managing MA/MAPD, PDP, & EGWP members
With an extreme focus on efficient and compliant management of MA/MAPD, PDP, & EGWP members, Miramar was initially designed internally for Convey’s own business process outsourcing teams. Now that Miramar is also available externally to Convey clients, the Miramar development team ensures that all stakeholders are the pillars for continued evolution.
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Miramar Modules
Full enrollment management, from intake and verification to reporting back to the health plan Miramar:Enroll can also handle all cases of disenrollment, re-enrollment, PBM and CMS reconciliations and reporting.
With premium billing invoicing and payment processing Miramar:Bill will monitor and manage all functions such as good cause reinstatements, failure to pay, refund processing, CMS & SSA reconciliation, and lockbox/ e-lockbox integration.
Grievances and inbound appeals are managed within Miramar:Resolve – research, tracking and resolution including all reporting and analysis for your health plan.
Miramar:Capture will manage all inbound and returned mail – including enrollment and privacy forms, coordination of benefits, and best available evidence.
Miramar:Fulfill – outbound mail processing including automated letter triggering, letter image retention, barcoding, tracking, inventory management, and quality control.
Connect consolidates steps and addresses member needs with dynamic member services and customer experience technology.
Bill
With premium billing invoicing and payment processing Miramar:Bill will monitor and manage all functions such as good cause reinstatements, failure to pay, refund processing, CMS & SSA reconciliation, and lockbox / e-lockbox integration.
Capture
Miramar:Capture will manage all inbound and returned mail – including enrollment and privacy forms, coordination of benefits, and best available evidence.
Resolve
Grievances and inbound appeals are managed within Miramar:Resolve – research, tracking and resolution including all reporting and analysis for your health plan.
Fulfill
Miramar:Fulfill – outbound mail processing including automated letter triggering, letter image retention, barcoding, tracking, inventory management, and quality control.