Overview

Miramar:Reveal by Convey Health Solutions is a tool designed for efficient Medicare member payment reconciliation. It helps health plans validate and process membership and premium data, ensuring that claims and payments are accurate. The platform facilitates retroactive processing, reduces discrepancies, and improves operational workflows. With its advanced capabilities, it ensures transparency, compliance, and revenue recovery for health organizations handling Medicare claims.

Features and Capabilities

• Accurate Membership & Premium Data Validation: Ensures the integrity of member enrollment and payment records.
• Retroactive Processing: Handles claims corrections by identifying and processing discrepancies from past periods.
• Coordination of Benefits: Streamlines the process for multiple insurers to ensure correct claims and payments.
• Error Identification & Revenue Recovery: Detects discrepancies and enables accurate recovery of payments.
• Comprehensive Reporting: Provides detailed insights into discrepancies, trends, and performance metrics for ongoing improvement.
• Compliance & Transparency: Ensures alignment with regulatory standards, enhancing operational transparency and trust.