Member360 is a comprehensive membership management system.
Features
- Includes: Eligibility & Enrollment, Enrollment Reconciliation, Premium
Billing (LICS, SSA, SPAPs & Split Billing), CMS Member Correspondence, TRR
& MMR Processing, Enrollment Discrepancy Detection,
- Tracks and reconciles TRC's and letters at the member level
- Automatically generates required CMS-mandated correspondence; allows
manual generation of correspondence as needed.
- Premium Billing and Collections (direct bill, SSA & ACH)
- Workflow by member status
- Includes interfaces with CMS and data processing vendors, and with
client's existing systems
- For MMPs, includes
- Passive & voluntary enrollments, cancellations, disenrollment's, opt
outs
- 834 Enrollment - Passive, Opt In/Out
- Automated MMP TRC Correspondence & Fulfillment
- Multiple data integrations
Benefits
- Reduces entry time by auto-loading demographic fields from TRR and
MMR
- Provides a workflow for correction and resubmission of rejected
members
- Automatically triggers letters based on member workflow status and TRC
codes received from the TRR
- Increases enrollment first-pass rate and adds key information not found on
the application by performing up-front eligibility verification
- Adjusts invoice amounts for LIS / LEP automatically based on CMS
rules
- Keeps your organization current with CMS requirements at no additional
cost
- Provides more benefits for less money; no hardware to purchase, no
software licenses and no costly on-site installations
- Increases CMS compliance and efficiencies while lowering
costs.
