MPPP360

Skip Navigation
Home

Medicare Prescription Payment Plan - MPPP

An end-to-end management of Part-D members opting for MPPP

Schedule a Demo

MedAdvantage360

MPPP360

  • Opt-in / Opt-out status handling
  • Maximum Monthly cap determination
  • Automated monthly invoicing based on TrOOP cost
  • Payment through Member Portal
  • Associate portal for easy work flow

MPPP360 is a system that handles Medicare Part D members who elect into the Maximum Monthly Cap on Cost-Sharing Payments Program or the OOP Smoothing Program, which is now named as Medicare Prescription Payment Plan (MPPP) by the CMS. This system has been created based on CMS guidance issued to facilitate the Inflation Reduction Act (IRA).

MPPP360 provides an integrated solution for the Part D enrollees who take the option to pay their OOP prescription drug costs in monthly installments over the course of the plan year, instead of paying OOP costs at the POS. The system manages member’s Opt-in/Opt-out into the MPPP, member maintenance, member prescription billing, delinquency processing, and financial reporting. Wipro also has the ability to provide member omnichannel support including back-office and call center services.

A comprehensive solution to manage Part D members who are elected in Medicare Prescription Payment Plan

Engagement Highlights

30%

Increase in
Operational efficiency

2X+

Increase in Member
experience and Retention

Streamlined
Billing

Ability to automatically create Direct invoices; view past invoices and apply automated adjustments based on enrollment and PBM data

Interoperable
Systems

System can be accessed through APIs or other interfaces allowing greater interoperability with other systems and third party applications

Seamless User
Experience

Automated workflows with an ability to make manual adjustments. Role based access to various users with Single Sign-On user interface.

Regulatory
Compliance

The MPPP360 rule engine is fully compliant with the CMS guidelines. Maintains and manages the member data and generates invoice based on Opt-in timing

Digital
Payments

The process of combining manual and electronic payment invoices allows for automatic receipt and posting of payments. Payments are managed through multiple sources.

Customer
Service

Back office support and call center services provided for member support including election and termination process.

Stay CMS Compliant with MPPP360 solution

Solution Benefits

Robust
Integration

All enrollments are identified with date spans in member management system reflecting enrollment accuracy.

Retro
processing

Powerful retro-processing engine identifies retro activity in member data including election status.

System
Automation

Automated member invoicing, payment reconciliation, delinquency processing and letter generation.

Payment
Processing

Effective management of multiple payment sources and automatic payment posting through billing solution.

Member
Support

Back office support and call center services provided for member support including election and termination process.

Regulatory
Compliance

Complies with all regulatory changes as guided by CMS to ensure that health plan meets all relevant regulatory requirements.

Member360

Fully Integrated, CMS Compliant Member Management System

Read More

AG360

End-to-end Appeals and Grievances management system

Read More