Leverage cutting-edge technology to accelerate Medicare Advantage enrollment growth in 2023 and beyond

Eliminate last-minute CMS PBP changes, elevate productivity, and auto-generate ANOC, EOC, and SB documents with a push of a button.

Industry Challenge 

  • Absence of a single source of truth for MA benefit data 
  • Dependency on legacy systems 
  • Manual processes to build Medicare Advantage benefit plans 

Impact 

  • Version control issues 
  • Errors and inconsistencies 
  • Decreased speed to market 

Our Solution 

  • Creates a single source of truth 
  • Eliminates dependency on spreadsheets to build MA benefit plans 
  • Improves collaboration to incrementally build products 
  • Increases accuracy and efficiency 

Industry Challenge 

  • Manual creation of member communication documents 
  • Repetitive efforts of creating documents from scratch every year 
  • Manual review and approval cycle 

Impact 

  • Increased risk of errors 
  • Compliance challenges 
  • Member frustration 

Our Solution 

  • Generates accurate ANOC, EOC, and SB documents 
  • Enables omnichannel reuse of language 
  • Improves timeliness and compliance 
  • Reduces cost and improves efficiency 

Industry Challenge 

  • Manual process of generating PBP bids 
  • Changes made every year to the compliance requirements by the CMS 
  • Small window for making revised submissions 

Impact 

  • Stressful and tedious process due to the last-minute rush 
  • High risk of errors 
  • Risk on non-compliance 
  • Small window for making revised submissions. 

Our Solution 

  • Auto-generates accurate CMS PBP bids for submission 
  • Accelerates speed to market 
  • Reduces last-minute fire drills 
  • Minimizes the risk of non-compliance and penalty 

Industry Challenge 

  • Reliance on legacy reporting tools 
  • Manual process of creating reports 

Impact 

  • Slow and inflexible systems and processes 
  • Decreased decision-making capability 

Our Solution 

  • Provides out-of-the-box custom reports 
  • Empower payers with key business insights 
  • Improves decision-making 

Industry Challenge 

  • Manually scraping data from competitors’ websites for competitive analysis 
  • Building comparative reports in spreadsheets 

Impact 

  • Slow and complex process 
  • High cost to ROI ratio 
  • Non-comprehensive analysis 

Our Solution 

  • Regularly updated and growing database of thousands of benefit plans 
  • Enables competitive analysis with thousands of competitors’ plans 
  • Multiple parameters for comprehensive analysis 
  • Auto-generate color-coded reports in Excel, giving them unprecedented competitive advantage. 

Why eMedicareSync ?

Redesign disparate legacy systems with an automated enterprise solution! eMedicareSync™ helps health plans reduce 75% of the time and effort required to build Medicare Advantage products and improve speed, accuracy, and cost-effectiveness of benefit plan design.
Compliant Documents
100%
Speed to Market
70%
Errors
90%
Admin Costs
75%
Industry-leading solution to solve Medicare Advantage plan management challenges

Choose an end-to-end solution or select any module to solve specific pain points

Our Medicare Advantage benefits plan management solution can be molded according to your business. Select from our integrated modules that suits your business to address your pain points and maximize investments.

Integration of other solutions with eMedicareSync™ ecosystem

eClaimsEngine™ – Our claims configuration solution, integrates as a component of eMedicareSync™ to configure your Medicare Advantage plans' benefits data at one place with intelligent decision support, eliminate repetitive data entry into Core-Admin and other systems, keep your claims system up-to-date, and automate the maintenance of your benefit configuration.
Case Study - Reduce quote to cliams
CASE STUDY

A large health plan on the East Coast increased speed to market and successfully became the first company to publish plans on the Medicare Advantage marketplace using eMedicareSync™.

Listen to Our Customer

''eMedicareSync™ reduced 75% time and effort to build Medicare/Medicare Advantage products and auto-generated all documents in time and with quality. This was our first CMS submission where there was no chaos due to last-minute changes.''
— Director, Marketing Communications

Frequently Asked Questions (FAQs)

Here are the answers to the most frequently asked questions about implementing end-to-end Medicare Advantage benefit plan management solution and partnering with Simplify Healthcare.

1. What is Medicare Advantage plan management?



Most Medicare plans run their product configuration process from spreadsheets, but that burdens the users with duplicate data entries into the CMS PBP system, increasing the risk of errors and last-minute fire drills that require manual data manipulation. Medicare Advantage plan management is the process of managing end-to-end Medicare advantage product/plan configuration, enabling health plans to automate their PBP processes, streamline operations, and auto-generate documents while complying with all state/federal policies, rules, and regulations.

2. What is CMS PBP integration and Medicare product configuration?



Plan Benefit Package (PBP) is a well-defined system enabling health plans to submit their Medicare Advantage plans for CMS approval. Our solution, eMedicareSync™, can be easily integrated with CMS to automate PBP submissions and efficiently configure customized Medicare products with just a few clicks.

3. What are the challenges with traditional Medicare Advantage plan management processes?



Traditional processes often create challenges like maintaining benefits data in Excel grids, inconsistencies between the grids, last-minute CMS changes, manual generation of documents, proofing, and re-proofing with every update. Similarly, loading your plan data into the CMS PBP system can be problematic since it is typically a manual data entry process that is slow, tedious, and error-prone. Finally, keeping up-to-date with CMS changes can be very difficult for health plans while ensuring the new requirements are fully understood, and the needed changes are made to the Medicare Advantage plans.

4. Why use the Medicare Advantage product configuration solution?



eMedicareSync™ is the industry’s first CMS PBP integrated turnkey MA product configuration solution, enabling health plans to automate end-to-end Medicare Advantage plan management and document generation processes. It helps improve accuracy, timeliness, and cut efforts/costs by up to 75%. The solution can help eliminate last-minute CMS changes and generate CMS PBP output and documents with the push of a button.

5. What kind of documents can be generated with a MA plan management solution?



With the MA plan management solution, health plans can auto-generate all MA compliant documents like ANOC, EOC, and SB with just a few clicks. The solution enables consistent and accurate document generation for reduced risk of penalties and timely and accurate filings.

6. How can you automate Medicare product management, PBP loading, and document generation?



Put the innovation at the core of your Medicare Advantage processes with eMedicareSync™, one-of-its-kind game-changing Medicare product management, PBP loading, and document generation solution. It helps automate plan development, ANOC/EOC document generation, auto compare products to ensure effective and efficient audit/QA, create a single source of truth for all Medicare Advantage product information, and comes pre-configured to load PBP to automatically updates CMS rules.