The Social Determinants of Health (SDoH)/ Supplemental Benefits Manager tracks the eligibility and delivery of supplemental or social benefits that a plan may offer in addition to traditional medical coverage. This Medicare supplemental benefits manager includes workflows to support the eligibility and benefit verification, vendor selection, referral to the member, and tracking of notification to the member beyond the typical Part C or Part D Medicare benefits. They are generally described as social or environmental benefits. Supplemental Benefits medical data management is ideal for Medicare home and community-based services, Medicare or MAPD plans.
Help with daily living activities such as bathing and light housekeeping
Services to provide in-home pest control
Prepared meals or supplemental nutrition are delivered to your home
Relieves a caregiver of his/her duties for the day to manage the care of a member with special needs
Support provided to help care for service dog
such as Community Outreach & support, dietician visits, and electricity
This medical data management system helps you assess report findings to determine the impact on outcomes, readmissions, ER visits, MLR, and more.
Includes new universe reporting requirements built into the system and accessible with one click.
With this medical data management system, you can streamline operational processes to manage more cases in less time
Monitor all program activity including related built-in universe reports
Scale as you add benefits and members, and expand to other LOBs
Prioritize resources by skill set to free up clinical staff for member care
Include program details to support successful Medicare and Medicaid bids
Use this medical data management system to confirm benefits and apply clinical criteria in a consistent, reportable manner