Premium Billing

Q: What does the Member Billing module offer?

The Member Billing module, also known as Mirra Health Care’s Premium Billing software or TPA Premium Billing, automates the generation of member invoices, handles payment postings, and seamlessly manages CMS-imposed retroactivity. It is fully integrated with our Membership Management system, eliminating manual entry for CMS-driven membership tasks.

Q: How does the Billing Module streamline the billing process for health plans?

The Premium Billing Module, also referred to as TPA Premium Billing software, is preferred by health plans for several reasons: 1. Maintenance of extensive audit trails 2. Significant time savings from automated retroactivity, payment postings, and transfers 3. Improved information accuracy 4. Ease of tracking and reconciling LIS & SSA payments

Q: What are the key features of the Premium Billing Module?

Generate monthly member, SSA, and CMS/LIS invoices based on enrollment and CMS bid data. 1. Separate Member (with LIS credits) and CMS (with subsidy amount) invoices. 2. Auto-update invoices daily for all retroactivity related to CMS enrollment, LIS, or LEP changes. 3. Post payments, including SSA, LIS, and member payments, from Lockbox, Credit/Debit Card, and manual entry.

Q: Why choose Mirra Health Care’s Premium Billing?

Mirra Health Care’s Premium Billing, also known as TPA Premium Billing software, stands out for its: 1. Seamless automation in generating invoices and handling payments. 2. Full integration with the Membership Management system, reducing manual entry tasks. 3. Feature-rich user interface for quick and easy customer service queries. 4. High level and quality of automation, minimizing efforts required to manage member premiums and payments.

Premium Billing

Our Member Billing module easily automates the process of generating member invoices and posting of related payments, while seamlessly dealing with CMS imposed retroactivity. The Billing Module is fully integrated with our Membership Management system which eliminates manual entry of all CMS-driven membership information, enrollment, termination and more. Our feature-rich user interface makes dealing with customer service queries quick and easy. The high level and quality of automation minimizes the efforts required to manage member premiums and payments.

Why our Premium Billing is preferred by Health Plans

Maintenance of extensive audit trails

Significant time saving from automated retroactivity, payment postings and transfers

Improved information accuracy

Ease of tracking and reconciling LIS & SSA payments

Why our Premium Billing is preferred by Health Plans

Maintenance of extensive audit trails

Significant time saving from automated retroactivity, payment postings and transfers

Improved information accuracy

Ease of tracking and reconciling LIS & SSA payments

Features at a glance

Generate monthly member, SSA and CMS/LIS invoices based on enrollment and CMS bid data

Separate Member (with LIS credits) and CMS (with subsidy amount) invoices

Auto-update invoices daily for all retroactivity related to CMS enrollment, LIS or LEP changes

Post payments including SSA, LIS and member payments from Lockbox, Credit/Debit Card and manual entry

Transfer payments as needed due to retro billing activity or pre-payment

Handle negative payments from CMS & SSA

Enforce documentation for manual adjustments and transfers

Generate Member Refund Checks as needed

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Why choose MIRRA's® Premium Billing?

Frequently Asked Questions

What does the Member Billing module offer?

How does the Billing Module streamline the billing process for health plans?

What are the key features of the Premium Billing Module?

Why choose Mirra Health Care’s Premium Billing?

Reviews & Testimonials

DJ OLIVERExecutive Director of Liberty Medicare Advantage

"In the process of looking for a Third Party Administrator, we identified Mirra as a candidate. After meeting with the team and understanding their experience, systems, and processes, we knew we had a great partnership opportunity. Mirra was able to transition our data quickly and effectively. Our teams work very closely to ensure successful operations of the health plan."

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."

DJ OLIVERExecutive Director of Liberty Medicare Advantage

NANCY GAREAUCEO of Ultimate Health Plans

DJ OLIVERExecutive Director of Liberty Medicare Advantage

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