CMS Compliance, Member Letters, and Maximizing Revenue
Can be Agonizing

Enrolling members into government programs is complex and involves layers of regulatory requirements. Time wasted with manual processes can impede staff productivity and profitability.

Getting the timing, language, premium amount, and CMS required language for member correspondence can be difficult and, if not done correctly, can initiate potential audits.

Reveleer's Solution Can Help You With Operational Efficiency

Reveleer’s Enrollment and Eligibility solution provides health plans with a highly automated solution that utilizes extensive pre-submission validations resulting in:

• Reduced manual labor
• Simplified enrollment status checking
• Highly accurate enrollment processing

System validations are done to ensure the data entered or batch submitted is formatted correctly (numbers in number fields, alpha characters in alpha fields, etc.). Eligibility validations are done via Batch Eligibility Query (BEQ) based on the information on the election. The system includes business rules regarding when certain elections can be used and what corresponding effective dates are viable.

Our member correspondence makes it simple as all CMS model letters are built within our system which helps automate the majority of your correspondence with intervention only required on exceptions found by our analytics. You have the ability to:

• Automate 95% of member correspondence
• Create, customize, or edit letters within the system
• View all past correspondence per member

Features