Our member management teams efficiently manage member accounts and registrations, including processing applications, collecting and correcting out-dated information, auto trigger ID card and correspondence and managing member data. Our highly experienced professionals will guarantee that a patient’s inquiries are promptly handled while updating them on outstanding claims, provider information, and member perks.
Member Enrolment Data capture - Paper/834/Proprietary formats
Maintaining member demographic, plan, PCP, benefits, etc… information up-to-date and triggering all corresponding reports/files/letters/ID cards needed for member, provider and TPA.
Synchronization of records with CMS database in case of Medicare program
COBRA file management
Health Risk Assessment form
Handling all up-to-date file exchange transactions, namely BEQ, MARx, DTRR, between “Synthcare and CMS”
Synthesis HealthSoft ‘Synthcare’ system can assist customer support team who handles incoming calls from hospitals, providers, or members seeking information on claims status, referrals, authorizations, and payments, as well as PCP changes and complaint resolution. Assuring that performance indicators and customer service needs are continuously met within set service level agreements. Our unique workflow was created to meet our clients’ and their patients’ demands while being adaptable, cost-effective, complete, and high-performing.