ikaMedicareGateway

Member growth and high ROI.

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ikaMedicareGateway transforms health plans’ Medicare enrollment and member reconciliation by increasing speed and accuracy. This flexibly configured, low-maintenance solution drives administrative efficiencies, adherence to the Centers for Medicare & Medicaid Services (CMS) requirements, and improved Star ratings.

ikaMedicareGateway is a full-feature, powerful enrollment solution for Medicare Advantage organizations. It has enabled health plans to achieve dramatic growth in membership enrollment while decreasing costs and increasing productivity—ultimately delivering a high return on investment.

Efficiency plus compliance

By automating member enrollment and reconciliation processes, ikaMedicareGateway dramatically increases administrative efficiencies while adhering to CMS regulations. As a total solution, it identifies, prioritizes, and corrects discrepancies between your plan and CMS, saving time and reducing errors. It also facilitates 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 configure the system to update existing plans, products, and membership yourself without changing any code, significantly reducing the cost of maintenance.

ikaMedicareGateway can also be integrated seamlessly with third party solutions or legacy systems—and is automatically upgraded with little additional effort as updates become available. The highly configurable solution easily scales to support rapid Medicare membership growth.

The benefits speak for themselves

ikaMedicareGateway enables you to:

  • Enroll members effortlessly with instant feedback on application completeness and validation
  • Create correspondence based on CMS letter guidance
  • Identify, prioritize, and correct discrepancies between your plan and CMS—including demographic, plan, and special status
  • Reconcile membership on a daily and monthly 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

Faster, more accurate enrollment and reconciliation

UCare, a Minnesota health plan servicing over 90,000 Medicare-eligible individuals through its Medicare plans, realized administrative cost savings and greater capacity for growth through efficiencies and fewer errors.

  • 102% increase in productivity
  • 80% reduction in application processing time
  • Over 99% new enrollment success rate
  • 40% growth in membership

View other products in Government Services Solutions:

ikaMedicareGateway Fundamentals
Consumer Web Portal
Payment Reconciliation
ikaClaims for Medicare
ikaCRM for Medicare
ikaCorrespondence
RAPS/EDPS
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