Quantcast Transaction Insight Enrollment Manager – Foresight Corporation
Innovative software for healthcare transaction automation, EDI validation, and advanced reporting

Transaction Insight® Enrollment Manager

As an extension of the Transaction Insight Automation Platform, Enrollment Manager streamlines the enrollment process for healthcare organizations through specialized validation, reporting, display and error correction of HIPAA 834 and proprietary format enrollment transactions.

Improve the Efficiency of your Enrollment Process

High-Speed Enrollment File Validation

Using the fastest transaction validation engine, ensure benefit enrollment and update files in HIPAA 834 and proprietary formats are compliant with standards and your custom business rules. Problem transactions are flagged with configurable error messages to facilitate correction.

Splitting and Routing

Eliminate full-file rejection of Change / Update files by splitting bad records and allowing the remainder of the file to proceed. Verify / Audit files that cannot be split are routed to the appropriate team for correction.

Plan Sponsor and Employer Communication

Inform key stakeholders of enrollment file status through detailed performance reporting and proactive alerts with links directly to errors within documents.

Work Queue Management

Automatically assign rejected enrollment transactions to specialized teams based on partner, line of business, transaction type, error types, geography and other user-definable criteria, and track your teams’ productivity with automatic performance reporting.

On-screen Error Correction & Re-submission

Allow your staff, plan sponsors and employers to correct enrollment transactions for and re-submit through the Transaction Insight portal or your own custom portal for immediate re-validation and adjudication.

Common errors within a file can be corrected in a single, global update for all plan members.

The Benefits

  • Improve claim auto-adjudication rates by ensuring member profile records are up to date before claims are received.
  • Reduce call volume by avoiding denials of service due to enrollment records not being processed timely.
  • Improve member relations by reducing denied claims due to missing or incorrect profile information.
  • Strengthen provider relations by reducing failed eligibility requests and pended claims.