Eligibility and
Enrollment Services

Reforms are changing the government healthcare services landscape. With the emergence of new healthcare services and programs, it’s critical to help your constituents understand and determine their eligibility for appropriate programs. And you need a rapid response to address new program demands. Our solutions can help you streamline enrollment, provide seamless access to benefits, and proactively reach out to your constituents.

For a better way to inform your population about their healthcare choices, look to our healthcare eligibility services. For four decades, we’ve helped government agencies implement and manage solutions that meet program needs – all while providing a high level of service and cost efficiency.

Our proven healthcare eligibility services expand access to information, increase enrollments, and help your population navigate their choices. Our enrollment solutions include:

• Health insurance exchange development and implementation
• Web-based program eligibility application processing
• Customer service call center operations
• Program outreach and education
• Quality assurance

Advantages for agencies

• Cost-efficient managed services
• Simplification of core agency processes with modernized workflow processes
• Fast, flexible and scalable technology
• Accurate, timely enrollment with less manual rework
• Increased transparency using drill-down dashboard reporting with predictive analytics available at your fingertips, on your schedule

Advantages for citizens

• Faster delivery of benefits with reduced paperwork and in-person visits
• Self-empowerment, self-service options available 24/7
• Real-time, no-waiting access to program information
• Personalized notifications

Comprehensive eligibility experience

As the world’s largest business process services company, we are improving the way businesses and governments interact with their citizens, patients, customers, and employees. Our mission is to modernize the constituent experience by making every interaction digital, personalized and secure. Due to our unrivaled experience in government services, we have a profound understanding of the wide range of government health and human services programs. By taking advantage of our in-depth experience, we can help you offer much-needed services to your citizens in an efficient, cost-effective way. Conduent has:

• Nearly 50 years of experience integrating, implementing and enhancing systems for Medicaid, CHIP and other public programs
• 34 years of experience with Healthcare Eligibility and Enrollment services
• 37 million people served in government health care services
• Served 23 million Medicaid and CHIP beneficiaries
• Handled over 30 million customer contacts annually supporting over 200+ languages
• More than 24 years of eligibility assessment and determination experience
• Assessed and processed over 3 million eligibility applications annually
• Over 15 years of performing outreach services, in addition to premium assessment, billing and collections