Streamline Medicare Eligibility Verification and Enrollment/Membership/Payment Reconciliation

Through a unique partnership with Government Works, a contractor with the Centers for Medicare & Medicaid Services (CMS), ikaSystems offers ikaMedicareGateway, which conducts instant eligibility queries against the Medicare Beneficiary Data (MBD) extract file from CMS’ MARx database. A hosted (ASP) solution, ikaMedicareGateway automates Medicare eligibility verification and enrollment/membership/payment reconciliation, allowing health plans to grow their Medicare business lines without adding staff. In addition, plans improve cash flow and member satisfaction through greater speed and accuracy.

ikaMedicareGateway delivers:

• Instant eligibility queries and beneficiary look-ups against the MARx database: Responses are immediate.
  
  
• Highly efficient online enrollment: Eligibility verification is fully automated, with integrated data pulling that ensures accuracy and reduces enrollment application processing time by 80 percent.
  
  
• Creation of error-free membership accretion files: Accretion rates of over 99% are achievable, significantly reducing rework and increasing cash flow by ensuring timely payment.
  
  
• Automated membership and payment reconciliation: ikaMedicareGateway users have seen reconciliation time reduced by an estimated 70 percent, speeding the discovery of discrepancies and missing dollars.
  
  
• Comprehensive data warehousing, reporting and efficiency features (e.g., automatic triggers): ikaMedicareGateway blends all the components of a highly intelligent system to fully inform health plans and increase their efficiency.