Digital. Dynamic. Dependable.
Accelerate Enrollment, Reduce Errors to Elevate Member Experience
Streamline and accelerate member onboarding with NewgenONE Member Enrollment & Management solution. Designed for Medicare, Medicaid, and Commercial/Exchange plans, the platform unifies intake, extraction, and integration for eligibility verification and plan assignment, service request management, and reconciliation into one seamless workflow. Leverage AI-driven automation, intelligent rules engines, and low-code agility to reduce errors, minimize rejections, and ensure CMS compliance. Empower health plans with faster enrolments, real-time visibility, and a fully digital, scalable experience.
Member Enrollment and Management: Buy All-in-one Pack or Choose an Individual Solution
Medicare Member Enrollment
Automates member onboarding, portal integration, digitization of forms, eligibility verification, CMS submissions, compliance tracking, automated communications, and audit-ready reporting and dashboards
Medicaid Member Enrollment
Processes state EDI 834 files, detects & routes enrollment errors, streamlines multi-state compliance workflows, automates communications, and provides audit-ready reporting and dashboards
Exchange/Commercial Member Enrollment
An end-to-end Exchange/Commercial member enrollment solution that automates EDI 834 processing, portal integration, eligibility validation, binder payment tracking, sending effectuated 834, and compliance workflows delivering accurate enrollments, timely communications, and audit-ready reporting
Member Servicing Request
Unified service request management solution that intelligently captures, routes, and tracks member enrollment requests across multiple channels – delivering faster resolution, proactive communication, and complete visibility
Fulfillment
An intelligent fulfillment solution that automates multi-lingual member communications across print and digital channels using configurable templates and triggering rules to ensure timely delivery, real-time tracking, seamless print vendor or portal integration, and audit-ready compliance
Medicare Member Enrollment
Automates member onboarding, portal integration, digitization of forms, eligibility verification, CMS submissions, compliance tracking, automated communications, and audit-ready reporting and dashboards
Medicaid Member Enrollment
Processes state EDI 834 files, detects & routes enrollment errors, streamlines multi-state compliance workflows, automates communications, and provides audit-ready reporting and dashboards
Exchange/Commercial Member Enrollment
An end-to-end Exchange/Commercial member enrollment solution that automates EDI 834 processing, portal integration, eligibility validation, binder payment tracking, sending effectuated 834, and compliance workflows delivering accurate enrollments, timely communications, and audit-ready reporting
Member Servicing Request
Unified service request management solution that intelligently captures, routes, and tracks member enrollment requests across multiple channels – delivering faster resolution, proactive communication, and complete visibility
Fulfillment
An intelligent fulfillment solution that automates multi-lingual member communications across print and digital channels using configurable templates and triggering rules to ensure timely delivery, real-time tracking, seamless print vendor or portal integration, and audit-ready compliance
Learn What NewgenONE Member Enrollment & Management Solution Can Do for You
Intelligent Automation
Achieve faster onboarding and elevated member satisfaction using intelligent automation to automate time-intensive workflows for all members.
Proactive CMS Compliance
Stay audit-ready with built-in compliance tools aligned with evolving CMS regulations. Utilize automated workflows to streamline submissions, validations, and reporting, minimizing errors and reducing the risk of penalties.
Unified Information Capture and Processing
Enable seamless case creation via portals, plan websites, OCR-scanned forms, EDI, and multiple file formats (including FFM pipe-delimited and XML) with smart routing to direct applications by program type (Medicare, Medicaid, Commercial) and screens for dual-eligible members.
Personalized Communications
Automatically create, manage, and deliver multi-lingual, program-specific (Medicare/Medicaid/Commercial) communications. Ensure accuracy, compliance, and ease for members, brokers, and stakeholders throughout the entire enrollment process.
Intelligent Automation
Achieve faster onboarding and elevated member satisfaction using intelligent automation to automate time-intensive workflows for all members.
Proactive CMS Compliance
Stay audit-ready with built-in compliance tools aligned with evolving CMS regulations. Utilize automated workflows to streamline submissions, validations, and reporting, minimizing errors and reducing the risk of penalties.
Unified Information Capture and Processing
Enable seamless case creation via portals, plan websites, OCR-scanned forms, EDI, and multiple file formats (including FFM pipe-delimited and XML) with smart routing to direct applications by program type (Medicare, Medicaid, Commercial) and screens for dual-eligible members.
Personalized Communications
Automatically create, manage, and deliver multi-lingual, program-specific (Medicare/Medicaid/Commercial) communications. Ensure accuracy, compliance, and ease for members, brokers, and stakeholders throughout the entire enrollment process.
