Overview

Miramar:Enroll Software is a purpose-built platform designed specifically to streamline the Medicare Advantage (MA) enrollment process. It offers an intuitive, compliant, and end-to-end system that enhances the consumer experience while minimizing administrative challenges. Unlike patchwork systems that can cause inefficiencies and customer frustration, this software integrates every stage of enrollment, from intake and eligibility verification to enrollment acceptance, benefit activation, and notification. The platform supports paper, electronic, and telephonic applications, ensuring compliance with Centers for Medicare and Medicaid Services (CMS) regulations. Its smart design includes automation, dynamic workflows, and seamless integration with external systems, such as claims processors and financial institutions. By reducing avoidable errors and compliance risks, it helps health plans optimize operational efficiency, improve member satisfaction, and achieve a competitive edge in the Medicare Advantage market.

Features and Capabilities

• Full Enrollment Lifecycle Management: Covers intake, eligibility verification, enrollment acceptance, and benefit activation.
• Smart Automation: Includes dynamic workflows, advanced work queues, and automated alerts.
• Multi-Channel Application Support: Accepts paper, electronic, and telephonic enrollment applications.
• Real-Time CMS Integration: Direct gateway to CMS for error detection and real-time reconciliation.
• Regulatory Compliance: Ensures adherence to evolving CMS guidelines and mandates.
• User-Friendly Interface: Smart wizards streamline processes for customer service and sales teams.
• Error Mitigation: Flags eligibility verification issues, reducing avoidable rejections to below CMS thresholds.
• Enhanced Communication: Provides timely notifications to beneficiaries as per CMS requirements.
• Scalable Architecture: Modular system adapts to varying needs of health plans.
• Marketing Integration: Tracks enrollment linked to marketing or broker sources for performance insights.
• Seamless Interoperability: Integrates with external systems, including claims processors and financial institutions.
• Improved Member Experience: Minimizes drop-offs and rejections, ensuring smooth enrollment and satisfaction.