Miramar

Miramar Technologies, developed by Convey Health Solutions, is an enterprise healthcare technology solution designed specifically for the government-sponsored healthcare markets. According to the vendor, this platform caters to health plan providers, government-sponsored plans, Medicare plans, Medicaid plans, and pharmacy benefit managers of various sizes. Miramar offers a range of features to support member services, enrollment, premium billing, data analytics, and administration of supplemental benefits.

Key Features

Miramar: Convey's Enterprise Healthcare Technology Solution: According to the vendor, this purpose-built platform is designed for government-sponsored healthcare markets, managing Medicare Advantage, prescription drug, and group programs. It provides support for member services, enrollment, premium billing, data analytics, and administration of supplemental benefits.

Enrollment & Billing Technology: The vendor claims that this feature offers dynamic flow and advanced work queue features, smartWizard utilities, automated alerts, and reconciliation rates that surpass traditional software vendors.

Strategic & Operational Health Plan Management Solutions: According to the vendor, this feature streamlines day-to-day operations with solutions for data reconciliation, sales force management, and compliance monitoring. It can seamlessly integrate into existing technology infrastructure.

Healthcare Data Analytics: The vendor states that this feature transforms raw data into actionable predictions by harmonizing clinical, claims, and SDOH data sources. It aims to enable revenue and payment integrity optimization.

Miramar:Enroll: According to the vendor, this feature provides full enrollment management from intake to reporting. It offers automated case handling for disenrollment, re-enrollment, and reconciliations. The vendor claims that it can be deployed as a modular solution for SaaS or BPaaS.

Miramar:Bill: The vendor claims that this feature enables custom invoicing, flexible payment methodologies, real-time premium adjustments, integration with premium payment information, and ensures complete adherence to CMS and SSA receivables reconciliation.

Miramar:Resolve: According to the vendor, this feature offers a robust appeals and grievance solution with compliance-focused case handling and resolution. It includes root cause analysis and process improvement for long-term grievance reduction.

Miramar:Capture: This feature aims to manage inbound and returned Medicare member mail. According to the vendor, it features flexible form capture requirements, automated workflows, and document triggering integration for enrollment, billing, and grievance processes.

Miramar:Fulfill: The vendor claims that this feature provides document fulfillment technology and services with mail stream tracking, fulfillment quality control, dedicated operational oversight, and inventory management.

Miramar:Connect: According to the vendor, this feature delivers dynamic Medicare member services and customer experience technology through an integrated, multi-channel system. It includes automation capabilities, enhanced IVR, customer experience interface, and self-service portals.