Medicare plan management solution

Simplify Medicare Advantage Plan Management

Industry’s first CMS PBP integrated Medicare Advantage product configuration solution that accounted for 25% of the total PBPs and 20% of the total EGWPs filed with CMS for 2021.

  • Auto-generate CMS PBP outputs, ANOC/EOC, and SB documents.
  • Improve accuracy, consistency, and speed-to-market.
  • Simplify competitive analysis for strategy-based decisions and ability to fine-tune plan designs.
  • Eliminate last-minute CMS changes and last-minute fire drills.

Automate the CMS PBP bid submissions, innovate, and grow with a SaaS-based enterprise solution that powers a new style of technology.

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

Market leader in benefit plan configuration

eMedicareSync™ is the industry’s first CMS PBP integrated turnkey end-to-end MA product/plan configuration and document generation solution (ANOC/EOC, SB) that improves accuracy, timeliness and cuts effort/cost by up to 75%.

Eliminate errors, inefficiency, and risk of penalties

The solution uses Excel grids to drive Medicare Advantage product configuration enabling health plans to reduce errors, eliminate duplicate data entries, and reduce multiple rounds of manual validation.

Automate end-to-end Medicare Advantage product lifecycle

eMedicareSync™ creates a single source of truth for benefits data and dynamically generates plan and compliance documents with just a few clicks.

Ensure end-to-end compliance

Import/export MA products to/from CMS PBP easily, automate workflows to enable collaboration across all stakeholders and accelerate response to changes in market structure and compliance requirements.

eMedicareSync™ is named as the 'Sole Leader' in the IDC's MarketScape.

2016 Vendor Assessment of the U.S. Health Plan Product/Plan Benefit Configuration Solutions.
eMedicareSync™ is named as the 'Sole Leader' in the IDC's MarketScape
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IDC MarketSpace: The US health plan has announced eMedicareSync™ as the ‘Sole Leader’ in the product/plan benefit configuration solutions category.

Learn how using a modular integrated solution, health plans can be future-ready, manage cost, limit risk, and drive growth.

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Why eMedicareSync™?

Redesign the 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.
Compliance Documents

Accurate, on-time up to 100%


Increase speed-to-market up to 70%


Decrease errors up to 90%

Admin Costs

Decrease admin costs up to 75%

Learn how health plans can accelerate, automate, and optimize CMS PBP bid submissions using eMedicareSync™.

Application Modules

Our Medicare Advantage plan management solution can be molded according to your business. Select from our integrated modules that suites your business to address your pain points and maximize investments.
Create single source of truth for your plan data

Take control of your data by managing its configuration and use

Establish a single source of truth for MA products via business rule driven interface with guardrails, annotate and track changes for regulatory and business communication content, eliminate Excel grids, automate workflows and routing of information between various teams using .Source
Auto-generate documents to meet regulations

Automate document generation and version management processes

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, and eliminate version issues with .Docs
Improve claims management accuracy

Simplify configuration of benefit plans and keep your claims system up-to-date

Configure your MA benefit plans 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 MA product configuration with .Claims
Design plans that are ready to compete

Design benefit plans that are ready to compete in your marketplace

Easily access and compare competitive data to drive which products you put in the marketplace with .Compete
Seamlessly share information across the enterprise

Automate the integration of key benefits data and documents into essential systems

Ensure your single source of truth is integrated everywhere across the enterprise. Seamlessly integrate benefit plan information to/from CMS PBP for MA Bids, engage all stakeholders via integrated use-case specific workflows vs. emails, and automate CMS PBP bid submissions using .Integrate

Expose your user-configurable data to standard reporting tools

Ensure your dynamic pristine data is integrated with your Master Data Management investments and is available in real-time to your reporting and business intelligence tools using the relational database format and flexibly captures all types of MA benefit plans using .DataMart
Improve speed-to-market with seamless CRM integration

Sell and quote while customizing your benefit plans

Simplify configuration of MA benefit plans with the intelligent decision support for sales, product development, and document generation. Get access to all applicable benefit plans, customize products, seamlessly integrate information to/from CMS PBP for MA Bids and increase speed-to-market with .Sales

Develop premium rates with a tight alignment to your plans

Automate the comparison between the actuarial and product data with .Actuarial

Frequently Asked Questions (FAQ's)

Here are the most common, frequently asked questions about implementing end-to-end Medicare Advantage 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.

Case Study - Reduce quote to cliams

CASE STUDY – Accelerate speed-to-market with a single source of truth for MA plan configuration

A large health plan on the East Coast was struggling with Medicare Advantage (MA) plans 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 efficient data and processes. They were looking for ways to eliminate manual legacy processes, automate MA product/plan configuration and document generation processes.

What our customers say.

''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

Ready to get started with eMedicareSync™?

Are you interested in learning more about eMedicareSync™? Our team is ready to answer all your questions. Let’s make smarter health ecosystems together! Schedule a 1:1 demo with us.
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