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Eligibility, Enrollment and Member Management

Our Eligibility, Enrollment and Member Management solutions offer both products and services to on-board Medicare beneficiaries on to the Medicare Advantage plans by offering a wide range of features and benefits.

Why our Eligibility, Enrollment and Member Management is preferred by Health Plans

Improves turnedaround time

Improves turnedaround time for applications

Improve care for Medicare members

Enable data-driven decision making via advanced analytics, thereby enabling better star ratings

Improves first pass and rate of acceptance and reduce denials through automated business rules

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Why our Eligibility, Enrollment and Member Management is preferred by Health Plans

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Improves turnedaround time

Improves turnedaround time for applications

Improve care

Improve care for Medicare members

Data-driven decision making

Enable data-driven decision making via advanced analytics, thereby enabling better star ratings

Improves rates of acceptance

Improves first pass and rate of acceptance and reduce denials through automated business rules

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Features at a glance

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Compliant with Medicare and Medicare-specific processes

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Interactive dashboard showcasing the key information areas like number of new members(plan wise), number of disenrolled members etc

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Ability to intake from multiple sources via online, paper, 834 EDI, OEC, custom format

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Available on desktop and mobile interfaces

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Real-time and batch mode eligibility checks through CMS (BEQ)

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Automated TRC processing

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Automated creation and fulfillment of all member correspondence including Annual notification of change (ANOC), Letters, Welcome Kit, ID Card, HRA, and AOR in compliance with CMS guidelines.

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Audit functionality support

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Configurable workflows

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Tracking of fulfillment / tasks

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HIPAA-compliant hosted solution

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Statutory and Ad hoc reporting

Why choose MIRRA's® Eligibility, Enrollment and Member Management?

Most of the products available in the market have a high initial investment, making it unaffordable for small & medium enterprises to come on board. Our affordable products and services integrated across Payers and Providers help small and big enterprises alike.

Our enrollment system is forecasted to deliver a first pass rate upwards of 95% with all the CMS specific business validations in place. The system is built based on substantial research and modern technology, offering a contemporary user experience.

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Reviews & Testimonials

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NANCY GAREAUCEO of Ultimate Health Plans

"In 2021, Ultimate Health Plans (UHP) partnered with Mirra Health Care (Mirra) to develop a software platform to support processing Claims, Customer Service, Eligibility, Enrollment, Premium Billing, Encounter Processing and a Provider Portal for our Medicare Advantage Plans. Mirra collaborated well with our operations and compliance teams to successfully design and implement a system that was innovative, efficient, and compliant with all Medicare and Florida Medicaid guidelines and requirements all within the scope of our required timeline. We greatly benefitted from the Mirra Project Management Team’s regular communication with Stakeholders through monthly meetings and recurring weekly breakout-focused calls, which were geared towards troubleshooting and goal alignment. Mirra was able to quickly maneuver and adapt their systems to our needs, resulting in successful implementation and go-live. Mirra continues to support our compliant operation and growth in the ever-changing healthcare industry rapidly and effectively updating their systems with new Medicare and Florida Medicaid rates and guidelines to ensure seamless compliance and efficiency. I have absolutely no reservation in recommending their systems to any Payer searching for improvement in their operational efficiency."

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