Business Process Outsourcing / Staffing

Staying compliant, current with policy changes, and up to date with your data and reconciliation are the challenges you face. We understand—and our expert team is here for you.

Whether you have a health plan membership of 80 or 8,000,000, we have a scalable staff solution to fit your needs. We utilize our Synchronicity™ Tools or your software to provide actionable solutions to keep you compliant with CMS.

OUR CORE BPO SERVICES INCLUDE:

• Enrollment
• Reconciliation
• Premium Billing
• Medicare Secondary Payer (MSP) Validations
• Coordination of Benefits (COB) Management
• End-to-End Member Reconciliation for Enrollment and Special Statuses
• Claim Recovery support
• Claims Processing

Our business model is not just focused on being in line with CMS regulations. We create operations systems that will increase efficiency and revenue, and produce an outstanding member experience.

• Use our proprietary software or yours – or a combination!
  • Integrate SyncEnroll™ or SyncRecon™ with your existing tools and processes
  • Augment areas where you don’t yet have operational tools in place

Madena supports all Government Program Sponsors including Medicare, Medicaid and Healthcare Exchanges.