We deliver specialized Member Management and Enrollment Services tailored for U.S. Healthcare and Medicare Advantage organizations, ensuring full compliance with CMS regulations, operational efficiency, and an exceptional member experience.
Our solutions support health plans and TPAs in managing the complete member lifecycle — from enrollment to ongoing engagement — maintaining the highest standards of accuracy, timeliness, and regulatory adherence.
End-to-End Lifecycle Management
Our Medicare member management services are built around flexibility, scalability, and operational excellence.
Skilled professionals who integrate with your current systems to manage enrollment and member data efficiently.
Dedicated enrollment specialists
Integrates with your existing systems
CMS-trained, HIPAA-compliant team
Our team ensures every member interaction is handled promptly and professionally in accordance with CMS guidelines.
Service Details
Our operations are fully aligned with CMS requirements, ensuring compliance and audit readiness at every step.
MARx transaction processing — enrollment, disenrollment, and updates
Daily Transaction Reply Reports (DTRR) reconciliation and error resolution
Batch Eligibility Query (BEQ) handling
Synchronization of member records with CMS systems
Support for CMS audits and compliance reporting
Seamless, secure, and compliant data exchange between health plans, CMS, and third-party systems.
Management of inbound and outbound EDI transactions
Integration with Synthcare by Synthesis HealthSoft
Continuous monitoring, reconciliation, and error handling
Data integrity checks to ensure accuracy and completeness
Our workflow model adapts to evolving client needs while maintaining high performance and cost efficiency.
Scalable operations to support business growth
Customizable workflows tailored to client requirements
Optimized processes to reduce operational costs
High-quality, consistent service delivery outcomes
The expertise and infrastructure that sets Synthesis HealthSoft apart
Deep expertise in Medicare Advantage & CMS processes
Proven experience with EDI 834, MARx, BEQ & DTRR
CMS-Compliant Workflows & HIPAA Secure Data
99%+ Accuracy Rate with SLA-Driven Delivery
AEP Readiness & Scalability for peak periods
Customizable workflows aligned to your systems
3 service models — Staffing, Tech & Hybrid
Rapid onboarding & transition support
Ready to streamline your Medicare member management? Let’s discuss the right solution for your organization.