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Identity, eligibility, and plan selection run as a single guided process.
AI-Guided Enrollment & EligibilityHealthOS Enrollment: From Application to Active Coverage,
HealthOS Enrollment: From Application to Active Coverage,
Without the Six-Form Detour
Guide applicants from identity verification to activated coverage in one flow, powered by NOVA, across Medicare, Medicaid, ACA, and ICHRA programs, on the same record CAPS activates claims against from day one.
HITRUSTSOC 2 Type IICMSHL7 FHIR
This Month's FunnelIdentityPlan Selection834 Files
Completion Rate91%
Avg. Time8 min
Activated MTD312
Application #4402Identity verified in 2 minutes
VerifiedApplication #4398At risk of drop-off, outreach triggered
At RiskBatch 834-0619Enrollment file generated
ProcessedAIAI PASS flagged 42 applications at risk of drop-off this week and triggered outreach before they lapsed.
Workspace Overview
What Is HealthOS Enrollment?
HealthOS Enrollment is the workspace where identity verification, eligibility determination, and plan selection run as one guided flow, instead of six separate forms that don't talk to each other. Coverage it activates is immediately visible to CAPS, Plan, and Member, the same day, not on the next nightly file.
Multi-Program Support
Configurable eligibility rules for Medicare, Medicaid, ACA, and ICHRA programs.
NOVA Prevents Drop-Off
Applicants at risk of abandoning the process are flagged before they leave.
Platform Foundation
Enrollment That Activates Into a Live Record, Not a File Drop.
Enrollment is often the slowest handoff in health plan operations, because eligibility systems and claims systems don't share data. HealthOS Enrollment runs on the same secure, shared core as every HealthOS workspace, so activated coverage is usable immediately.
Immutable Security & Audit
Every application decision is logged, supporting HITRUST and SOC 2 Type II obligations by default.
Shared Data Core
Activated coverage is immediately visible to CAPS, Plan, and Member, without a separate sync.
AI PASS Embedded Intelligence
Drop-off prediction and automated document verification keep applicants moving through the funnel.
Inside Enrollment
Five Modules. Everything Enrollment Operations Run On.
Pick a module to see what your team actually touches inside it.
Identity Verification
Applicants verify identity in minutes through document capture and automated checks.
Document CaptureAutomated ValidationFraud Signal DetectionMobile-First
Avg Verification Time2.1 min
Auto-Verified89%
Flagged for Review4%
Application #4402Identity verified
VerifiedApplication #4399Document quality issue
RetryApplication #4395Manual review required
ReviewHow Work Moves
This Month's Enrollment Funnel.
Every channel an applicant uses, tracked as one conversation.
An applicant begins enrollment through the web, a call center transfer, or a broker-assisted flow.
Document capture and automated checks confirm identity, typically within minutes.
The applicant compares eligible plans and selects coverage based on real cost estimates.
Coverage activates and is immediately visible to CAPS, Plan, and Member, the same day.
The Intelligence Layer, Inside Enrollment
Keeping Applicants Moving Through the Funnel, Not Stuck in It.
AI PASS flags applicants at risk of abandoning the process before they leave, verifies documents automatically, and screens for identity and application fraud on intake.
Learn more about AI PASSLive decision intelligence● Active
Application #4398At Risk01 / Review
Analysis completeIdentity verified · Plan comparison started 3 days ago · No activity since; drop-off pattern matches prior abandoned applications.
RecommendationTrigger guided outreach with the applicant’s shortlisted plans pre-loaded.
Confidence 92%
Why HealthOS Enrollment?
The Numbers Behind the Console.
What health plans and marketplaces typically see after moving enrollment onto this workspace.
72.6Member NPS
3.6xAutomation
35%Higher Member Engagement
Why Enrollment
What Changes When Enrollment Runs on This Workspace.
The difference shows up in how many applicants actually make it through.
The Old Way
- Identity verification takes days and applicants abandon the process waiting.
- Eligibility rules live in a separate system from plan comparison, so applicants guess.
- Activated coverage doesn't reach claims systems for days, delaying care.
- Document review means every application gets the same manual scrutiny.
On Enrollment
- Identity verification completes in minutes through automated document checks.
- Plan comparison is ranked against the applicant's actual eligibility and estimated cost.
- Activated coverage is visible to CAPS and Plan the same day, not the next batch cycle.
- AI PASS reviews documents automatically, reserving manual review for genuine exceptions.
Security & Compliance
Built to the Standards Your Compliance Team Already Holds You To.
Role-based access control, encryption in transit and at rest, and a complete audit log across every module — the same baseline for every HealthOS workspace.
HITRUSTSOC 2 Type IINCQAHL7 FHIR R4CMS Interoperability RuleEDI 837 · 835 · 270 · 271
FAQ
Frequently Asked Questions.
Which programs does HealthOS Enrollment support?
Enrollment workflows are configurable for Medicare, Medicaid, ACA marketplace, and ICHRA programs, with eligibility rules specific to each.
How quickly is activated coverage visible to claims processing?
Because Enrollment and CAPS share the same data core, activated coverage is visible for eligibility checks and claims processing the same day.
Does this reduce manual workload on enrollment staff?
Yes. Identity verification and document review are automated for most applications, so staff time concentrates on the exceptions that genuinely need a person.
Is HealthOS Enrollment secure and compliant?
Yes. Enrollment aligns with HIPAA, HITRUST, SOC 2 Type II, and CMS requirements, with a complete audit log across every application.
One Console, One Suite
Six Workspaces. One Record.
Every HealthOS workspace reads and writes to the same core. Start with Enrollment, connect the rest whenever your team is ready.
Get Started
See HealthOS Enrollment in the context of your operations.
Bring your line of business and your hardest workflow — we’ll show you how it runs on one intelligent platform.
