Our flagship product was  designed by Medicare specialists to meet the needs of Medicare Advantage Plans following the 2003 Medicare  Modernization Act. MedicareCRM is a proven, fiscally responsible solution for every Medicare Advantage sponsor – local, regional and national. 

MedicareCRM adopters include forward thinking mega‐national plans and as well community and regional plans.  All agree: If any one of your business platforms is not up to regulatory and technological standards, your ability to compete is severely compromised.

Acquiring and retaining members against a backdrop of reimbursement-reduction is at the core of MedicareCRM.  Most Medicare Advantage Plans are perpetually stuck playing catch-up in operationalizing marketing, sales and enrollment efforts to comply with ever restrictive CMS legislation; this is particularly true with the on-going MIPPA mandates. The MA industry is undergoing unparalleled changes that dramatically alter how plans can market to and enroll new beneficiaries.  These seismic shifts in policy require every plan to adopt innovative and immediate cost-saving member acquisition practices to gain (and keep) market share.

Organizations that continue on their “business as usual” culture are greatly underestimating the scope of their liability to CMS, and Plans that pull back too far concede their ability to compete effectively. MedicareCRM clients have found the balance, and are now reaping the rewards of a growing membership.     

Our MedicareCRM platform supports all government subsidized healthcare programs. Workflows integrate direct Marketing, call centers, sales professionals, enrollment systems and compliance utilizing the internet as a secure global delivery system.

HealthPlanCRM has been reconciling 834s, Transaction Reply Reports and Monthly Membership Reports since CMS began providing data feeds to its sponsors (don’t tell the sales and marketing folks, but accreting members, plan changes and Disenrollments is why HealthPlanCRM was founded).  Accurately maintaining member eligibility files is one of the most taxing and important tasks for plans, particularly Medicare Advantage and Part D plans.  HeathPlanCRM’s internally developed EDI’s are the only fully-automated system designed specifically to integrate with CMS and state transactions. 

HealthPlanCRM provided 100% atomization of the TRR and MMR reconciliation process and maintains real-time dashboards linking transactions to sales and marketing data – a powerful combination. 

Correct membership data ensures that our clients receive 100% of the reimbursements to which they are entitled. End-to-end tracking of all TRR/MMR codes means foolproof compliance with CMS commission requirements and delivers our clients a sense of control over their membership data – not to mention a push button sales commission ledger tool.