Streamlining Medicare and Medicaid with AI: Introducing DualEnroll.ai
Right Skale Inc. has introduced DualEnroll.ai, an innovative artificial intelligence platform designed to streamline the dual enrollment and recertification processes for both Medicare and Medicaid. This AI solution addresses the pervasive issues of manual enrollment, known for its error-prone nature and extended processing times, which threaten member retention and contribute to financial inefficiencies for payers.
Current industry data exposes significant failures within the dual enrollment system, revealing that over 35% of attempts encounter delays or inaccuracies. Traditional methods can extend enrollment duration to six to eight weeks and incur costs exceeding $2,400 per case. Such inefficiencies contribute to an estimated annual revenue leakage of over $4.2 billion, emphasizing the urgent need for enhanced regulatory compliance and accuracy in eligibility verification.
Puneet Shivam, CEO of Right Skale, remarked, “With the dual-eligible population growing, payers cannot ignore the burdens of manual enrollment systems that threaten both retention and revenue.” Shivam highlighted that DualEnroll.ai leverages intelligent automation to ensure compliance, expedite processing times, and secure essential coverage for qualified members.
Enhanced Capabilities and Compliance
The platform's capabilities include AI-driven rapid document processing, AI-powered optical character recognition, real-time eligibility checks across key databases, and proactive alerts for pending recertifications. Comprehensive audit tracking further supports regulatory compliance efforts, reducing operational risks and enhancing claims processing timelines.
Substantial Performance Improvements
Initial adopters of DualEnroll.ai have reported significant operational cost reductions related to enrollment and recertification by 40–60%. Additionally, there was a notable 90% decrease in processing errors, alongside improved member retention rates. Vinod Sharma, Head of Healthcare Business Unit at Right Skale, confirmed, “Tasks that previously took weeks are now achievable within minutes, embedding both accuracy and compliance.”
With projections estimating the dual-eligible population to expand to 15.3 million by 2030, driven by demographic trends and policy reforms, the need for rigorous verification and uninterrupted coverage is paramount. The legacy manual enrollment model is increasingly seen as a compliance threat, with potential breaches eroding trust and risking carrier relationships.
DualEnroll.ai is immediately available for healthcare payers involved with Medicare and Medicaid, offering a scalable solution to mitigate risks and enhance financial outcomes. Healthcare organizations seeking further information or a demonstration are encouraged to visit Right Skale's official website. Based in Silicon Valley, Right Skale specializes in AI-driven solutions for industries under stringent regulation, partnering globally to boost operational efficiencies and deliver substantial business value.