Enrollment & Eligibility

Wipro EMaaS’s Enrollment and Eligibility module efficiently manages the complete Medicaid enrollment lifecycle. Leveraging configurable rules for enrollment periods and innovative features to simplify Medicaid Managed Care services, its enables agencies to implement real-time plan changes more effectively.

Key Functions

The Enrollment and Eligibility module manages the Medicaid enrollment process from end to end, supporting agencies in several critical areas:

• Eligibility Inquiry Support: Assist with inquiries related to eligibility, ensuring clarity and understanding for applicants.
• MAGI Process Assistance: Aid in the modified adjusted gross income (MAGI) eligibility determination process.
• Initial Enrollment Periods: Provide newly eligible individuals and potential enrollees with an initial enrollment window.
• Health Plan Changes: Support enrollees in changing their health plans as needed.
• Real-time Enrollment: Enable day-one or same-day plan enrollment to expedite access to coverage.
• Managed Care Guidance: Instruct enrollees and potential enrollees on the benefits and use of Managed Care services.
• Education on Health Homes: Educate enrollees about high-quality health homes and patient-centered medical homes.
• Multilingual Support: Offer assistance in multiple languages to serve non-English speaking enrollees effectively.

Embrace a comprehensive solution for Medicaid enrollment and eligibility management that simplifies processes and enhances the enrollee experience.