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Client Newsletter

Spring 2022 Edition

Welcome to the spring 2022 Client Newsletter


With the unexpected double-digit growth in Medicaid enrollment these past few years, it’s been a challenge for states and MCOs to assure access to appropriate dental care and oral health equity for all members. Scaling up membership quickly and expanding benefits is a tough when a Medicaid program is being managed with manual and paper-based processes.

In contrast, SKYGEN’s technology-enabled approach to specialty benefits is driving results for states and MCOs that have modernized Medicaid administration with us. During the economic shutdown SKYGEN rapidly implemented 60 emergency workflow adjustments to help our clients navigate the challenging new landscape. We’ve also helped MCOs respond quickly to requests by their clients to put increased benefits in place that ensure all members have the opportunity and ability to access quality dental care.

woman smiling in dentist chair


Expanded Medicaid Benefits Success Story

When the State of West Virginia expanded Medicaid dental benefits on select services for adult beneficiaries, two MCOs partnering with SKYGEN wanted to deliver for their client quickly. With SKYGEN’s enhanced benefit configuration and flexible claims automation, the team was able to roll out the benefit functionality within 30 days, so the $1,000 additional benefit was available to members quickly.

To ensure members do not incur any out-of-pocket expenses, the state requested prior authorization on all expanded benefit services except for the periodic exam, initial comprehensive exam, and comprehensive periodontal evaluation. SKYGEN met this request, and added an accumulator by setting the maximum benefit dollar amount with a yearly period for the codes that make up the expanded benefit. As claims are processed the member’s accumulator balance is updated. Payments to the provider end once the maximum amount is consumed. 


Members have several ways to easily check their balance, including through SKYGEN’s Member Mobile app, the Member Web Portal, and by contacting SKYGEN’s Call Center. Providers can also check member balances through the Provider Web Portal. Our MCO partners are already seeing early returns on the desired outcomes of better overall consumer experiences and increased member satisfaction.


30-Day Transition to TPA Success Story

With a rapidly changing Medicaid environment, in-house benefit program management can run into unexpected challenges. That was the case for another MCO that also works with the State of West Virginia. After two months of managing the expanded Medicaid dental benefits program, this MCO realized it wasn’t able to perform as planned. SKYGEN was asked to take over administration of this program. We made this transition smoothly within 30 days.  

SKYGEN has comprehensive digital strategies and tools to that enable our partners to respond effectively and with far less friction to increases in membership and new market opportunities. By reducing cost and providing innovation like the Medicaid Member Mobile app as well as flexible plan design, SKYGEN helps Medicaid programs establish stronger connections with members and implement strategies that improve access to quality care. 

female dentist smiling


Moving Oral Health Equity Forward with SKYGEN

SKYGEN’s digital approach aligns people, processes and technology to support MCOs in advancing oral health equity goals. The pandemic exposed what Medicaid program administrators have known all along – that vulnerable people suffer the most in times of economic stress. Today, due to record Medicaid enrollment, MCOs are having a greater challenge to ensure everyone has access to appropriate dental care and oral health equity. Learn how our automation and flexible strategies can offer greater access to dental care. 


As you may recall, several months ago, we asked our clients for feedback on how we’re doing supporting your business and where we can improve. We’ve taken that feedback very seriously and are working to make improvements in the areas you highlighted. We want to take a moment to share our progress in one particular area and tell you about some exciting improvement you can expect in 2022.

One of the key areas you asked us to improve was our communication. Your feedback made it clear that you want to know more about how SKYGEN can help you streamline and grow your business.  

For some time now, we’ve provided (and will continue to provide) the market and company news via the weekly Market Insights Newsletter and this Quarterly Client Newsletter. If you are not receiving either of these communications, simply reach out to your Client Experience Executive to be added to our mailing list!

Now, in addition to these existing communications, we’re excited to announce a new series! Starting in January 2022, we’ll be running a free, monthly educational webinar series featuring SKYGEN and industry experts that will introduce you to new and innovative ideas in specialty benefits.


skygen cafe

Introducing the SKYGEN Café

Serving "coffee break" webinars on the hottest topics in specialty benefits

Join us for the new SKYGEN Café, a free, monthly educational webinar series featuring SKYGEN and industry experts that will introduce you to new and innovative ideas in specialty benefits. 

We understanding that your time is valuable, so each virtual coffee break webinar will be "snack-sized" – never longer than 30 minutes – but they'll be jam packed with powerful insights on topics like:    

  • Maximizing the Medicare Dental opportunity
  • Getting the most out of your TPA partnership
  • Transforming member and provider experiences
  • And much more


Can't make the monthly webinar? Past webinars will be available to you on-demand, still fresh and piping hot. We'll see you at the SKYGEN Café soon!


