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Miramar:Member

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Miramar is a Medicare Advantage member administration platform from Convey Health Solutions that brings enrollment, eligibility, premium billing, reconciliation, document processing, grievance management, and member service workflows together in one integrated system. Purpose-built for the complexities of Medicare, Miramar helps health plans manage critical member administration processes from enrollment intake and verification through ongoing eligibility, billing, reconciliation, communications, and service. The platform supports Medicare Advantage plans, Prescription Drug Plans, Employer Group Waiver Plans, and Special Needs Plans. Miramar connects enrollment, billing, and reconciliation workflows so that changes in member information move across related processes with less manual intervention and fewer operational handoffs. Capabilities include enrollment and eligibility management, premium invoicing and payment processing, CMS reconciliation, document capture and fulfillment, grievance management, reporting, and customer service technology. The platform integrates with CMS and external enrollment portals and can connect with health plan systems and partners, including claims processors, pharmacy benefit managers, and financial institutions through APIs and other integrations. Contact center teams have access to consolidated member information, action items, and alerts to help resolve member needs with less system navigation. By replacing fragmented member administration processes with a connected platform designed for Medicare, Miramar helps health plans reduce manual work, improve operational and billing accuracy, strengthen compliance, and deliver a more consistent member experience.

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