Preferred Vendor
Anchor orchestrates non-medical benefits for dual-eligible members within existing care management workflows. Care managers activate needs-based benefits in fewer steps, plans match each need to the funding source responsible for it and can prove what was delivered, and members receive the services matched to their needs.
Anchor recommends; the care manager decides. Anchor does not author criteria, determine eligibility, or enforce caps.
Non-medical benefit orchestration for Medicare Advantage plans serving dual-eligible members
Non-Medical Benefit Orchestration
Each funding source works with its own vendors, data formats, and reporting cadence. Caseloads run in the hundreds, and the next call may reach a different care manager, with no single record of what was referred or where it stands.
Anchor orchestrates non-medical benefits for dual-eligible members. Care managers work from one screen, and every service is substantiated at the member level.
Anchor works within existing care management workflows. No care-management platform integration required to begin.
Anchor matches the member against the plan's criteria and surfaces the benefits to consider. The plan determines eligibility. For SSBCI, the qualification is recorded with the benefit criteria and the PBP that applied.
Which source covers the need first: a Medicare-covered service, the plan's supplemental benefit, a Medicaid waiver, or a community program. Sequencing never withholds a benefit the member qualifies for.
Referrals to contracted vendors and community programs, with the latest available cap balance at referral. Anchor documents every referral, and each vendor's record is accepted and graded.
Member-level data captured at the point of decision: benefit criteria, PBP, evidence, who decided, and when. Producible for any member, any date.
Anchor recommends; the care manager decides. Anchor does not author criteria, determine eligibility, or enforce caps.
Care management, finance, and quality read the same member-level record of needs, referrals, and services.
Care managers send referrals and confirm services from one screen, replacing manual steps.
Anchor records which funding source covers each need first and matches each authorization to a delivery record the plan can show at the member level.
Members receive needs-based services. The status of every referral sits in one record the plan can read when the member calls.
The spend happens either way. Anchor makes it activated, matched to delivery, and attributable, from one record.
One screen from need to confirmed service. Fewer steps per activation.
Where a referral or an open request stands, on the first call.
Referrals sent, fulfilled, and time to delivery, by vendor.
Benefits activated and days to confirmation as member-level inputs.
Member-level determinations, with criteria and PBP on record, attributed, producible for any member, any date.
Authorization matched to delivery. The documented event behind each funded service.
Cap use, time to activation, and vendor delivery as observations.
Anchor documents four outcomes at the member level as the work happens, within the plan’s existing care management workflow.
Needs-based benefits referred for each member.
Referrals matched to a vendor or program record, accepted and graded.
Time from referral to a confirmed service, per referral.
Time spent on referrals and follow-up, per member.
We’ll build a sample member record for one of your states and a benefit class: the criteria and PBP on record, the funding source that covers each need first, each referral, and each vendor’s record. Our team walks you through what it contains.
Anchor orchestrates non-medical benefits for dual-eligible members. Every service is substantiated at the member level.
Request a Demo