We are pleased to announce the appointment of Steve Berryman as our new Chief Executive Officer!

In his new role, Steve is responsible for creating SKYGEN’s strategy driving execution to deliver growth, profitability, and client satisfaction.

“Steve is a champion of our company values, our people, and leveraging SKYGEN’s technology and benefit management expertise to help our clients be successful.”


SKYGEN leaders share their insights, perspectives and new ideas on the issues and opportunities facing healthcare today.


Digital transformation continues to sweep across healthcare. For the dental market, transformation is happening in waves. As a trusted, transformative partner to the most efficient dental plans in the nation, SKYGEN is keeping you ahead of the digital curve in dental benefits administration and exceptional experiences.

Find-A-Provider 1.0

Find-A-Provider is a great example of an essential feature for dental plan members that is improving dental experiences as the technology advances. Find-A-Provider is often simply an alphabetized list of dental provider participating in the plan that is searchable by zip code, allowing members to see providers in close proximity. Over time, some have been enhanced to allow members to search using additional criteria, such as type of dental provider or dental service needed, and search on a mobile device that connects to geographic mapping. 

While Find-A-Provider 1.0 is helpful, there are some issues:

  • 75% of patients never scroll past the first page of search results
  • 18% of patients simply choose the provider ranked first in search results

Dental plan members are finding a provider, but are they finding the best provider for them – the one that is more likely to meet their needs and create patient satisfaction? In addition, should high-quality providers be missed solely because their name is closer to Z than A?  

Transforming Find-A-Provider

Seeing an opportunity to improve this critical dental plan feature, SKYGEN developed Enhanced Find-A-Provider. Unlike traditional location-based tools, this smart tool uses proximity and provider ratings to direct members to nearby providers that offer the most appropriate and efficient dental care. It includes configurable travel tolerances by market so that travel is appropriate for specific geographic or metropolitan areas. Enhanced Find-A-Provider is:

Good for payers – Dental plans gain significant cost of care savings by shifting members to locations with the optimum blend of ratings and travel distance. Potential cost of care savings could be as high as $.29 PMPM when health plans shift 10% of their members to higher-performing providers. 


Cost of Care Savings


Good for providers – Providers that are high-performing gain a powerful marketing tool and can realize better ROI on their investment in an efficient, quality patient experience. Enhanced Find-A-Provider search results can be randomized to avoid overwhelming a particular provider location or locations.

Good for members – Members are referred to nearby providers that are recognized as providing high quality, appropriate and effective care at lower costs. When members are satisfied with their dental care and its cost, they are likely to stay with that provider and take advantage of preventive care, which can improve oral health outcomes. 


female dentist smiling by chair

Payers can make this smart tool available to members via patient portal, on the SKYGEN Member Mobile App, or both. By replacing old-school provider search features with Enhanced Find-A-Provider, payers create a win across the board.

Enhanced Find-A-Provider is one of three SKYGEN Provider Select solutions that is available individually or as the Provider Select Suite. If you have questions about Enhanced Find-A-Provider’s smart technology or would like to take it for a test drive, contact your Account Manager today. 


We’re excited to announce some enhancements to the Enterprise System to address Commercial and individual market needs.

woman on tablet

Portal Upgrades Streamline Broker Functions

We are releasing new features to our online broker portal, including 24/7 access and a host of digital sales tools and resources to improve client engagement and help brokers gain a competitive edge.

Most notably, we have added more commission schedule flexibility to the portal’s Broker Commission Module. A member level commission schedule enables brokers to get paid at different rates for different members if applicable. We also updated our Brokers API to enable existing participations to be transferred from one broker to another.


Online Portal Facilitates Purchase of Individual Insurance

We are also introducing an online enrollment portal to meet growing market demand for individual benefit plans. The portal offers a step-by-step guided shopping experience for individuals to self-purchase and enroll in a benefits plan.

The portal integrates with clients’ public facing marketing websites and SKYGEN's Enterprise System. It is available as a web app that supports desktop, tablet and mobile responsiveness. The portal enables individuals to view and manage insurance plans, along with the following functions:

  • Shop, compare and purchase different dental and vision insurance plans
  • Manage account details, such as adding dependents and updating credit card information


Contact your Client Experience Executive to learn more!

Learn how you can transform the delivery of health benefits with SKYGEN.