Medicare Member Enrollment Technology

A comprehensive technology solution for the Medicare member enrollment administration.

The enrollment process can be laden with pain points especially when it comes to eligibility verification, enrollment acceptance and validation, and benefit activation and notification. And each step is bound by federal regulations, making compliance paramount.

Insert a built-for-Medicare enrollment solution that supports the entire enrollment lifecycle with ease and a focus on your member’s experience.

Tailored for Medicare enrollments

This purpose-built system is meticulously crafted to cater specifically to the complexities of the Medicare landscape. Unlike generic solutions, our Miramar:Member has evolved over time to meet the exacting standards set by CMS, adapting to stringent guidelines, service level requirements, and industry compliance measures.

Benefits of the enrollment solution

Multi-Channel Enrollment Management

Experience streamlined intake and verification processes across various channels, ensuring data accuracy and completeness while reducing rejections

Real-Time Work Queue Distribution

Tasks are efficiently allocated in real-time, enhancing productivity and responsiveness.

Automatic Triggers and Configurable Workflows

Benefit from automatic triggers for exhibits upon enrollment and TRR processing, alongside configurable workflows tailored to member enrollment status.

Timely Reconciliation and Integration

Enjoy timely and accurate reconciliation through automated processes, coupled with full integration with premium payment information to promptly address member needs.

CMS Compliance

We capture all CMS-mandated information and update the platform, maintaining your compliance with evolving Medicare regulations, reducing risk, and ensuring quality.

Key functionality of our Medicare member enrollment management solution

Enrollment Intake

Disenrollment Processing

Cancellation Processing

LEP Attestation Processing

CMS Reconciliation

Broker Commission Data Feed

Eligibility Verification (BEQ)

Enrollment Verification

Opt-Out Processing

Out of Area Processing

Telephonic Pre-enrollment and Enrollment

Work Queues

Enrollment Processing

Eligibility Processing for Employer Groups

Retro Processing

TRR Processing

Medical Claims Eligibility Feed

PBM Eligibility Feed

Exhibit Triggering

Enrollment Maintenance

Incomplete Enrollment / Disenrollment Review

Good Cause Reinstatements

Good Cause Reinstatements

PBM Reconciliation

SmartWizards

Take the first step toward seamless Medicare enrollment management.

Our team of experts is standing by to show you the difference a purpose-built solution can make and how you can revolutionize your operations.