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.

Improve Data Accuracy and Collaboration

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
  • Increases accuracy and efficiency
  • Eliminates dependency on spreadsheets to build MA benefit plans
  • Improves collaboration to incrementally build products

Deliver Delightful Member Experiences

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

Simplify Filing to Ensure End-to-End Compliance

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

Make Informed Decisions With Actionable Insights

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

Gain Competitive Advantage With Market Intelligence

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.
.Docs

Document Generation

  • Dynamically generate print-ready ANOC/EOC, SB documents to meet regulations
  • Enable omni-channel re-use of the language
  • Review formatted content within the application
  • Share information on web portals or through print
  • Eliminate version issues
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.Compete

Competitive Data Analysis

  • Competitive Data Analysis
  • Easily access and compare competitive data
  • Access benefit data of thousands of competitors
  • Build products guided by insights
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.Actuarial

Product Data Comparison

  • Automate the comparison between the actuarial and product data
  • Reduce back and forth between product and actuarial teams
  • Improve operational efficiency
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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.
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Our Success Stories

Leading health plans rely on Simplify Healthcare to work smarter, faster, and optimize operational efficiency. Read about our success stories and learn how we have enabled higher client satisfaction.

*All personal information submitted by you will be used by us in accordance with our Privacy Policy.

A Large Health Payer Leveraged eMedicareSync™ VAP to Timely and Cost-Effectively Create Compliant ANOCs/EOCs and SBs

Read this case study by Simplify Healthcare to learn how a large Health Payer in the Northeast leveraged eMedicareSync™ Value Assurance Package to timely and cost-effectively generate compliant ANOCs/EOCs and SBs.

Elbow-to-elbow support for end-to-end document generation

Zero Compliance Issues

Generated fully compliant ANOC/EOC and SB documents
Cost-Effective Solution

Budget-friendly solution for document generation
100% Accurate Documents

Built documents with zero errors
Peace of Mind

No last-minute rush or long and stressful working hours
 

*All personal information submitted by you will be used by us in accordance with our Privacy Policy.

A large Payer became the first to publish plans on the MA marketplace using eMedicareSync™

A large Payer was struggling with their Medicare Advantage (MA) plan management. They were unable to integrate data from multiple sources into a single integrated system to get a 360-degree view of information and drive accurate and efficient data and processes. They were looking for ways to eliminate manual legacy processes, automate MA product/plan configuration and document generation processes, improve the quality of care and patient engagement, consolidate data, and accelerate speed to market.

Accelerate speed to market with a single source of truth for MA plan configuration

Faster speed to market

Improved speed to market to successfully become the first company to publish plans on the Medicare Advantage marketplace.
Improved quality of care

Enabled integrated data operability for data-driven and collaborative MA product management and care management.
Access to single source of truth

Leveraged a single source of truth to automate CMS PBP bid submissions, auto-generate documents, and elevate productivity.
Optimize Medicare Star ratings

Helped manage last-minute CMS changes, decrease submission errors, lower admin costs, and risk of penalties to optimize CMS Star ratings.

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
''Simplify Healthcare is a long-term strategy partner and a key part of our ecosystem. In the past 3 years, eMedicareSync™ has consistently helped us manage our Medicare products with ease. However, the new VAP service takes the whole experience up a notch. We want to continue using VAP year-on-year for our document generation needs.''
— VP, Marketing Communications
''eMedicareSync™ infused efficiency in every process of Medicare Advantage plan management. It gave us a significant competitive advantage as we were able to build product and communication documents accurately and fast. We became the first company to publish plans on the Medicare Advantage marketplace.''
— Senior Director, Medicare Enrollment

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.

What's Trending

Get the latest updates from Simplify Healthcare. Discover industry-leading ideas and deep insights in the form of blogs, podcasts, webinars, case studies, whitepapers, events, and more.

Webinar

Webinar – The Platform Potential for End-to-End Medicare Plan Management

Join our webinar to know how Medicare Healthcare Payers can accelerate speed to market of benefit plans and increase MA enrollment growth in 2023 using our automation solution.

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Press Releases

Simplify Healthcare’s eMedicareSync™ completes another successful bid season after automating 29% of CMS PBP bid submissions for 2023

Simplify Healthcare has enabled submission of over 29% of the total PBPs to the CMS accounting for an increase of 16% YoY.

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Simplify Healthcare completed another successful bid season after automating 26% of CMS PBP bid submissions for 2022 with eMedicareSync™

Simplify Healthcare is proud to announce that Medicare Advantage individual plans filed through eMedicareSync™ have accounted for 26% of the PBPs filed with the CMS this year.

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Simplify Healthcare tripled its CMS PBP bid submissions for 2021 Medicare Advantage Plans through eMedicareSync™

Simplify Healthcare is proud to announce that Medicare Advantage individual plans filed through eMedicareSync™ have tripled since last year and accounted for 25% of the PBPs and 20% of EGWPS filed with the CMS this year.

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Blogs

Get Fast, Accurate, Data-Driven Insights into Thousands of MA Healthcare Payers

Medicare Advantage (MA) is a fast-growing and highly competitive space. Insights into competitors’ Medicare Advantage plans can help Payers make informed decisions that are better aligned with their business goals.

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Eliminate the Complexity of CMS Updates and Accelerate Speed to Market of MA Plans in 2023

Health Payers in the Medicare Advantage market can start building their benefit plans 6 weeks before the final CMS PBP software release. Read our article to know how you can gain early to market advantage.

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How Can Healthcare Payers Overcome CMS PBP Bid Submission Challenges?

The manual process of making PBP bid submissions to the CMS can be time-consuming and error-prone. Discover how Payers can optimize the process.

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