Synchronicity

Madena Solutions > Reconciliation Software: Synchronicity

Making data make sense

Synchronicity™ is Madena’s state-of-the-art reconciliation Software as a Service (SaaS). Crafted from our decades of experience with CMS, Synchronicity™ is a comprehensive collection of data analysis, revenue enhancement, and reconciliation tools. You may subscribe to individual modules that fit your needs and access workflows through our web-based portal. Synchronicity™ is completely customizable to individual plan requirements.

Use Synchronicity™ two ways:

FULL SERVICE

Let our expert team work the data, providing you with reports and action steps that you can immediately implement for greater compliance and efficiency

HANDS ON

Manage your own work items and discrepancies with our user-friendly web portal.

Synchronicity™ supports all Medicare and Prescription Drug plans.

Synchronicity™ Tools

Identify enrollment, demographic, plan and status discrepancies. Migrate historical data to our platform to maintain a comprehensive member view and perform reconciliation on prior years.

Identify gaps in your LEP administration and premium billing processes. This module validates retroactive reporting and accurately reflects changes and removals in the premium billing.

Reconcile LIS premium subsidy and cost sharing levels with your premium billing system and Pharmacy Benefit Manager (PBM). Our comprehensive LIS reconciliation will decrease overrides at pharmacy point of sale and PDE rejections due to inaccurate cost sharing.

Identify member billing issues resulting from premium payment option discrepancies. Reconcile LEP and optional supplemental benefit premium collection for members on SSA/RRB withholding.

Efficiently group records, track ECRS submission, and reconcile primacy flags in your claims payment system. Customizable business rules help you manage MSP revenue recovery.

Pair with our COB module to Increase overall efficiency and identify overlaps in CMS files.

Increase accuracy of your COB processing and decrease administration staff requirements. Extensive, customizable business logic manages complex files and minimizes duplication.

Generate required CMS and plan correspondence. The letter management queue allows for individual letter printing, batch printing, or the creation of a print/mail vendor file in a customizable format.

Link your Finance team and month-end reporting activities directly to the reconciliation work being performed by the (our) operations team. Identify the financial impact of discrepancies and report under/overpayments for accruals.

A customized and comprehensive TRR matrix identifies actionable TRCs and sorts them into work queues. Work TRC efficiently and provide tracking to ensure compliance with Medicare standards. Produce reports for tracking and trending.

Reduce errors and RPC rejections by the systematic creation of archivable RPC packets and cover and submission sheets. Upload FDRs to close out items or identify rejections requiring resubmission. Generate RPC reporting to allow inventory management and oversight, and track trends.

Create EDV packets to ensure streamlined submission of data from EDV worksheets and supporting documentation. Meet monthly Medicare audit requirements and track audit success or failure to implement internal coaching and process improvement.

Identify discrepancies between health plan systems and CMS. Reduce incorrect CMS capitation payments, incorrect LEP collections and LIS subsidies, OOA reduction in CMS payment, and incorrect premium payment or collection of plan premium.

Part C & D Recovery analytics identify claims paid primary in error and allows for recovery of eligible amounts. Based on validation performed for primary other coverage records in MSP and COB modules.

LET'S GET STARTED

Call 720-428-2650 to discover optimized Synchronicity™ solutions for your company.