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AI Enrollment Solution

enGen enRoll™

Streamline workflows, prevent downstream errors, and increase member retention.

The hidden costs of messy enrollment data

Manual reprocessing, faulty records, and partial data ownership prevent healthcare payers from unlocking their data’s full value.  

 

8-12%

typical error rates in enrollment submissions

$172

average cost per enrollment error

25%

of healthcare spending goes to administrative tasks

27%

cost overun on healthcare IT projects

$250B

annual expenditure on administrative tasks industry-wide

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Three service level options.
Complete control of your data.

From analysis and assessment to automated data corrections, enGen enRoll™ will offer three levels of service. Enjoy full ownership of your data at all times. 

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Score

Free AI data analysis

Upload up to 5,000 records and get secure, AI-driven data insights.

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Fix

Correct and clean data

Validate and cleanse data with multi-format ingestion and standardization.

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Manage

Fully automate workflows

Real-time integration, advanced analytics, and an audit workbench.

Flexible by design,
compliant by default

enRoll fits seamlessly with current workflows, handles a wide variety of data formats, and keeps all data secure—no complex setup required.


Ironclad compliance

• HIPAA and X12 standard adherence built into every process
• Automated regulatory updates for evolving requirements
• Comprehensive audit trails and documentation
• Privacy-first security backed by IBM infrastructure

Composable platform

• Deploy individual modules (Claims, Reimbursement) or the full suite 
• Configure workflows to match existing processes 
• Scale from 50K to 500K+ members without reconfiguration 
• Multi-format data ingestion (CSV, TXT)
 

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Get a free enrollment data score in 15 minutes or less

Generate an AI-driven data report using the Score module. Quickly find errors, prioritize next steps, and get a comprehensive cost breakdown.  

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How it works: 

1. Upload your forms:

Upload your multi-format enrollment documents from PDFs, scans, or structured data. 

2. Review error types, savings, and costs:

Get specific details and dollar amounts per error and see the cumulative cost at a glance. 

3. Get actionable insights:

Receive clear, tangible suggestions that help you resolve issues before downstream errors impact members and revenue. 

Unlock your enrollment data’s full potential

Organize, clean, and transform your most valuable asset without compromising its future.

Stay nimble, stay secure: Access the platform via IBM’s cloud infrastructure. Native connectivity with clearinghouses, TPAs, and all existing systems. Proactive fraud detection and prevention with enterprise-grade protection. 

Double-down on member loyalty: Accurate, clean data is the foundation of a successful retention strategy. Increase and maintain loyalty by offering the error-free experience your members expect.  

Own your data: Enjoy data-agnostic architecture, cloud-native flexibility, and zero integration lock-in. Avoid clearinghouse costs, inefficient vendor processing, and other third-party dependencies. 

Zero training required: Clean, intuitive UI promises high adoption without sacrificing  functionality. Easily evaluate enrollment data across multiple sources and formats. Technical jargon is conveniently translated into business terminology. 

High value at a low cost: Low-friction implementation and self-service onboarding pave the way for immediate value delivery at scale. Efficiently handle peak enrollment periods without staffing increases. 

FAQs


What happens to my data once I upload it to Score? 
Data is automatically deleted after 30 days. Your account information is stored securely and can be deleted upon request. There is no PHI/PII processing. The free version only accepts de-identified enrollment data.

Is my data secured while being processed?  
Yes—your data security is our top priority. All data is encrypted in transit and at rest. We follow HIPAA compliance requirements for healthcare data. Processing occurs in secure, isolated environments and access is strictly limited to essential system functions. We maintain comprehensive audit logs of all data access.

Can I process multiple files at once? 
Files are processed one at a time to ensure accurate results and system performance. You can upload a new file as soon as your previous file's results are available.

What does my enrollment file score mean? 
Your score represents the error rate in your enrollment file based on 834 EDI requirements. A lower error rate is better. Our goal is to help you get as close to 0% as possible.

What are the different types of errors I'm seeing?
Each error type has different cost implications and urgency levels for your enrollment process.  We identify three types of issues in your enrollment data.

Severe/Data Gaps: Critical errors that will block enrollment or cause significant costs, including missing required information

Moderate: Issues that likely won't prevent enrollment, but may result in deferred costs.

Minor: Low risk errors with low probability of future costs 

Why is there a 5,000 record limit?
The 5,000-record limit allows you to get meaningful insights into your data. For most customers, this sample size is large enough to identify systematic issues and estimate the value of processing your complete files.

How accurate is your AI error detection? 
Our system uses a minimum confidence threshold for flagging errors. Every error highlighted has met our reliability standards. We've trained our AI specifically on 834 EDI requirements and healthcare enrollment patterns to ensure accurate, relevant results.

Ready to take control of your enrollment data?

Generate powerful enrollment insights in minutes. Upload your data, locate errors, and uncover costs.