Main Category: Medicare / Medicaid / SCHIP
Also Included In: IT / Internet / E-mail
Article Date: 26 Nov 2010 – 4:00 PST
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UCare, the fourth largest health plan in Minnesota, has gone live with solutions from ikaSystems designed to improve interactions with Medicare Advantage enrollees while supporting the plan’s administrative cost reduction and compliance goals. ikaSystems, a premier provider of enterprise-level cloud computing solutions for health insurance plans, is helping UCare both ease the complexity of Medicare Advantage enrollment and reconciliation processes and supply prospective members with a robust enrollment experience via the Internet.
“At the same time, we wanted to improve our interactions with prospective members by supplying a highly functional Web portal for enrollment. We felt that ikaSystems delivered a solution that helped prospective members enroll and connect with us easily, efficiently and cost-effectively.”
“After evaluating several vendors, it became clear that ikaSystems had the ideal solution for supporting our membership growth without increasing administrative costs,” said Beth Monsrud, senior vice president and chief financial officer at UCare. “At the same time, we wanted to improve our interactions with prospective members by supplying a highly functional Web portal for enrollment. We felt that ikaSystems delivered a solution that helped prospective members enroll and connect with us easily, efficiently and cost-effectively.”
UCare, which serves more than 200,000 members across Minnesota and western Wisconsin, was searching for a way to help the organization manage its Medicare enrollment growth through streamlined enrollment processes, stay compliant with Medicare regulations and control the administrative costs associated with member and payment reconciliation. After an extensive search, UCare selected ikaMedicareGateway based on its ability to meet all three criteria, plus the Member Portal for its ability to automate the enrollment process for prospective members.
According to Monsrud, “In previous open enrollment sessions, UCare would bring in temporary employees to handle manual enrollment processes, which became more cumbersome year after year as our membership expanded. This year, just two months after deploying ikaSystems’ solutions, we have already eliminated the need to bring on extra help, enabling us to significantly reduce administrative costs.”
In addition to deploying the Enrollment Pathways module of ikaMedicareGateway, UCare has also gone live with the Reconciliation Module, which helps health plans minimize discrepancies, perform more efficient discrepancy resolution, and minimize resources and rework during member and payment reconciliation processes.
“Health plans today are being forced to navigate an increasingly complex landscape. The regulatory impact of upcoming health care reform will require significant resources and flexibility to meet evolving business needs,” said Ravi Ika, chief executive officer of ikaSystems. “UCare has identified an opportunity to automate and streamline previously manual, cumbersome processes with ikaSystems, which will free up valuable resources to focus on the bigger challenges on the horizon.”
ikaMedicareGateway and ikaPortals are a part of ikaEnterprise, an end-to-end cloud computing-based solution for health plan business process optimization and intelligence management. It includes full sales cycle automation, core claims adjudication, care management and proactive quality measurement and reporting with self-service portals for sales, administrative, employer, member and provider use. ikaEnterprise has been successfully deployed, typically in a software-as-a-service (SaaS) model, in some of the nation’s finest health plans to reduce administrative costs in their commercial, Medicare and Medicaid business lines.
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