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Managing member premiums and payments is a complex and time-consuming task for health plans. From handling CMS-imposed retroactivity to ensuring accurate information tracking and reconciling various payments, the administrative burden is overwhelming. Mirra's TPA Premium Billing Solution addresses these challenges by offering a comprehensive, automated system that streamlines the entire billing process for healthcare plans.
In this blog post, we will share comprehensive insights into Mirra Health Care's healthcare Premium Billing solution, highlighting its features, benefits, and the crucial role of efficient premium billing in the healthcare industry. Read on for more.
Importance of Efficient Premium Billing for Health Plans
Premium billing is the process of generating invoices for health plan members and collecting payments. This process involves various tasks that range from handling retroactive changes, posting payments from different sources to ensuring compliance with CMS guidelines.
Efficient healthcare premium billing ensures that insurers receive accurate payments from members, SSA, and CMS on time. It helps health plans manage their cash flow and ensures financial stability to allocate resources to improve patient care and services.
In addition, outsourcing and automating the premium billing process from TPAs reduces the administrative burden on staff. Therefore, they can focus on more critical tasks, such as improving member services, managing provider relationships, and developing strategic initiatives to enhance the overall quality of the care management system.
Moreover, accurate and timely billing is crucial for maintaining member satisfaction. Health plans that can efficiently manage premium billing are less likely to face member complaints related to billing errors, delayed invoices, or incorrect payment postings. This improves the overall member experience and builds trust and loyalty, which ultimately contributes to business growth.
7 Proven Benefits of Mirra’s TPA Premium Billing Solution
Mirra's TPA Premium Billing Solution is designed to address the complexities of premium billing. It is a preferred choice for health plans for its advanced features and endless benefits. Here’s a closer look at what sets Mirra's Medicare billing services apart.
1. Comprehensive Automation
One of the most significant advantages of Mirra's member billing module is its industry-leading automation that can transform the healthcare premium billing ecosystem. It automates the generation of member invoices and the posting of related payments. This not only saves significant time by automating repetitive tasks but also minimizes the efforts required to manage member premiums and payments.
2. Effortless Integration
Mirra's TPA premium billing module is fully integrated with the Membership Management system to ensure a seamless flow of information. This integration helps eliminate manual data entry errors and ensures the accuracy of member information.
In addition, this feature also allows for efficient data management across different systems, ensuring that all information is easily accessible and synchronized.
3. Efficient Handling of Retroactivity
One of the biggest challenges for health plans is handling retroactive changes imposed by CMS. Mirra's TPA Premium Billing solution efficiently manages retroactivity by auto-updating invoices daily for all retroactive changes related to CMS enrollment, LIS, or LEP changes. As a result, all changes are accurately reflected in the invoices, reducing the chances of errors and ensuring compliance with CMS guidelines.
4. Enhanced Information Accuracy
With extensive audit trails and automated processes, Mirra's TPA premium billing solution significantly improves the accuracy of information. This ensures that all payments, adjustments, and transfers are documented and tracked to provide health plans with reliable and accurate financial data.
This information accuracy helps health plans in developing strategic initiatives and improving services. In addition, accurate billing information enhances the reputation of health plans and builds trust among members, providers, and regulatory bodies.
Read More: 5. Simplified Payment Posting and Transfers
At Mirra, we simplify the process of payment posting from various sources, including SSA, LIS, and member payments through Lockbox, credit or debit cards. It also ensures easy and automatic transfer of payments for retro billing activity or pre-payment and handles negative payments from CMS & SSA efficiently.
6. Easy Tracking and Reconciliation
Health plans can easily track and reconcile LIS & SSA payments with Mirra's healthcare premium billing solution. The system enforces documentation for manual adjustments and transfers, ensuring that all financial activities are transparent and easy to follow.
Detailed documentation and tracking help health plans stay audit-ready. In addition, clear tracking and reconciliation processes promote accountability and ensure that all billing activities are properly managed by the designated staff.
7. User-Friendly Interface
The feature-rich user interface of Mirra's TPA premium billing solution makes the process of dealing with customer service queries quick and easy. As a result, health plans can resolve issues on time and improve member satisfaction.
Crucial Functionalities of Mirra's TPA Premium Billing Solution
- Generate Monthly Invoices: Create member, SSA, and CMS/LIS invoices based on enrollment and CMS bid data.
- Separate Invoices: Generate separate Member (with LIS credits) and CMS (with subsidy amount) invoices.
- Auto-Update Invoices: Daily updates for all retroactivity related to CMS enrollment, LIS, or LEP changes.
- Post Payments: Handle payments from various sources including Lockbox, Credit/Debit Card, and manual entry.
- Transfer Payments: Automatically transfer payments due to retro billing activity or pre-payment.
- Handle Negative Payments: Automatically manage negative payments from CMS & SSA.
- Enforce Documentation: Ensure thorough documentation for manual adjustments and transfers.
- Generate Refund Checks: Issue member refund checks as needed.
Mirra's TPA Premium Billing Solution offers a robust, automated system that simplifies the complexities of managing member premiums and payments. The automated healthcare premium billing system seamlessly integrates with the existing system to improve overall operational efficiency and reduce administrative burdens. As a result, health plans can allocate resources more efficiently and invest in initiatives that will enhance the quality of care and services.
Mirra also offers Medicare Advantage in a Box suite which includes a range of products and services, including Eligibility, Enrollment, Member Management, Claims Adjudication, EDPS, Utilization Management, and more, all designed by industry experts to integrate payer, provider, and patient. This holistic approach ensures that health plans can deliver superior care and achieve their strategic goals effectively. Connect with our experts now to schedule a no-obligation demo!
