Marketplace Membership Reconciliation
Solve problems at the source before they enter the process.
Infogix provides health plans with data analysis that ensures data integrity and automated reconciliation to provide transparency into both Marketplace Membership Reconciliation and Member Premium and APTC Reconciliation through flexible reporting and dashboards.
Validating marketplace membership for completeness up front in the process saves headaches in the form of time and money when incomplete or incorrect data is not reconciled. Finding reconciliation issues early in the process speeds up the member enrollment process and avoids errors that can pollute other downstream processes. Backing out bad data involves both understanding what systems have been impacted and then notifying the relevant stakeholders to fix those issues.
Infogix offers a suite of solutions in all of these areas, and have witnessed first-hand that quality data can’t be taken for granted, which is why many customers rely upon Infogix Marketplace Membership Reconciliation to ensure that any problems are identified and fixed at the source when they are less expensive to remediate.
Specific analysis provided around Marketplace Membership Reconciliation include:
- Reconcile between the issuer’s and government’s membership data (e.g. 834 files, Pre-Audit and RCNO)
- Detect duplicate file submission
- Flag incomplete data submission
How We Can Help
The Affordable Care Act offers health plans a variety of new revenue opportunities. By doing the financial reconciliation related to your exchange driven membership, you can ensure that you are capturing all the revenue from the new members and subsidies available from the government. You’ll also maintain the necessary compliance, avoiding misreported enrollment information and associated fines and customer service issues.