HEALTHsuite Advantage™Medicare Advantage Enrollment, Billing and Reconciliation

Plans currently administering Medicare Advantage and those contemplating launching an MA offering do not always share the same challenges:

• Not all health plans are prepared to replace their core systems (ie. claims) all at once – and prefer a phased approach
• Other organizations prefer to administer MA on their current claims platform but understand they require specific functionality to meet the rigors of CMS enrollment, billing and reconciliation

HEALTHsuite Advantage’s Enrollment, Premium Billing and Reconciliation (EBR) solution can operate independently or serve as a “Front-End” and integrate with any claim system.

Standalone or integrated, our EBR solution may be implemented and configured rapidly to manage MA enrollment and bi-directional communications with CMS.

Industry standard and proprietary interfaces are available to support integration with any claims administration system (ANSI x12 834, or 834 mapped to proprietary format, etc.)

RAM’s offering, Medicare Advantage-in-a-Box, powered by HEALTHsuite Advantage, not only automates all aspects of enrollment, billing and reconciliation, but also features an accelerated implementation mode; drastically collapsing time to market and saving your organization valuable time and money.

Add RAM’s vast experience in Medicare Advantage administration and CMS compliance to the mix, and you have the keys to success for taking your Medicare offering to the next level.

The superior BPaaS Services for EBR available through RAM Health Services include:

• Enrollment and Eligibility Management
• Premium Billing and Payment Processing
• Financial Reconciliation
• Customer Service / Call Center Management
• Mailroom and Fulfillment Services
• Reporting and Compliance
• And more…

Contact us today to see how RAM’s EBR solutions (technology platform and / or BPaaS options) can provide you with the most expedient and compliant path to operational excellence in your enrollment, billing and reconciliation processes.