Case Study: Leading US Based Health Plan achieves digital SOA transformation and major cost savings with Newgen Software

Digital Transformation of Scope of Appointment (SOA) Process for a Leading US-based Health Plan

A leading US health plan serving nearly 6 million members across Medicaid, Medicare Advantage and Medicare Part D needed to comply with CMS rules requiring a Scope of Appointment (SOA) be captured before face-to-face sales meetings. Their legacy process—agents or prospects calling a centralized call center or using paper forms—was slow, error-prone and costly (about $101k/month for call center ops plus $20k/month for sales support), created visibility and compliance gaps, and constrained agent productivity and scheduling.

Newgen implemented a mobile SOA app on its Enterprise Mobility Framework (NEMF) that lets agents collect digitally signed, CMS-compliant SOAs via iOS/Android, integrates with CRM/OmniDocs for centralized archival, and enforces rule-based validation and encryption. The solution halved form-fill time (10→5 minutes), cut turnaround for missing forms from five days to minutes, reduced monthly call-center costs to roughly $32k and eliminated the $20k sales-support spend, enabled processing of up to 160k SOAs, and improved compliance and process visibility.