CMS regulation changes and AEP volume surges put a stress on your team. Then add in internal workflow pivots and your SLA window starts to close.
The result is a denial notice delivered to a Spanish-speaking member in English, or days late. That is both a member experience failure and a corrective action waiting to happen.
We support the full range of health plan letter programs from Utilization Management and Chronic Care Management to pharmacy, denial and appeal notices, NOMNC, EOBs and more.
At intake, each letter is classified by content type, regulatory obligation, jurisdiction, language requirement and risk level. From that classification, the right workflow is triggered automatically and it covers the right controls, review tier and output format applied consistently.
Nothing is treated as generic. We know the controls that apply to a CMS-regulated denial notice are not the same controls that you apply to a wellness reminder and your program reflects that distinction at every step.
TDL Healthcare integrates directly into your existing environment, including proprietary platforms, document management systems, or standard file delivery. We provide ongoing, configured connections built to help your program run smoothly and always on.
Files are ingested, classified and routed within minutes of arrival. When AEP volume surges or a regulatory change triggers a production spike, the workflow doesn't degrade. We work together with you to engineer to your volume patterns, including peaks and we do that before the first file arrives.
Proprietary anonymization technology strips PHI/PII before content enters the language and accessibility workflow, so member data is protected at the point of processing.
Automation workflows operate within defined risk threshold and we apply human review where compliance exposure is highest – for example on denial letters, CMS-regulated content and accessibility formats.
Our goal is make sure that review effort matches risk level. High-stakes content gets expert review while routine content moves at automated speed. These distinctions are built into the workflows, rather than left to judgment.
Large print, Braille, audio and 508-compliant digital formats aren't produced separately and bolted on after the fact. They move with the letter, through the same governed workflow, triggered by the same classification that drives everything else.
Every letter carries a complete chain of custody from intake through delivery.
When you're asked to prove your process internally or by a third party (CMS, a state regulator) the documentation is ready without reconstruction.
We support the full range of health plan letter programs from Utilization Management and Chronic Care Management to pharmacy, denial and appeal notices, NOMNC, EOBs and more.
Every redetermination cycle is a coverage-loss risk for members who can't act on what they're sent. In an Illinois study of Medicaid beneficiaries, those with limited English proficiency had over 5 times the odds of losing coverage at redetermination compared to English-proficient beneficiaries. This was not because they'd become ineligible, but because the notice didn't reach them in a language they understood and could act on.
TDL Healthcare brings redetermination and renewal communications into the same governed, secure workflow as your other regulated member letters - translated, on your state's timeline, every cycle. Always on.
2,000+ letters per week, delivered to members within 7 days, no exceptions.
A Chronic Care Management letter program required multilingual and ADA-compliant delivery under strict onshore processing and onshore security requirements during a period of sustained high volume.
On-time delivery
SLA maintained at peak volume
Accuracy on regulated content
Large print, braille, audio and 508 remediation
