WESTBOROUGH, MASS. — April 26, 2016 —Advalent, a premier provider of enterprise solutions for healthcare payer organizations, has released a unique 7 Piece Lego Enrollment suite encompassing EDI Gateway, Enrollment Plus, Premium Billing and Commission systems, as well as Member, Employer and Broker Portals. This suite offers a highly automated model which promotes operational efficiency, allowing plans to achieve simplicity with minimum wasted effort and without compromising program integrity.
Advalent’s Enrollment Suite manages automated processing of inbound and outbound enrollment transactions (Medicare / Medicaid / Exchange/ Commercial/ Custom), coupled with premium billing and commission system capabilities. The suite allows further flexibility by offering multi-channel access to different self-service tools which seamlessly integrate across multiple health insurance platforms, thus permitting real-time collaboration. This unique solution permits easy customizations while adhering to federal and state’s rules and program designs. This suite of products promotes configuration over custom development enabling quick turnaround in offering immediate results, thereby reducing manual labor while increasing data accuracy and record-processing. In addition, the Enrollment suite gives payers the ability to improve application processing accuracy, eligibility verification, premium billing performance, broker commission and payment reconciliation consequently managing end-to-end processes for multiple streams within the organization.
Enrollment, Premium Billing, Commissions and self-service portals form a key layer within the payer organization. If data and automation within this layer are well- managed, the benefits of the results are quickly seen rippling through the downstream systems such as Claims, PBMs and DWH, etc. This plug and play Enrollment Suite is built with comprehensive and sophisticated technology, keeping in mind the business needs of the health plans. Users can implement the suite one piece at a time, changing “out of the box” functionality as needed, while integrating it with existing systems and eliminating errors owed to manual processes. Through process automation, payers will be able to capitalize on explosive growth in the market while lowering administrative costs and see results which are reflected in exchange driven markets.
Advalent’s smart exception logic module and interactive dashboards make it possible for the health plans to automate enrollment, as well as monitor the exceptions received from members and plans. Based on the exception trends, configurable error queues are created allowing users to precisely and efficiently correct membership records. Advalent’s Enrollment suite users have seen payment and enrollment reconciliation errors reduced by an estimated 50 percent due to greater automation and accuracy, boosting the handling of discrepancies. Furthermore, the suite also offers comprehensive data warehousing, reporting and labor-saving features. With its unique platform, Advalent is dedicated to keeping organizations fully compliant with high degree of automation so that health plans can achieve maximum productivity.
Advalent’s Enrollment Plus is the foundation and an integral component of Advalent’s larger comprehensive product line, which includes tools that automate the full spectrum of administrative processes, including Premium Billing, Commissions, Encounters and Care Management.
Advalent’s Premium Billing System offers health plans a highly configurable solution to automate all aspects of Premium Billing, member payments and real-time reconciliation.
Advalent’s Commission System manages broker commissions based on the enrollment and group payments, further more manifested by the broker self-service portals.
Advalent’s EDI gateway handles all electronic transactions with CMS, states and delegated entities in a seamless and compliant manner. Advalent will ensure compliance and adapt to conform with any changes to these transactions.
Advalent’s Portals offer self-service capabilities to support functionality of enrollment, premium billing and compliance. Advalent Portals provide a real-time view which provides up-to-date information to users. Portals drive engagement with value added services and health management education. Portals offer a secure way for users to reach health plans with their appeals and grievances.
“Advalent is reinventing healthcare technology. We are standardizing often duplicated tasks at health plans into configurable solutions, there by offering an affordable solution without compromising features and flexibility while being compliant. Advalent’s Enrollment Suite packages solutions that are typically disconnected into a single solution, eliminating data synchronization issues. We are applying latest technological advancements to healthcare IT to make it more widely available and affordable.” Sasidhar Parvatham, CEO Advalent Corporation.
Founded in 2009, Advalent is based out of Westborough, Massachusetts.