Medicare Prescription Payment Plan - MPPP
An end-to-end management of Part-D members opting for MPPP
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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.