Enrollment Solutions

Enrollment applications come in all shapes and sizes.  Some payers have a single-page enrollment form while others may have a 15-page packet.  Regardless of the size, this information needs to be accurately captured and converted to a usable format.  Smart Data Solutions can capture your enrollment forms and can even help you develop new enrollment form layouts to further streamline the process.

Although the 834 is the most commonly used format for this information, many employer groups lack the tools needed to create an 834 themselves.  This results in the groups creating and sending data in whatever format they can. There is seemingly no limit to the different ways enrollment data is submitted by employer groups. Regardless of whether it’s flat files, spreadsheets, CSV files, delimited files, XML, fixed-width, or anything else, Smart Data Solutions can accept, consolidate, and deliver the data in a single normalized stream.  

When it comes to full files or change files, at the end of the day, you need to work with the formats your systems are able to accept and process.  No matter if you are receiving full files, change files, or a mix of both, Smart Data Solutions can receive these varied formats and convert them to the desired outcome. We can screen full files against prior submitted information, consolidating to just a single change file.  Likewise, we can accumulate information from change files and convert it to a regular full file. Regardless of how the information was submitted, you receive exactly what you need as the end result.

Our customized enrollment solutions don’t just stop at converting the applications.  Many of our payers have integrated their Primary Care Provider (PCP) assignment directly into our enrollment process.  Using your business rules along with the location and provider information, Smart Data Solutions can identify the correct PCP and assign it to the member automatically.