Fuel Your Growth in the Medicaid Market

Leverage eMedicaidSync™ to enable a connected benefits journey for the Medicaid market.

Launch Medicaid Products Faster Than Competitors

Manage Products in One Place

Create accurate Medicaid Managed Care (MMC) and Medicaid Fee-For-Service (MFFS) benefit plans from a single source of truth.

Robust Collaboration

Enable cross functional teams and business processes by activating out-of-the-box workflows across unlimited users.

Launch Medicaid Products Faster Than Competitors

Manage Products in One Place

Create accurate Medicaid Managed Care (MMC) and Medicaid Fee-For-Service (MFFS) benefit plans from a single source of truth.

Robust Collaboration

Enable cross functional teams and business processes by activating out-of-the-box workflows across unlimited users.

End-to-End Compliance With Medicaid Documents

Errata-Free Compliance

Achieve 100% compliance with Medicaid materials including Handbooks and Booklets by leveraging a 508-compliant document automation engine.

Take Confident Decisions With Data

Real-Time Reporting and Insights

Take advantage of the full suite of standard and custom reporting and analytics options across the platform.

Take Confident Decisions With Data

Real-Time Reporting and Insights

Take advantage of the full suite of standard and custom reporting and analytics options across the platform.

Integrated Operational Excellence of Your Medicaid Business

Automate Integrations with Claims

Keep your claims system always in sync with Medicaid benefits information connected out-of-the-box.

Seamless API Integrations

Take advantage of hundreds of out-of-the-box API end points to integrate with other areas of your architecture ecosystem.

Listen to Our Customers

Frequently Asked Questions (FAQs)

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

What is Medicaid benefit plan management?

Medicaid benefit plans solution encompasses the entire Medicaid benefit plan management process, including configuring and updating the plans, generating documents, and integrating that information across the organization while maintaining CMS and State compliance.

What are the challenges with traditional Medicaid benefit plan build processes?

The traditional, manual Medicaid benefit plan management processes, based on benefits grids, are prone to errors. These processes involve back and forth that ultimately result in version control issues and erroneous information being manually entered into Core-Admin and other systems. With traditional processes, it usually takes weeks to configure a market-ready Medicaid benefit plan. Moreover, managing Medicaid benefit plans with spreadsheets and communicating via emails means last-minute changes, which often pose challenges for already overburdened product teams. Some of the critical challenges with legacy benefit plan configuration processes are:

  • Data-driven Excel grids with repetitive data entry into Core-Admin and other systems leads to a lack of version control with data redundancy.
  • Lack of central repository to manage Medical, Dental, Hearing, Vision services, and multiple States’ product requirements.
  • Handling CMS and State compliance become a challenge.
  • Lack of data integration and workflow collaboration across other systems and stakeholders.
  • There is no single source of truth methodology to update/manage all product data, including handbooks, booklets, and other marketing materials.
  • Disparate legacy Medicaid plan management processes result in low data accuracy, high risk of errors, and data redundancy.
  • Processes were labor-intensive, prone to human error, and improving speed to market was a massive challenge.

What are the benefits of automating your Medicaid plan management processes?

Here are some of the key benefits of automating your Medicaid benefit plan management processes:

  • Reduce turnaround time and improve speed to market.
  • Reduce errors, improve data accuracy, and consistency.
  • Create a single source of truth for Hearing, Medical, Dental, and Vision services and manage single or multiple States’ product requirements in a single integrated system.
  • Promote data reusability and reduce the risk of errors due to manual processes.
  • Use the market-leading single source of truth approach as a central repository to make changes to your plan data. Apply changes in one location and have them reflect in all aspects of your plan.
  • Easily update Medicaid plan data and auto-generate documents, handbooks, and booklets in just a few clicks.
  • Automate your CMS and State regulation compliance processes with a more robust quality audit and easy mandate update incorporation.

How does eMedicaidSync™, an automated Medicaid benefit plan management solution, fix issues seen in legacy processes?

eMedicaidSync™ provides a single source of truth to Medicaid Managed Care plans and Medicaid Fee-For-Service programs to manage plan data, documents, systems integration while handling each State’s requirements. It utilizes an advanced single source of truth methodology that acts as a central repository for the Medicaid benefit plan data making it accessible across the enterprise. When changes are applied to the master template, it reflects the changes across all sections. An automated solution means stakeholders do not have to communicate via emails and spreadsheets. There is better version control, and it’s easier to implement last-minute changes.

Here are some ways eMedicaidSync™ solves the issues with legacy processes:

  • A single source of truth solution to manage Medicaid benefit plans data, documents, systems integration while handling each State’s requirements.
  • Efficiently manage last-minute changes with eMedicaidSync™’s workflow management, enabling collaboration across all stakeholders, and data changes are seamlessly applied across the enterprise.
  • A proven platform with benefit plan management capabilities for Medicaid Managed Care plans and Medicaid Fee-For-Service programs.
  • Health Plans can now easily manage CMS, State mandate updates, auto-generate documents, handbooks, and booklets with just a few clicks.
  • Reduce turnaround time to fewer calendar days and thus significantly improve your speed to market by up to 70%.
  • Ensure a single source of truth for multiple States’ products and quickly decrease admin costs by up to 75%.

Can eMedicaidSync™ help with CMS and State regulation compliance?

Yes, it absolutely can. eMedicaidSync™ is the only solution developed by Health Plan professionals keeping in mind the specific requirements of Health Plans. With eMedicaidSync™, you would be able to implement CMS and State regulations, update, and be ready to roll out the product in just a few days. You would also be able to auto-generate Medicaid benefit plan-related communication documents like handbooks, booklets, and other marketing materials with only a few clicks.

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Simplify Healthcare launches eMedicaidSync™, a single source of truth Medicaid Benefit Plan management solution

Simplify Healthcare is proud to announce the launch of its new solution, eMedicaidSync™, a single source of truth Medicaid Benefit Plan management solution for Medicaid Managed Care and Medicaid Fee-For-Service plans.

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