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.

Imagenet - Member Comms & Rconciliation

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.

Imagenet - Automated Document Creation

Automated Document Creation

Generate compliant, member-friendly ANOCs and EOCs directly from PBP data using smart templates and CMS-aligned workflows.

Imagenet - Actionable Reconciliation Logic

Actionable Reconciliation Logic

Flag duplicate and non-actionable records before they cause downstream errors, rework, or audit findings.

Imagenet - One Platform, Fewer Vendors

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.
Imagent - Simplify Complexity. Improve Accuracy. Enhance Member Satisfaction.

“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

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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.
Imagent - Simplify Complexity. Improve Accuracy. Enhance Member Satisfaction.
Imagenet - Case Study: Streamlining Member Materials for 100+ Benefit Plans

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.

Frequently Asked Questions

How does Imagenet help health plans automate ANOC/EOC creation?

Imagenet generates compliant, member‑friendly ANOCs and EOCs directly from PBP data using smart templates and CMS‑aligned workflows. This reduces manual effort, improves accuracy, and helps plans avoid CMS findings.

What reconciliation capabilities does Imagenet provide?

The platform uses rules‑driven logic to flag duplicate, inaccurate, or non‑actionable records before they cause downstream errors. This improves payment accuracy, reduces rework, and strengthens audit readiness.

How does Imagenet support Other Health Insurance (OHI) and Coordination of Benefits (COB) validation?

Imagenet centralizes benefits data and automates OHI and COB reconciliation through MSP and COB modules. These tools validate coverage, prevent duplicate payments, and ensure claims are processed accurately across multiple payers.

What makes Imagenet’s platform different from traditional member communications vendors?

Imagenet consolidates development of communications, reconciliation, translation, print, and fulfillment into one governed platform. This reduces vendor sprawl, improves version control, and ensures consistent, compliant materials across all plan types.

How does Imagenet improve compliance and reduce CMS audit risk?

By validating data upstream, enforcing version control, automating workflows, and maintaining audit‑ready documentation, Imagenet helps health plans reduce errors, avoid CMS findings, and deliver accurate member communications on time.

See What Imagenet’s Member Communications & Reconciliation Solution Can Do for You