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Features include new enrollment consolidation and efficient handling of CMS transactions

BELLEVUE, Wash.–(BUSINESS WIRE)–Edifecs, Inc., a global health information technology solutions company, launched its Enrollment Management for Medicare Advantage solution to streamline automation of new member acquisition and enrollment processes for Medicare Advantage Organizations (MAOs). An alternative to manual touchpoints, the solution will improve operations through workflows, end-to-end enrollment lifecycle visibility and dashboard reporting for health plans looking to automate processes for Medicare Advantage enrollment.

The Medicare Advantage market continues to grow at steady rates (enrollment between 2019 and 2020 grew by about 2.1 million beneficiaries or nine percent, according to the Kaiser Family Foundation), and competition between health plans continues to heat up. As such, participating health plans must continuously seek ways to differentiate themselves and reduce operational costs. Outmoded IT infrastructure and highly manual enrollment operations put constraints on market expansion initiatives and can negatively impact a new member’s initial satisfaction.

“Members determine the success for all health plans and it is critical for health plans to enroll members in a cost-effective, efficient and timely manner,” said Sunny Singh, CEO of Edifecs. “Members today are more involved in their healthcare and their expectations for quality service are high. This solution will solve the many challenges health plans experience operating legacy enrollment systems and outdated technology that can lead to exacerbated enrollment timeframes and a lack of enrollment visibility.”

Staying competitive in today’s health insurance market requires more than just cost reduction. Edifecs offers the only enrollment hub designed for health plans of all sizes and all lines of business with Enrollment Management for Medicare Advantage. Through the enrollment hub health plans will be able to:

  • Consolidate enrollment operations across all product lines
  • Eliminate redundant IT systems
  • Gain economies of scale regarding IT total cost of ownership
  • Leverage a solution built on the market-leading EDI platform
  • Improve operational efficiencies by reducing manual touchpoints
  • Track each received and submitted member transaction

This solution further accelerates Edifecs’ mission of automating, optimizing and ensuring compliance within the healthcare ecosystem. The Enrollment Management for Medicare Advantage solution will accelerate market growth for health plans, grow top-line revenue and mitigate risk by establishing an enrollment hub.

To learn more about the Edifecs Enrollment Management for Medicare Advantage solution, visit

About Edifecs, Inc.

Edifecs develops innovative, cost-cutting information technology solutions to transform the global healthcare marketplace. Since 1996, Edifecs technology has helped healthcare providers, insurers, pharmacy benefit management companies and other trading partners trim waste, reduce costs and increase revenues. More than 350 healthcare customers today use Edifecs solutions to simplify and unify financial and clinical transactions. In addition, Edifecs develops transaction interoperability and standards compliance solutions for worldwide customers in non-healthcare industry segments. Edifecs is based in Bellevue, WA, with operations internationally. For more information, please visit


Janet Hohmann


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