VIDABility Logo - Eligibility Management

Eligibility Management

Cloud-based member enrollment and eligibility data management solution for commercial, Medicare, Medicaid, and Public Exchange markets that enhances user visibility during the entire life-cycle of eligibility information.

VIDABility™ is a comprehensive solution that manages the coverage and relationships of insured members and their dependents and increases the visibility during the entire lifecycle of enrollment history. It provides easy access to member eligibility information from multiple sources in real-time while maintaining the most accurate eligibility data, in one place, all the time. 

VIDABility

Benefits

  • Simplifies and improves member administration via member-centric architecture and access to real-time data
  • Reconciles premium payments to eligibility for Medicare and Medicaid programs
  • Provides single source and visibility into the member transactions via user interface for improved customer service
  • Adaptable to meet changing business needs and scalable to meet growth demands

VIDABility

Advantages

  • Manages enrollment and eligibility records for Medicaid and commercial exchange
  • Allows Medicare Advantage eligibility processing and maintenance:
    • Enrollment request processing (MARx)
    • Updating enrollment statuses
    • Benefit Eligibility Query (BEQ) request and response processing
    • CMS enrollment response processing (DTRR)
  • Enables configuration of coverage levels, relationships and vendors
  • Provides member-provider assignment functionality
  • Permits unlimited benefit packages and premium structures
  • Eliminates duplicate data entry and associated complexity and problems
  • Allows unlimited insurance and relation tracking of insured members and any related entities
  • Ensures most accurate data is available in real-time
  • Provides transaction history traceability by member

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