partners, submitting claims and billing premiums.

Primary Drivers

Increase automation and accuracy for enrollment maintenance
Effortlessly coordinate enrollment with employer groups and carve-out carriers
Quickly respond to changes to support business
Improve performance while reducing cost with managing enrollment
Eliminate support of in-house black-box scripts and development efforts
Standardization of X12 834 model enabling consistency and automation with enrollment processing over proprietary file layouts, email/mail/fax member rosters and web sponsored portals
Reconciliation and audit of the monthly audit and all daily changes

Enrollment Capabilities

Simplified and accurate enrollment maintenance for employer groups, delegates, Medicaid and Medicare Advantage
Cloud-based EDI as a Service enabling visual collaboration and streamlining administration
Eliminate need for in-house development and application support by Healthcare EDI professionals responsible for managing proprietary transactions with trading partners
More efficient and less expensive than developing internal solution or black-box type outsourced services with limited or no transaction visibility
Capability to import and convert proprietary file formats into standard EDI X12 HIPAA compliant transactions, addressing EDI/HIPAA regulatory requirements
Automated data processing that allows benefit administrators and healthcare claim processors to funnel transactions through a robust translation and Advanced Rules Engine
Advanced Rules Engine incorporating 14+ years of business transaction processing expertise offering exceptional file optimization, configurable rules, and exception logging and reporting
Branded, intuitive EDI transaction portal for editing, error reporting and management of transaction activity with trading partner(s)
Workflows designed to enable business analysts to manage, remediate and report on incomplete data and rejected transactions
Full reconciliation and audit of the monthly audit and daily changes
Reduce administrative costs by automating common tasks and translating complex business logic with easy-to-use tools supporting workflow
Expedient system implementation that supports trading partners and outsourced business processes

Get more from your EDI investment.

VisibilEDI is a long-standing industry leader known for our understanding of the healthcare landscape. We’ll show you how the VisibilEDI EDI Gateway will simplify your work flow and reduce your costs. If you’re ready for an easy-to-implement, easy-to-use EDI solution, schedule a consultation with one of our experts. Start simplifying and saving!

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