Enrollment numbers continue to surge—Are you ready?

As healthcare payers navigate the changed industry landscape reflecting ACA-related reforms, demand for member enrollment services has increased dramatically, as has demand for solutions to manage increased billing and collections needs. Firstsource lightens those burdens by providing leading-edge solutions for enrolling and assisting members, monitoring and pursuing revenue, and managing interactions with government agencies regarding federal benefits.

Customer care for the heart of your business

New Member Enrollment/Existing Member Changes

Firstsource agents are trained and technologically equipped to manage inbound and outbound new member enrollment. Aided by our automated data management systems, they are able to process physical and electronic forms to keep databases updated and facilitate efficient enrollment and eligibility turnaround. Firstsource agents also assist in changing plan information for existing members for cancellations, reinstatements, and member disenrollment.

Member Customer Service

Firstsource helps you increase member satisfaction and decrease churn by providing the highest quality of customer service to your members. From our omni-channel customer contact center, our agents are able to explain benefits and products, check on claim or approval status, update member and dependent information in our database and other member requests, all in a timely and capable fashion with minimal waiting.

New Member Welcome Calls

Your new member onboarding process opens with welcome calls from our friendly and professional contact center agents. They are able to educate new members on the details and benefits of their new plan, answer questions, and determine eligibility for other benefit programs within your system. They also attach a pleasant voice to your service and establish a pattern of pleasant interactions that can reduce stress and increase loyalty in members throughout the life of their plan.

Simplifying income management for a complex industry

Retrospective Review and Reconciliation

Firstsource’s automated technology, centralized data management, and industry knowledge allow us to effectively audit and analyze eligibility and benefits of members, along with billing and clinical documentation, to assess the accuracy of retrospective billing, reconcile reimbursements, and provide documentation that enables you to address discrepancies with minimal impact to provider relationships.

Premium Billing Reconciliation

Through our fully integrated billing system, Firstsource tracks posting and receipt of premium payments, reconciling them with actual revenue reports, enabling accurate billing and collections and identifying potential sources of loss for future attention. 

Premium Collections

Firstsource manages invoicing and payments of premiums to minimize payable funds and maximize revenue, including paper and electronic invoicing of subscriber and group premiums. We also address billing issues and track and pursue premium payment delinquencies to recover funds, all in compliance with your standards for customer service to maintain a positive relationship with members.

Capitation Rate Discrepancy Monitoring

As discrepancies become apparent between capitation rates and actual provider costs, Firstsource provides documentation for costs and payments, tracks where the associated funds originated and went, and monitors future activity to ensure that discrepancies are minimal or nonexistent in the future.

Helping your members navigate their federal health benefits

Screening, Follow-Up, and Conversion

Specialized agents with Firstsource are trained and experienced with the intricacies and specific requirements associated with benefits through Medicare and Medicaid. By screening members’ eligibility for federal health benefits, we are able to ensure that members are receiving the coverage they need while minimizing improper payments. When applicable, we follow up on that screening with eligible members and assist in a smooth conversion into the appropriate programs.

Enrollment

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New Member Enrollment / Existing Member Changes

Member Customer Service

New Member Welcome Calls

Billing

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Retrospective Review and Reconciliation

Premium Billing Reconciliation

Premium Collections

Capitation Rate Discrepancy Monitoring

Medicare / Medicaid

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Screening, Follow-Up, and Conversion