Maximize Medicare member touchpoints and stay engaged throughout the year, while simplifying benefit administration for you
The US healthcare industry is now becoming more consumer centric. There has been significant reorientation towards value-based care and greater payer-provider collaboration. In addition, driven by unpredictable regulatory changes, Medicare Advantage players have moved towards smart systems which can expand into new product lines or handle any changes in provider management and claims management.
Wipro’s ‘Medicare in a Box’ consists of a set of integrated turnkey modules that increase your core operational efficiency and achieve sustained cost controls. The Member360 module is a comprehensive end-to-end Medicare Advantage membership management system serving 18 clients and more than 60 Centers for Medicare & Medicaid Services (CMS) contracts. Revenue360 is an integrated, CMS compliant Medicare Advantage membership reconciliation system that has the ability to intake a variety of CMS files and process data as per CMS requirements. EDPS (Encounter Data Processing System) ensures 100% compliance in encounter data submission to the CMS while automating most of the manual process. The Plexis QC – Claims Processing module provides reliable performance for high claims volumes allowing customers to grow as they optimize.