Home Healthcare Payer

Member Management

Member Management

Realkey Software Solutions Private Limited ' skilled team of subject matter experts manages the eligibility and enrollment process for our clients, including the verification and determination of each member's coverage specificity. Delegating this task to Realkey Software Solutions Private Limited allows your organization to free up resources and concentrate on core business functions that optimize internal operations.

  • If the member or dependents are covered by an active policy or plan
  • If the member or dependents needs to be enrolled
  • If the member and dependents’ opted coverage has a valid coverage period to enroll
  • Switching over plans from the previous year and initiating the coverage under new plans
  • Ensuring the correct PPO coverage is linked to each member in the case of commercial payers for small groups
  • Making sure the defined stop loss coverages are linked to correct groups
  • Capturing and checking the patient information against the eligibility database