< + > IBM and enGen Collaborate to Eliminate Errors in Member Enrollment

According to research by enGen, a healthtech company that serves payers and providers with automated solutions, they found that each error in member enrollment data costs an average of $172 in fixes and downstream problems. A new solution called enGen enRoll^TM, an AI-driven collaboration between enGen and IBM, was designed to address this problem. Maynd Jolly, Chief Financial Officer and Senior Vice President of Client Partnership at enGen, and Matt Gierhart, Vice President of Product Management at IBM, discuss the implications and promise of the product in this interview at the recent HLTH Conference.

Another statistic cited by Jolly is that one of enGen’s health plan clients experiences 40 million errors a year in enrollment data. Fixing these errors takes time and money away from innovation by payers and has significant effect on downstream operations that impact the member experience and access to care.

Gierhart describes the three parts of enGen enRoll:

• The “score” module is a free tool that helps payers  discover and assess costly errors in enrollment files using deidentified data.
• The “fix” module uses AI-agents to flag and correct errors in format and structure – enabling teams to focus on higher value work and cut processing time to minutes.
• The “manage” module identifies gaps and fills them, further increasing overall efficiency.

Jolly also talks about involving client companies in the development of this tool, and the incentives offered.  enGen and IBM are now looking for payer organizations that want to pilot this program at their organizations to improve their enrollment processes.

Check out this interview with enGen and IBM to learn more about leveraging technology and AI to improve member enrollment, reducing costly errors and downstream issues.

Learn more about enGen: https://goengen.com/

Learn more about IBM: https://www.ibm.com/industries/healthcare

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