MEMBER COMMS & RECONCILIATION
Deliver Accurate, Compliant Member Communications On Time
Automate ANOC/EOC creation, benefits reconciliation, and Other Health Insurance (OHI) validation with intelligent document processing and rules-driven workflows so you reduce errors, avoid CMS findings, and give members a clearer, more confident experience.
Purpose-Built by Health Plan Experts.
Proven to Improve Performance.
Imagenet’s platform was designed by professionals who’ve lived the payer experience. From automated document generation to audit-ready reconciliation, we simplify the most complex processes so your teams can focus on what matters most.
Automated Document Creation
Generate compliant, member-friendly ANOCs and EOCs directly from PBP data using smart templates and CMS-aligned workflows.
Actionable Reconciliation Logic
Flag duplicate and non-actionable records before they cause downstream errors, rework, or audit findings.
One Platform, Fewer Vendors
From translation to print, fulfillment to COB logic—streamline communications and reconciliation through one trusted partner.
Simplify Complexity. Improve Accuracy. Enhance Member Satisfaction.
Imagenet’s Member Communications & Reconciliation suite—powered by CodySoft®—centralizes and automates member-facing communications, reconciliation, and benefits coordination. By digitizing materials, ensuring version control, and validating data upstream, we drive accuracy, compliance, and faster delivery.
Our Core Solutions:
Member Communications – Centralized document management, streamlined fulfillment, and seamless production of plan benefits materials.
Benefits Reconciliation & Payment Accuracy – Real-time data synchronization for Medicare Secondary Payer (MSP) and Coordination of Benefits (COB), reducing overpayments and ensuring claims accuracy.
With CM & PBP Modules, our team was able to develop and fulfill over 46,000 plan documents for more than 480 unique plans—Individual & Family (on & off-exchange), Small & Large Group plans. Imagenet’s support made the entire process smoother, faster, and fully compliant.
— A Leading Southwest Medicare Advantage & Commercial Group Plan
Optimized Member Communications & Fulfillment
Delivering clear, accurate member communications across every touchpoint. Our solutions make it easy to manage critical documents—from plan benefits and member notices to secure print and distribution. With a focus on compliance and accuracy, we ensure health plans can operate with confidence and efficiency.
Core Capabilities:
Plan Benefit Package Module® (PBP): Centralized management of plan benefit data to simplify CMS bid review, creation of PBP-specific member materials, and accurate data sharing.
Collateral Management Module® (CM): Web-based platform that manages the creation, approval, and composition of member materials like ANOCs, EOCs, and Summary of Benefits (SBs).
Print & Fulfillment: Secure, HIPAA-compliant print and distribution of member materials with 508 remediation and translation services for accessibility and language needs.
Real-Time Benefits Reconciliation & Payment Accuracy
Our technology-driven solutions proactively synchronize benefits data and optimize payment integrity for payers. By centralizing data and automating reconciliation workflows, we reduce overpayments, improve claims accuracy, and ensure regulatory compliance.
Core Capabilities:
Medicare Secondary Payer (MSP) Module: Prevents payment duplication and reduces overpayments through coverage validation and reconciliation.
Coordination of Benefits (COB) Module: Streamlines benefits synchronization and coordination across multiple payers, ensuring accuracy in claims processing and minimizing administrative burden.
Case Study: Streamlining Member Materials for 100+ Benefit Plans
A Puerto Rico-based health plan—serving more than 117,000 Medicare Advantage members and offering Medicaid and commercial products—was managing over 100 benefit plans with no centralized system, leading to inconsistent formatting, version control issues, and elevated compliance risk. Imagenet implemented a structured, audit-ready solution—powered by CodySoft®—to digitize, organize, and streamline document workflows. The result: faster production, fewer errors, and improved CMS alignment.
See What Imagenet’s Member Communications & Reconciliation Solution Can Do for You
Looking for More Technology and Services Support?
CODY®, an Imagenet company, offers a full range of consulting, technology, and operational support solutions designed to help health plans streamline operations, improve compliance, and drive performance.