Appstix Technologies manages the eligibility and enrollment process for our clients, including the verification and determination of each member's coverage to help automate the process and free up necessary resources.
Appstix Technologies ' skilled team of subject matter experts manages the eligibility and enrollment process for our clients, including the verification and determination of each member's coverage specificity. Delegating this task to Appstix Technologies allows your organization to free up resources and concentrate on core business functions that optimize internal operations.
skilled SMEs identify the patient/member to determine:
- If the member or dependents are covered by an active policy or plan
- If the member or dependents needs to be enrolled
- If the member and dependents’ opted coverage has a valid coverage period to enroll
Our eligibility and enrollment solutions handle
- Switching over plans from the previous year and initiating the coverage under new plans
- Ensuring the correct PPO coverage is linked to each member in the case of commercial payers for small groups
- Making sure the defined stop loss coverages are linked to correct groups
- Capturing and checking the patient information against the eligibility database