Our Enrollment and Eligibility module manages the end-to-end Medicaid enrollment process through rules configuration for enrollment periods such as:

• Supporting eligibility-related inquiries.
• Helping with the modified adjusted gross income (MAGI) eligibility process.
• Providing newly eligible enrollees and potential enrollees an initial enrollment period.
• Helping enrollees to change health plans.
• Implementing day-one or same-day, real-time plan enrollment, if requested by the state agency.

Managed Care services

The module’s innovative capabilities enable agencies to streamline their Medicaid Managed Care services and more effectively accomplish these essential tasks:

• Assist enrollees and potential enrollees with signups for a  Managed Care health plan.
• Instruct enrollees and potential enrollees on Managed Care services.
• Process Managed Care health plan transfer requests.
• Educate enrollees on high-quality health homes and patient-centered medical homes.
• Create and distribute enrollment documents to Managed Care enrollees and potential enrollees.
• Provide Spanish and other foreign language translation capabilities as needed via telephone.

Omnichannel enrollment broker services

Wipro’s Enrollment and Eligibility module can also enhance agency operations and bring new efficiencies to key enrollment activities:

• Mailroom staff can design, print, and mail enrollment packages. After receiving completed applications by mail, teams can index, scan, and process them using AI-enabled OCR technology.
• Call center services can enroll members on the phone and provide multilingual support.
• Web portals enable online enrollment to Managed Care plans.
• The module’s CRM platform can log and track all interactions, as well as provide detailed reporting.