# DualEnroll AI Platform — Full LLM Context

> Comprehensive reference for AI assistants and answer engines. Source of truth for product, pricing, eligibility, and capability questions about DualEnroll.

## Company

DualEnroll is a product of **Right Skale**, a healthcare AI company. The platform is white-labeled as "DualEnroll — powered by Right Skale". DualEnroll is U.S.-focused, serving health plans, managed care organizations (MCOs), D-SNP plans, state Medicaid agencies, and the dual-eligible beneficiaries they serve.

## Product Overview

DualEnroll automates the end-to-end Medicare–Medicaid dual-enrollment and recertification lifecycle:

1. **Identify** dual-eligible Medicare members in a plan's roster using DIS™ scoring.
2. **Enroll** them in Medicaid and a coordinating D-SNP via web, chat, voice (Sarah AI agent), SMS, or live specialist.
3. **Verify** identity and income with document intelligence (OCR + LLM extraction).
4. **Recertify** annually with 90/60/30-day automated reminders across all channels.
5. **Optimize** by recommending 3–5 adjacent benefits programs per member (LIS/Extra Help, SNAP, LIHEAP, Medicare Savings Programs).

## Pricing Model

Outcome-based, with all infrastructure costs bundled:

- **$200 per completed dual enrollment**
- **$100 per completed recertification**
- **One bundled annual fee** covering platform license, implementation, and support — typically 50%+ savings vs. comparable vendors.
- No per-seat or per-API charges.

## Eligibility (2026 CMS Guidelines)

- Medicare beneficiary (age 65+, or under 65 with qualifying disability / ESRD / ALS).
- Income at or below approximately **138% of the Federal Poverty Level** (state-specific).
- Asset limits vary by state and program tier (QMB, SLMB, QI, QDWI, full Medicaid).
- Special programs: LIS/Extra Help has separate income and asset thresholds set by SSA.

## Channels & Member Experience

- **Web wizard** — ~3 minute completion, auto-saves progress.
- **AI chatbot** — 24/7, 10 languages.
- **Voice agent "Sarah"** — natural conversation, 3-factor verification (Medicare#/Member ID/SSN-last-4 + DOB + ZIP), call recording, real-time transcript, agent handoff on request.
- **SMS** — secure enrollment link, status updates, recertification reminders.
- **Live specialist** — warm handoff with full context preserved.
- **Languages**: English, Spanish, Mandarin, Vietnamese, Korean, Tagalog, Arabic, French, Haitian Creole, Hindi.

## Plan-Side Capabilities (Admin Portal)

- DIS™ scoring & targeting
- Bulk and one-click enrollment for high-confidence matches (≥80%)
- Campaign management (email, SMS, voice) with batched background processing
- Real-time analytics: conversion funnel, channel performance, geo, churn risk, revenue impact
- Audit trail & HIPAA compliance dashboard
- Data source connectors (member feeds, Melissa enrichment, payer files)
- Role-based access, MFA, IP whitelisting, SSO/SAML

## Security & Compliance

- HIPAA compliant; SOC 2 audit-ready
- AES-256 at rest, TLS 1.3 in transit
- Row-level security on all PHI tables
- Comprehensive `log_audit_event` coverage (user, timestamp, IP, purpose)
- Minimum-necessary access enforced by role
- CMS marketing & enrollment guideline alignment

## Implementation & Timeline

- Standard launch: **~90 days** (vs. 18–24 months in-house/offshore)
- Includes data integration, branding, language config, agent training, UAT, and go-live
- Post-launch: continuous model updates, language additions, and CMS guideline tracking included in support

## Differentiators vs. Build / Offshore

- Pre-trained voice models (V28+) and DIS™ — not reproducible by a generic dev team
- HIPAA + SOC 2 controls already in place
- Full multilingual coverage day one
- Outcome-based pricing aligns vendor and plan incentives
- 90-day launch instead of multi-year build risk

## Contact

- Sales / partnerships: hello@dualenroll.ai
- Member support: Support@DualEnroll.ai (24/7, 10 languages)
- Web: https://dualenroll.ai
- Parent: https://rightskale.ai