Fusion CX provides comprehensive healthcare enrollment and billing support services that help health plans and third-party administrators (TPAs) streamline their processes, improve member satisfaction and reduce operational costs. From online enrollment assistance to billing services and social determinants of health enrollment, our solutions are designed for the complex needs of health plans and for compliance with healthcare regulations.
With over 22 years of experience, Fusion CX combines advanced technology and a skilled workforce to run efficient, accurate and compliant Medicare Open Enrollment and billing processes. Enrollment work connects with eligibility verification, member support and claims support, so the data captured at sign-up carries through to every bill and claim.
Our multilingual, omnichannel teams help health plans and TPAs improve operational efficiency and give members a clear, consistent experience from their first enrollment call to their first premium bill.
Four connected services that take a member from application to accurate, on-time premium billing.
Members guided through a customizable online enrollment process that complies with healthcare regulations and standards, for a smooth, error-free experience.
Social factors considered during enrollment to address the needs of diverse populations, with tailored support that promotes better health outcomes.
Accurate, timely billing of premiums and payments, streamlined collection for better cash flow, and billing discrepancies resolved to protect financial integrity.
Enrollment and billing systems integrated through automation, reducing manual errors and giving members and providers real-time updates.
Open enrollment compresses a year of sign-ups into a few weeks, and billing errors follow close behind. Here is how we prepare.
Plan-specific training, approved scripts, system access and surge seats in place before Annual or Open Enrollment begins, so day one runs like day thirty.
Applications captured and checked for missing or inconsistent member, dependent and eligibility data before submission, cutting rework and rejected enrollments.
Invoices, payment posting and reconciliation handled on schedule, with discrepancies routed to a dedicated queue and resolved with members and employer groups.
Welcome calls, ID card questions and first-bill explanations handled proactively, so new members start their coverage confident rather than confused.
Conversational AI voice bots can automate up to 75% of inquiries during Annual and Open Enrollment, and Omind products sit inside every program. People stay in the loop on every decision that affects coverage or cost.
Automated audits and compliance checks on every enrollment call and chat catch data capture errors and missed disclosures before they become billing problems.
GenAI voice agents answer enrollment status, premium due date and payment questions during Annual and Open Enrollment, with a clean handoff to an agent.
Real-time accent harmonization helps members, including older adults, understand plan options, premiums and billing details the first time.
Compliant, inclusive enrollment and billing at the scale enrollment season demands.
End-to-end support from online sign-ups to billing and reconciliation, built to minimize errors and penalties.
Teams that adapt to evolving health plan needs, enrollment periods and plan complexity.
Social determinants of health services that support equitable access to benefits for all members.
Multilingual support for clear communication and accessibility across diverse member populations.
Member data protected with access controls and audit trails, plus PCI DSS and ISO/IEC 27001:2022.
40+ delivery centers in 13 countries keep enrollment and billing running through peaks and outages.
What happened when health plans and healthcare organizations handed member communications to Fusion CX.
Tell us about your enrollment periods, member volumes and billing workflows. A healthcare CX specialist will follow up with a scope, ramp plan and pricing.
Guides for health plans and TPAs preparing for enrollment season.
The questions health plans and TPAs ask us most often about enrollment and billing support.
Fusion CX provides online enrollment assistance, billing services and social determinants of health enrollment to streamline the enrollment process and ensure accurate billing. We also integrate enrollment and billing workflows through automation, so members and providers get real-time updates.
Fusion CX identifies and resolves billing discrepancies efficiently, routing each one to a dedicated queue with a clear owner. This protects financial integrity and maintains positive relationships with members, employer groups and providers.
Yes. We offer online enrollment assistance, guiding members through the process step by step to ensure a seamless, error-free experience that complies with healthcare regulations and your plan's requirements, with help available by phone, chat or email.
We incorporate social determinants of health enrollment services so that members' unique social and economic circumstances are considered during enrollment. Tailored support helps diverse populations access the benefits available to them, which can contribute to better health outcomes.
Fusion CX combines decades of expertise, AI-driven technology and a commitment to social inclusion to offer streamlined, compliant and efficient enrollment and billing services. Our HIPAA-compliant, multilingual teams scale up for enrollment periods and back down when they close.
