A Health Plan’s Story: Optimized Operations and Improved Revenue Assurance driven by an Enrollment Hub

Very few will argue that the business of healthcare has been particularly easy, streamlined, or straight forward over the past couple of decades. It is increasingly complex, with more regulations to adhere to, and more health plan competition than in the past. Health plans today are engaging in more M&A activity and most operate more than one line of business (LOB). These aspects not only contribute to rising IT costs and complexity for plans but can also have a negative impact on revenue streams. So, where should the health plans of today start when looking at ways to optimize operations and improve revenue assurance? They should start at the beginning of their customers lifecycle…with enrollment.

In this case study, learn how a northeast regional health plan made a strategic decision to engage with an outside vendor to establish their own Enrollment Hub.

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Edifecs Inc. is a global healthcare software company committed to improving outcomes, reducing costs, and elevating the value of healthcare for everyone. Edifecs delivers the industry’s premier IT partnership platform to providers, insurers, pharmacy benefit management companies, and other trading partners. By mobilizing its leading solutions at the front end of the healthcare information pipeline, Edifecs provides a unified platform for partners to flexibly pilot and scale new initiatives using their existing enterprise systems. Since 1996, hundreds of healthcare customers have relied on Edifecs partnership solutions to future-proof their leading initiatives in the midst of a dynamic healthcare landscape. Edifecs is based in Bellevue, WA, with operations internationally. Learn more about us at edifecs.com.

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