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Manage

Better enrollment.
Better experience.

How do you master the myriad systems you need to manage the members it took considerable resources to attract?

99.5% enrollment success

Streamline enrollment

Trust a solution designed for the Medicare market from intake and verification to reporting.

Convey’s Miramar:Member platform isn’t retrofitted for Medicare. It was built for it and evolved to meet changing CMS guidelines, intense service level requirements, and industry compliance and quality standards. We complete millions of enrollments every year. 99.5% are auto-processed, with reconciliation rates that exceed most competitors.

Full CMS integration ensures fast, compliant enrollment. Members enroll by phone, paper, or through our secure portal. If calls come in, contact center representatives are armed with knowledge and technology, creating a seamless experience for the member that meets our standard of first-call resolution. Effortless document fulfillment services include document-triggering integrations for all enrollment procedures.

Better manage enrollments

Elevate plan and member experience

Marry purpose-built technology and compassionate service for an effective, positive member and plan experience.

Billing, invoicing, and payment processing
  • Automated adjustments for member coverage changes
  • Personalized invoicing
  • Versatile payment options
  • Seamless integration with premium payment information
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Reconciliation

Eliminate missed revenue and inaccurate claims payments through increased visibility into how data flows through your organization and how to improve operational success.

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Grievance cause analysis

Whether we are managing members through enrollment and premium billing processes, or assisting them with use of their supplemental and extra benefits, we are prepared to best handle your membership every step of the way.

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Efficient authentic interactions

Miramar gives our customer service advocates access to critical details. It compiles complex information and presents it in a straightforward, easy-to-use format for the member and the health plan.

We guide customer service representatives through relevant information based on prompts in the conversation. Script automation, real-time member status, updates, and alerts ensure consistency and compliance.

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Aligned rewards and incentives programs

Convey initiates and delivers rewards through multiple flexible channels linked to plan objectives. We configure each program to achieve better-quality outcomes and member satisfaction by aligning the right members with the right incentives. End-to-end programs drive member action and deliver the right rewards to improve health and satisfaction. We believe that healthy activities should be rewarded with health-related incentives.

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Ensure year-round compliance success

Avoid enforcement and sanctions with Online Monitoring Tool (OMT), an integrated healthcare compliance software solution that supports your organization. Simplify critical activities that often rely on manual documentation and distribution. Make informed decisions to reduce the risk of CMS compliance actions, material financial loss, or damage to your organization’s reputation.

Three of the seven OMT modules—Materials, Notices, and corrective actions plans (CAPs)—are designed to alleviate and better manage compliance department demands by addressing the areas with the highest perceived risk of non-compliance.

  • Materials tracks your marketing and member materials with version controls.
  • Notices automates the significant volume of HPMS and other notifications for easy tracking and storage.
  • CAPs manages and tracks corrective action plans.
Better manage compliance

Complete Member Management

The Miramar platform manages the entire member journey, from pre-enrollment to billing to supplemental benefits. Plans and members enjoy a better experience that relies on exceptional CRM support and efficient member information collection.

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Better manage your health plan operations from pre-enrollment to billing to supplemental benefits with the Miramar platform.

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