Eligibility Management

Baker Tilly Vantagen clients benefit from eligibility management practices that focus on the timely, accurate and secure updating of membership records.  File transmissions take place on a scheduled basis within 24-48 hours of receiving employee census data. Baker Tilly Vantagen benefits specialists use direct access carrier procedures to initiate exception, priority membership updates outside of the scheduled automated file transmission.  These same specialists also analyze reports provided by carriers after each file load to determine each file’s impact and assist in more proactively managing eligibility.

Baker Tilly Vantagen information specialists develop automated files to insurer specifications and the client’s assigned structure, and do so in a structured test environment that ensures data accuracy.  Baker Tilly Vantagen billing specialists audit system data to carrier data as an additional measure to minimize data disjoints. All total, these systems and combined processes help maximize the probability that the most accurate membership is covered.