Skip to contentOne Flow, Not Six Forms
Identity, eligibility, and plan selection run as a single NOVA-guided process.
AI-Guided Enrollment & EligibilityHealth Plan Enrollment Software:
Health Plan Enrollment Software:
From Application to Active Coverage
Health plan enrollment software that guides applicants from identity verification to activated coverage in one flow across Medicare, Medicaid, ACA, and ICHRA, with Aipass™ flagging drop-off risk.
Completion Rate91%
Avg. Time8 min
Activated MTD312
What Is HealthOS Enrollment?
HealthOS Enrollment is the eligibility workspace within HealthOS. It runs identity verification, eligibility determination, and plan selection as a single flow guided by NOVA, HealthAxis' omnichannel AI contact center, so applicants never have to navigate multiple separate forms. Activated coverage is visible to CAPS, plans, and members on the same day.
Within Enrollment, NOVA, serving as the intelligent vertical of Aipass™, handles inquiries across calls, texts, emails, and other channels. It interprets each request using available data and context, automates routine responses, and routes complex or low-confidence cases directly to human representatives.
Medicare, Medicaid, ACA and ICHRA in One Workspace
Configurable eligibility rules for Medicare, Medicaid, ACA, and ICHRA programs, in one workspace.
NOVA Flags Drop-Off Risk Before Applicants Leave
It flags applicants at risk of abandoning the process before they leave.
Enrollment That Activates Into a Live Record
Enrollment is often the slowest handoff in health plan operations. HealthOS Enrollment runs on the same shared core as every HealthOS workspace, so coverage activates into a live record instead of waiting for a file to be sent and loaded.
Audit Log on Every Application Decision
Every application decision is logged, supporting HITRUST and SOC 2 Type II obligations by default.
One Shared Record Across CAPS, Plan, and Member
Activated coverage is immediately visible to CAPS, Plan and Member, without a separate sync.
Aipass™ Embedded Intelligence
Aipass™, the embedded intelligence layer running across HealthOS, powers NOVA-guided Enrollment to predict drop-off and automatically verify documents, keeping applicants moving through the funnel. See how NOVA-guided enrollment works.
Enrollment Software for Medicare, Medicaid, ACA, and ICHRA
HealthOS Enrollment applies configurable eligibility rules for four programs, so one workspace covers each program a plan runs.
Medicare Enrollment Software
Configure Medicare eligibility rules in the workspace and apply them in the same guided flow as every other program.
Medicaid Enrollment Automation
Aipass™ automates identity verification and document review for most applications, reserving manual review for real exceptions.
ACA and Health Insurance Enrollment Software
Plans are ranked against eligibility and estimated cost during plan selection.
ICHRA Enrollment
Configurable eligibility rules for Individual Coverage Health Reimbursement Arrangement (ICHRA) sit in the same workspace.
Five Modules for Health Plan Enrollment Operations
HealthOS Enrollment has five modules that cover the enrollment path from first identity check to the transaction that activates coverage.
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%
Eligibility Determination
Applies the configured eligibility rules for Medicare, Medicaid, ACA, or ICHRA to each applicant.
Plan Selection
Ranks plans against the applicant's eligibility and estimated cost.
Application Processing
Processes each application, writes every decision to the audit log, and routes real exceptions to manual review.
Transaction Handling
Handles the transaction that activates coverage, so it is visible to CAPS, Plan, and Member the same day.
Sample Enrollment Funnel: Application to Activated Coverage
Sample data from the console preview, not customer results. The funnel has four steps: application started, identity verified, plan selected, activated. In the sample, 91% of applications are completed, the average time is 8 minutes, 312 are activated month to date, and 42 at-risk applications were flagged by NOVA that week.
- Application Started
- Identity Verified
- Plan Selected
- Activated
Keeping Applicants Moving Through the Funnel, Not Stuck in It
NOVA-guided enrollment intervenes when applicants are at risk of abandoning, while Aipass™ automatically verifies documents and screens for fraud at intake. In the console sample, an at-risk application carries a 92% confidence score.
Confidence 92%
What Changes When Enrollment Runs on One Workspace
Four things change when enrollment runs on one workspace.
| Before | With HealthOS Enrollment |
|---|---|
| Identity verification takes days | Identity verification completes in minutes |
| Eligibility rules sit apart from plan comparison | Plans are ranked against eligibility and estimated cost |
| Activated coverage takes days to reach claims | Coverage is visible to CAPS and Plan the same day |
| Every application gets the same manual review | Aipass™ reserves manual review for real exceptions |
Security and Compliance Standards for Enrollment
Role-based access control, encryption in transit and at rest, and a complete audit log. HealthOS Enrollment aligns with HITRUST, SOC 2 Type II, NCQA, HL7 FHIR R4, the CMS Interoperability Rule, and EDI 837, 835, 270 and 271.
HITRUSTSOC 2 Type IINCQAHL7 FHIR R4CMS Interoperability RuleEDI 837 · 835 · 270 · 271
Frequently Asked Questions
Health plan enrollment software is the system a plan uses to take an applicant from application to active coverage: verifying identity, determining eligibility, selecting a plan and processing the application. HealthOS Enrollment does this in a NOVA-guided flow.
HealthOS Enrollment supports Medicare, Medicaid, ACA marketplace and ICHRA, with configurable eligibility rules for each.
Activated coverage is visible to CAPS, Plan and Member the same day, because Enrollment and CAPS share a data core and no separate sync is needed.
Yes. Identity verification and document review are automated for most applications, and Aipass™ reserves manual review for real exceptions.
NOVA guides applicants through each step of the enrollment process and prevents abandonment in real time, while Aipass™ operates in the background to verify documents and detect fraud.
HealthOS Enrollment aligns with HIPAA, HITRUST, SOC 2 Type II and CMS requirements. It uses role-based access control, encryption in transit and at rest, and a complete audit log of every application decision.
Yes. The Console page shows a sample enrollment console, including the funnel and NOVA drop-off flags.
The compliance section lists HITRUST, SOC 2 Type II, NCQA, HL7 FHIR R4, the CMS Interoperability Rule and EDI 837, 835, 270 and 271.
Six Workspaces. One Record.
CAPS, Plan, Provider, Member, Enrollment, and Sentinel all read and write to the same core. See the full HealthOS platform.
