The overall bidding process for Medicare Advantage business allows very little time for companies to introduce changes in health plan benefits and payment structure, configure those in the system, and then critically test the business application and underlying infrastructure. These changes along with requisite testing need to be completed in a four-month period after the bid approval by CMS. At the same time, the changes need to be reflected in multiple systems, which include enrollment systems, an insurance marketplace platform (insurance exchanges), a core administration system, and reporting systems.
Capgemini provides Medicare Advantage business configuration and testing services to help insurers meet the four month deadline. Our solution combines technology and business components to provide assistance across all processes. We provide Medicare Advantage AHIP certified domain experts, highly experienced benefit configurators and testers, a highly experienced configurator for agreement pricing contracts, proven artifacts such as test beds, industry best practices and test strategies, and a ready test execution automation framework which can be customized and adapted for any Medicare admin platform.