Medicare
Advantage One by VSI Technologies is an integrated solution for carriers to design, launch, and operate MA plans. The Plan Configuration Engine supports benefit customization, network-tier modeling, and CMS compliance checks. An Enrollment & Billing Module automates CN1/N252 transactions, eligibility feeds, and premium reconciliations. A Care Coordination Hub connects members to case managers, telehealth services, and social-determinants programs, leveraging AI-driven risk stratification and predictive alerts. A Member Portal offers personalized plan comparisons, cost-estimate tools, and provider-finder search. Underlying these components, a Data Warehouse aggregates claims, utilization, and satisfaction data into dashboards tracking Star Ratings, HEDIS measures, and financial performance. Policy-as-code enforces CMS regulations, while a robust audit framework supports Part C and D compliance. Outcome-based pricing aligns VSI's fees to quality-score improvements, enrollment growth, and cost-of-care reductions. Medicare
Advantage One accelerates plan launches, enhances member satisfaction, and drives operational efficiencies in the competitive MA market.
