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Customer Service Management

Our Customer Service Management solution provides Health Plans with a holistic solution to manage all customers, applicants, providers, agents and prospects’ service-related processes. Productivity and service levels can be monitored and improved through dashboard, standard CMS, management and ad hoc reports.

Why our Customer Service Management preferred by Health Plans

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Manages all service related processes of applicants/customers/providers/agents/prospects in structured manner

Help to solve issues through real time accurate information from dependent systems

Optimize open masks efficiently

Help manage marketing efforts effectiveness

Reports/Analysis for CMS/ internal management

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Why our Customer Service Management preferred by Health Plans

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Error Correction

Manages all service related processes of applicants/customers/ providers/agents/prospects in structured manner

Real time accurate information

Help to solve issues through real time accurate information from dependent systems

Optimize open tasks efficiently

Optimize open masks efficiently

Manage marketing

Help manage marketing efforts effectiveness

Insights

Reports/Analysis for CMS/ internal management

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Features at a glance

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Customer Service Representatives (CSR) get a web-based user interface for viewing claim details for a member. Details include service and payment details, claims details, provider details, notes, edits, MOOP history and activity logger

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CSR can view the Pre-authorizations for a member. Details include summary, notes, contacts, attachments, letters, status history

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CSR can capture the caller details and verify the member details

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CSR verify whether the caller is an authorized representative before giving any information about a member

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CSR can add temporary/ permanent authorization for becoming member representatives basis member authorization

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CSR can view information related to membership, claims, authorizations, quality, enrollment, fulfillment, tasks, materials requested, appeals & grievances for a member

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CSR can capture the event details like event description, event category, notes, communication address, event outcome. The event can be routed to other departments

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CSR can see the details of the previous events, pending events in queues

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CSR can edit the event from the queues and add relevant notes

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CSR can view the provider basic details, members mapped to providers, claim details, pre-auth details

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CSR can view the call logs, authorized member details and applicant details for an agent

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CSR can view the application details, fulfillment (communication) and tasks for an applicant

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Integrates with telephony system to capture caller information

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Tracks the status of each event though color coding thus avoiding breach of SLA’s

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Captures the RSVP data for webinars

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Provides CMS reports on scheduled frequency

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Users can generate real time reports

Why choose MIRRA’s® Customer Service Management Solution?

Ideal for health plans, our Customer Service solution provides a single system through which health plans can provide effective and efficient service to all its stakeholders. Regulatory compliance coupled with stakeholders satisfaction ensures sustainable growth for the health plan in a cost effective manner

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Reviews & Testimonials

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"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."

NANCY GAREAUCEO of Ultimate Health Plans

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