Products

Enrollment/Eligibility

Enrollment
Reduce your costs and maintain compliance by automating your member eligibility verification using the CMS-endorsed and recommended BEQ process. Automate your letter generation, election adjudication (up to 98% adjudication rates) and TRR processing.

Voyager’s Enrollment/Eligibility Module provides the ability to:
	Accept MA-PD, MA and PDP enrollment data
	Export enrollment/disenrollment, correction and change transactions for submission to CMS
	In-load weekly/monthly Election Transaction Reply Files (TRR)
	Export BEQ files for submission to CMS
	In-load BEQ reply files from CMS
	Export approved/eligible members to core claims system
	Utilize manual entry of election form data
	Import data files containing election transactions
	Utilize the flexible rules engine to edit election data for errors and work flow
	Manage exceptions by creating work items placed in work queues
	Allow examiners the ability to review/document and create correspondence and correct election data
	Build correspondence packages from stored Word Document template libraries
	Automatically initiate correspondence manually or from the rules engine
	Export CMS ready files for BEQ submissions, enroll/dis-enroll and corrections files
	Export enrolled members in to a core claims system
	Export queued correspondence for electronic print and fulfillment