Enrollments Processing

Member and provider enrollments handled end to end

Enrollment forms, changes and terminations captured accurately and returned as clean electronic records — so premiums bill on time and eligibility data stays trustworthy.

Get a custom proposal All payer services

What we process

Delivered from our operations centre with document management, workflow reporting and daily email status reports, so every form sent to us is accounted for.

Member Enrollment Processing

Paper and PDF enrollment forms converted into clean electronic records for your core system — including changes and terminations.

Enrollment forms captured as indexed images plus a full field-level data file
Electronic file returned within 2 business days so premiums can be billed sooner
Member changes and terminations processed without adding headcount on your side
Enrollment statistics and member change reports for plan management
Every form and attachment stored in searchable document management

Provider Enrollment & Credentialing Support

Enrollment applications for Medicare, Medicaid and commercial payers, with CAQH upkeep and re-validation tracking.

New provider, group and location enrollments prepared and submitted
CAQH profile setup, attestation and ongoing maintenance
Re-credentialing and revalidation deadlines tracked before they lapse
Payer follow-up until an effective date is confirmed in writing
Status reporting by provider, payer and application stage

Enrollment Data Quality & Reconciliation

Validation, correction and reconciliation work that keeps eligibility and roster data accurate between systems.

Field-level validation against your business and plan rules
Duplicate, mismatch and missing-data exception queues
Roster and eligibility file reconciliation between systems
Correction cycles with a full audit trail of what changed
Daily email status reports on volumes, exceptions and turnaround

What this changes for your team

Enrollment work is seasonal and unforgiving. We absorb the peaks so your staff stay on exceptions and member service.

Faster premium billing on new members
Fewer eligibility-driven claim denials
No seasonal hiring for open-enrolment peaks
Cleaner rosters shared with providers and vendors

Built for health plans, TPAs and MCOs

Get a custom proposal for your plan operations

Tell us your payer type, membership and the work you want to hand off. We come back with a scoped proposal covering turnaround, accuracy standards, staffing and pricing.

Scope and turnaround commitments for your claim and document volumes
Dedicated, trained teams that scale through enrollment peaks
Accuracy, audit and HIPAA-minded controls documented up front
Transparent pricing tied to the volumes you actually process

Prefer to talk first? Call 630-430-1040

Get a custom proposal

Tell us about your plan and volumes. We'll come back with scope, staffing and pricing built for your operation.