Part D Enrollment Reconciliation
The heart of PDE reconciliation lies within health plan enrollment data.
It takes an experienced, knowledgeable, strong cross-functional team to successfully manage this vitally important operation—including a strong PBM that can provide actionable data and tools to assist health plans that lack these valuable items. GHG can help you optimize PDE processing by bridging these gaps through a combination of expert guidance, staffing and proprietary reconciliation software.
The heart of our solution is Valencia, a software tool that serves as a single source for CMS membership, payment and reconciliation data. Valencia also connects PDE data with the critical annual Part D estimated settlements. Whether speaking of our technology or our professional services, Gorman Health Group solutions will be designed around identifying and fixing the root cause issues, thus reducing the ongoing burden to PBMs responsible for readjudicating PDEs.
For more information, please contact ghg@gormanhealthgroup.com today.
