Member360° is a comprehensive Medicare Advantage Membership Management System.
Key features include:
Automated Medicare Eligibility Verification
As applications are entered either by batch or online, each member’s Medicare eligibility is verified. During the verification process, CMS member-specific data such as ESRD, Medicare eligibility start date, LIS, and LIC are automatically added to Member360°.
Enrollment Transaction Validation and Submission
Our solution validates every enrollment transaction for eligibility and format prior to submission to CMS, producing a high acceptance rate. Member360° also captures, stores, and reports on the CMS transaction reports (such as the BCS, TRR, and MRR).
Membership Management
The Member360° system maintains a current and complete history on all eligibility, enrollment, and billing transactions. Further, standard work queues allow staff (such as, enrollment, finance, and customer services) to efficiently address issues, research, or answer questions related to individual or groups of members.
Market Leading Premium Billing
Our billing solution supports standard as well as LIC/LIS and SSA billing scenarios. The split billing feature enables your Plan to accept third-party payments on behalf of members.
CMS Correspondence
The Member360° system supports CMS correspondence.
How does Member360° benefit your Plan?
• Reduces entry time by auto-loading demographic fields from the TRR and MMR
• Provides a workflow for rejected members creating an easy-to-manage membership
• Provides TRC escalation reports
• 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
• Produces the Acumen file automatically• Adjusts invoice amounts for LIS/LEP automatically based on CMS rules
The Infocrossing Difference
Infocrossing is a premier provider of selective IT and Business Process Outsourcing solutions. Over 80 percent of Medicare Advantage Plans take advantage of our solutions to address their membership management, eligibility/enrollment, payment reconciliation and clinical risk adjustment business and regulatory requirements. With the backing of our parent company, Wipro Ltd., a $5.5 billion technology services company, we offer proven technical delivery capabilities and long-term financial stability unmatched in the industry.
Call Infocrossing Now
For more information, please contact Infocrossing at 866.779.4369.
