Member growth and high ROI for smaller memberships.
ikaMedicareGateway Fundamentals is a tailored solution that focuses on the fundamental business processes necessary to increase the speed and accuracy of Medicare enrollment and member reconciliation for health plans with fewer than 20,000 Medicare lives. The solution offers a pre-configured set of the core functions available in our full-featured ikaMedicareGateway solution that meets the specific needs of health plans with smaller Medicare memberships.
Similar to ikaMedicareGateway, it is a low-maintenance solution that drives administrative efficiencies, adherence to the Centers for Medicare & Medicaid Services (CMS) requirements and improved Star ratings. Fundamentals makes it possible for health plans with smaller budgets to achieve maximum enrollment and reconciliation efficiencies and high ROI.
Efficiency plus compliance
By automating member enrollment and reconciliation processes, ikaMedicareGateway Fundamentals increases administrative efficiencies that enable health plans with smaller memberships to compete effectively. It facilitates meeting CMS timelines with automated letter generation; automated CMS file generation, transmission, and processing; and real-time eligibility and entitlement verification. ikaSystems continually reviews CMS guidance and regulations and makes updates to the system to reflect necessary changes.
As your Medicare business evolves, you can easily refresh the system to update existing plans, products, and membership in-house without changing any code, significantly reducing the cost of maintenance.
Fundamentals can also be integrated seamlessly with third party solutions or legacy systems and is automatically upgraded with little additional effort as updates become available. This base solution can easily be upgraded to ikaMedicareGateway to support larger Medicare memberships after rapid growth.
The benefits speak for themselves
ikaMedicareGateway Fundamentals core functions enable you to:
- Enroll members effortlessly with instant feedback on application completeness and validation
- Create correspondence based on CMS letter guidance
- Reconcile membership on a daily basis
- Reconcile CMS special status via automated daily maintenance
- Submit, monitor, and archive CMS files via optional services
- Increase administrative efficiencies with quicker processes and reduced rework
- Expand Medicare enrollment without adding staff resources
- Improve CMS Star measures by speeding enrollment, lowering disenrollment, and enhancing customer satisfaction
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