We Serve Medicare Plans

Unique Solutions, Unified Approach

Convey Health Solutions offers healthcare-specific technology and services that:

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Simplify and strengthen complex member relationships in the Medicare and Medicaid markets

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Provide a suite of administrative solutions that improve operational efficiencies

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Drive compliance and quality while meeting industry and regulatory demands

Founded in 2001

100+ Years of CMS Experience

Serving 19% of Medicare Advantage Lives

9 of the Top 10 Health Plans are Convey Clients

Discover how we serve the following sectors through comprehensive, end-to-end member management solutions:

Medicare

MA / MAPD, PDP, EGWP

Medicare Advantage Plans

The Medicare Advantage (MA / MAPD) landscape is one of the fastest growing and most competitive markets in the health insurance industry. As the Medicare population grows and value-based reimbursement models take hold, health plans are facing even more challenges. Knowing that flexibility is critical, Convey offers a variety of solutions that can easily be deployed in order to strengthen your health plan’s Medicare Advantage service offerings. Whether your health plan is seeking a technology-only solution, a comprehensive technology and service model, or expert advisory services, Convey works with you to develop the most cost-effective and compliant solution.

Convey offers Software as a Service (SaaS), outsourced solutions, and advisory solutions for the following plan types:

 

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Health Maintenance Organization (HMO)

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Preferred Provider Organization (PPO)

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Medicare-Medicaid Plan (MMP)

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Program of All-Inclusive Care for the Elderly (PACE)

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Special Needs Plan (SNP)

  • Including ISNPs
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Private Fee-For-Service Plan (PFFS)

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And more

Individual Prescription Plans (PDP)

To be successful in today’s Medicare environment, Prescription Drug Plans are seeking better, more cost-effective solutions to increase member satisfaction while improving their responsiveness to regulatory changes. Convey Health Solutions understands these challenges and has built its operations and solutions to reduce cost and improve performance.

With high fixed costs, low margins and an intensive regulatory environment, the Medicare Part D market is a challenge for any health plan. Having participated in Medicare Part D since its inception, Convey combines purpose-built technology, an experienced Part D service organization, and CMS-compliant processes to rapidly respond to the demands of the Part D market and population. As your partner, we will tailor the most cost-effective solution, allowing your health plan to provide superior service at lower cost.

Employer Group Waiver Plans (EGWP / MA-EGWP)

The Medicare Employer Group Waiver (EGWP) market is one of the most challenging markets within Medicare. Besides having to manage in a highly regulated environment, health plans also must face complex group-specific requirements that can create risk and add layers of manual processes and workarounds.

Traditional EGWP solutions combine multiple technologies and services that can cause disconnected processes and poor responsiveness. Convey provides a fully integrated, single platform and service model to enhance your EGWP administrative program and deliver optimal service levels and higher member satisfaction scores. Convey’s EGWP solutions and services can manage groups of any size or scale and serves some of the largest, most complex EGWP programs in the industry today.

Questions?

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