Smarter, Faster Medicare Advantage Enrollment Technology
U.S. Owned & Operated Since 2006
Established alongside Medicare Advantage (MA), we’ve harnessed big data, predictive analytics, and our proprietary algorithms to fuel compliant membership growth for start-ups, regional, provider-owned, university-affiliated, national insurers and TPAs.
Our deep expertise and exclusive focus on MA allow us to outpace global competitors and serve as a dedicated partner in achieving our client’s strategic vision.
Frictionless Member Lifecycle
First impressions matter. A seamless enrollment process is fundamental to member satisfaction, financial stability, regulatory compliance, and competitive advantage.
Medicare CRM®
The first purpose-built marketing & sales engine for MA. Real-time marketing & sales channel management. Proven with 17 years in-market, MCRM is the preeminent solution by which all others are measured.
ECM™
Enrollment Channel Management is the single source for application intake - eliminating the need for multiple vendors and creating a unified member experience.
EMMA™
Enrollment, Member Management &Administration automates everything from enrollment processing through ongoing member administration including all transactions with CMS. Real-time letter generation, CMS compliant workflows, and much more.
Automated.
Intelligent.
Compliant.
Manage all communications with CMS via the most advanced features and frequent enhancements that integrate new regulatory requirements.
Performance Optimization
- Intelligent, rules-based enrollment
- Exceptions sorted into logical queues
- Automated CMS letter generation
- Streamlined UI with easy access to data
Enrollment Processing
- Application intake from any source
- Automated, real-time completeness checks
- Real-time Eligibility Determination
- Enrollment to CMS confirmation within 24 hours
CMS Compliance
- CMS Timelines Enforcement
- Monthly reconciliation CMS data vs. EMMA
- Model and Non-Model Member Correspondence
- Automated complex calculations (eligibility, LEP, etc.)
Accretion & Reconciliation
- Cavulus or Plan acting as CMS Submitter
- MBIT creation for CMS submission
- Complete TRR processing with automation > 90%
- MA/MAPD/ PDP/Group/SNP workflows */
Change is inevitable. Leverage out-of-the-box best practices along with uncommon flexibility for unique business rules, TPA arrangements, and an evolving regulatory environment.
Cavulus Benefits
No seat-licensing or per-user costs.
Vertically integrated, completely U.S.-based employee model.
Exclusive focus on Medicare Advantage.
Built-In CMS Compliant Workflows.
Cavulus support included 24x7x365.
Leverage deep payor expertise and national insights.
Our Latest Thinking
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