MPPP360

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Medicare Prescription Payment Plan - MPPP

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

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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
and Payments

Manages eligibility, enrollment, member maintenance, prescription billing, delinquency processing, and financial reporting.

Automated
Processes

Fully automated current and retro invoice calculations capabilities based on Member opt-in and prescription data adjustments.  

Seamless Integrations
and Operations

Real-time/batch integrations with Health plans, PBMs, Payment gateways, and Fulfillment partners. End-to-end ownership of customer service and back-office operations.

Customizable
Portal

Optional device-agnostic Member portal with self-service capabilities and Health Plan specific branding.

AI/ Natural Language
Processing

Automate call scheduling and opt-in/opt-out processing, offer 24/7 customer support and forecast medication cost & utilization.

Customer
Service

Improves star ratings by enhancing Customer Service and Member experience.

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

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AG360

End-to-end Appeals and Grievances management system

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