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Quality Management
Quality Management
QAPrima, our innovative quality management tool helps health plans in improving their rating thus improving their revenues through supplemental / MRR process. It provides a comprehensive look at health plan/ provider performance data for multiple quality measures across multiple IPA’s, with an emphasis on convenience and ease of use.
Why our Quality Management tool is preferred by Health Plans
View rating
View rating accross IPA's/Providers at on glance
Reduce errors and denials
Reduce errors and denials with strategically-designed user-friendly workflow
Track & submit HEDIS/MRR
Track & submit HEDIS/MRR data from a single program
Identify organization performance trends
Identify organization performance trends to pinpoint opportunities for improvement
Identify individual performance trends
Identify individual performance trends for education and retraining opportunities
Why our Quality Management tool is preferred by Health Plans
View rating
View rating accross IPA's/Providers at on glance
Reduce errors and denials
Reduce errors and denials with strategically-designed user-friendly workflow
Track & submit HEDIS/MRR
Track & submit HEDIS/MRR data from a single program
Identify organization performance trends
Identify organization performance trends to pinpoint opportunities for improvement
Identify individual performance trends
Identify individual performance trends for education and retraining opportunities
Features at a glance
Interactive dashboard showcasing the key information areas like providers, members, insurance, IPAs along with monthly scorecards for IPAs and Healthplans and denominator/ numerator summary (measure wise)
Master data of IPAs, Providers, Healthplans, Measure (Star score crtiterias and Weightages)
Bulk data processing as received from different Healthplans and IPAs files in system for gap closure(Non-Compliant records) and rating improvements (Conversion of Non-Compliant records to Compliant)
NCQA adhered data processing of measures at member, measurement year and episode level as applicable
Gap submission for different quality measures within a single platform for HEDIS and MRR adhering to NCQA standards
Gap Auditing functionality to approve or reject the submitted gap and subsequently leading to rating improvements
Dynamic scorecards for different entities like provider scorecard, IPA scorecard, HealthPlan scorecards to fetch a quick summary of current stats along with overall scores/rating. Available with Export feature
Dynamic report generation feature to download data for different criteria like Non-compliant report, Compliant report, HbA1c Report, Part D reports etc. Data can be generated as per the measurement year and month selected. Available with Filters, Search functionality and Export functionality as well
Supplemental Data export functionality to download data submitted for current measurement year and all
Real-time tracking of productivity and performance mechanisms
User Management covering user creation and role creation feature. Access Management to allocate specific user behaviour role wise
Download BrochureWhy choose MIRRA's® Quality Management Solution?
The value is in the details. As a leading US Health Care supporting organization, we at MIRRA® Health Care understand the daily demands of Payers, Providers and Patients. MIRRA®’s quality portal, QAPrima, is designed to ensure you have everything you need in one convenient platform.
QAPrima provides the ability to conveniently identify under-performance and capture missing information to improve ratings through supplemental MRR process.
QAPrima’s unique ability to track performance and productivity creates an opportunity for organizations to easily and effectively measure and monitor their providers’ and employees’ work. This data can be used to identify trends and shortfalls, revealing areas in need of retraining and, ultimately, leading to a visible, measurable improvement in quality and outcomes.
Reviews & Testimonials
"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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