Headquartered in Pittsburgh, software firm specializes in Medicare health
plan enrollment and compliance
PITTSBURGH, Jan. 10 /PRNewswire/ -- Premier Market Connections, a company specializing in technology for the health care industry, has developed a solution that benefits seniors and dramatically simplifies Medicare Advantage plans' struggle for compliance, operational efficiency, and offers other solutions to boost the bottom-line for health plans. MedicareCRM will be presenting at the Medicare Advantage Congress, Scottsdale, AZ on January 23, 2008.
MedicareCRM(TM) is the first solution specifically designed for Medicare Advantage plans of all sizes. It is a web-based, user-friendly system developed by Ronald Ortiz, a managed care senior executive, and Patrick Phillips, a software engineer with specialized knowledge in healthcare informatics. Their 30 years of combined experience in the managed care industry, coupled with the industry's shake-up following the 2003 Medicare Modernization Act, led to the development of MedicareCRM(TM). This modular web-based platform is a proven cost effective tool for health plans that also supports the education of and the ability to audit sales professionals. A key benefit of MedicareCRM(TM) is ensuring compliance of CMS marketing guidelines, a guarantee that Medicare consumers may clearly understand the differences between plan benefits and choices.
In October 2007, the Centers for Medicare and Medicaid Services (CMS), began releasing information on deficiencies found in Medicare Advantage (MA) and Prescription Drug Plans (PDP) audits. Capitalizing on the fallout, members of Congress seized upon the findings as a further cause for more accountability and oversight of the MA program. Now, in the midst of the federally-mandated November 15 to April 2008 four and one-half month enrollment period, health plans grapple with the challenge of generating the maximum number of enrollments this year, maintenance of CMS compliance, and operating as effectively and efficiently as possible. For Medicare Advantage plans, enrollment is a critical factor to ensure that membership economics are sustainable.
According to census figures, 47 million Americans are currently eligible for Medicare. By 2022, this population will double to more than 94 million Americans. The Medicare Modernization Act has created an ever-changing, increasingly complex world of health plan product offerings, often confusing seniors, and their families, who are forced to fend for themselves through a sea of Medicare plan choices including PDPs, health maintenance organizations, (HMOs), preferred provider organization, (PPOs), private fee for service plans, (PFFSs), and Medicare special needs plans, (SNPs). CMS data indicates that many Medicare eligible Americans do not enroll in a plan due to this confusion and the short enrollment time frame.
MedicareCRM(TM) ensures that all health plan products, sales materials and marketing campaigns are used compliantly, effectively and efficiently. The system continuously documents that all sales staff comply with CMS regulations and are able to clearly educate potential enrollees about plan features and benefits. Vital to each health plan, MedicareCRM(TM) also provides health plan executives with real time campaign statistical information and detailed activities of staff encounters with all potential Medicare-eligible enrollees looking for coverage.
MedicareCRM(TM)'s mission is to improve the public/private partnership of the current Medicare system so that beneficiaries achieve a new standard of excellent service, while ensuring ROI for Medicare Advantage plans. A business segment of Premier Market Connections, this privately held company holds offices in Pittsburgh, PA, and Portland, OR, and has clients ranked in the top 10 Medicare plans in the United States, according to U.S. News and World Report. For more information, please visit http://www.medicarecrm.com.
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