PremiumAssist Frequently Asked Questions
What differentiates Centauri from others in the marketplace?
Centauri provides superior compassionate outreach based on exceptional analytics and targeting which allows us to focus on the right members in your population who are most likely to need these additional benefits. Centauri also has demonstrated our ability to be nimble and responsive to changes which occur in the complex payment model and changes that CMS implements from time to time.
Why is retention of duals important?
Because Dual Eligibility is based on concurrent payment model any member who loses benefit eligibility during the year can mean immediate loss to your premium dollars as well as to the member. Ensuring a pro-active retention strategy is critical to minimizing the impact.
How long have you been working with Medicare Advantage plans?
Centauri has been working with Medicare Advantage plans for over 30 years throughout the United States.
What states do you have experience in?
All states except Puerto Rico.
Do you use predictive analytics in your targeting?
Yes, we use a proprietary predictive model that allows us to identify current non duals with the highest probability to gain dual status. The current model overall can identify nearly 99% of duals within the top four deciles of the non dual population allowing us to hone in the members who are most likely to be dual eligible within a population. We also run analytics on the current partial dual population to identify those members who are most likely to qualify for full dual status.
Social Service+
What is Social Service+?
Social Service+ is a social service referral and support program that utilizes a social determinants of health (SDoH) assessment model. Social Service+ (SS+) assists Medicare Advantage plan members by conducting an assessment, identifying local resources to solve problems, providing resources, assisting them in connecting with those local services and following up to ensure they have received the services needed.
How can you help our members?
Utilizing two web-based tools, SS+ Specialists will screen and assess your members' needs to identify likely local/state/federal benefits eligibility and identify other needs that can be met from community social service organizations.
What kind of programs will you refer our members to?
Assisting members to determine likely eligibility for benefits and entitlements is only one part of the solution to a problem of financial, environment and/or social insecurity. Directing and helping them to locate assistance from within their local community is at the heart of the service provided by Social Service+. Based on an individual assessment, we frequently refer members in need to Food Pantries, Home Delivered Meals, Senior Case Management Agencies, Subsidized Transportation agencies, etc.
Are you going to be providing the services to our members?
SS+ Specialists provide members with verbal and written information about eligibility and application processes, support direct access to benefit enrollment and community programs to meet life challenges as defined within models of Social Determinants of Health.
Will you be completing applications for members?
While completing the actual application remains the member's responsibility, the SS+ Specialist will help guide them with direct connections to local community support agencies. Our Specialists will continue to call to check in on how their application submission is going. We are dedicated to making sure we are helping your members as much as possible so that they can receive the benefits/services needed.