RESOLVE

Robust, compliance-driven grievances & appeals solution – focusing on intake-to-resolution.
Miramar:Resolve ensures accuracy and timeliness, with a one-screen view of all activities on a grievance which allows an auditor to capture the “story” of a grievance.

Grievances and appeals are a natural part of handling Medicare beneficiaries. Being able to manage the grievance processes is only one facet of Miramar:Resolve.

The ability to capture detailed information of a member’s interaction is critical for the health plan so that a clearer picture of the grievance is identified.

Miramar:Resolve enables your health plan to easily provide a root cause analysis for each grievance type.

Each grievance and appeal intake can be easily researched due to the tight integration to other Miramar technologies – reducing the confusion surrounding cause and effect for the grievance.

Miramar:Resolve

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Grievance Management

5

Complaint Research

5

Complaint Tracking

5

Complaint Resolution

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Appeals Intake

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Root Cause Analysis

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Missed Opportunity Analysis

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SmartWizards

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