A Comprehensive Medicare Advantage Appeals and Grievances and Complaint Tracking System
Wipro's A&G360 application allows Medicare Advantage Organizations (MAOs) to comprehensively manage their end-to-end Appeals & Grievances (A&G) process, and contains a Complaint Tracking System (CTS). With healthcare reform and regulatory amendments driving transformational changes in the sector, Wipro offers MAOs a suite of technology systems to help them remain compliant with CMS (Centers for Medicare and Medicaid Services) mandates and to enhance the quality of care delivered to their members.
The A&G360 product enables plans to process, track and identify all incoming Appeals, Grievances and complaints to ensure they remain compliant with CMS's changing regulatory requirements. The software also allows users to issue and track the required CMS letters within the specified turnaround timeframes.
Wipro's A&G360 system can be purchased as a standalone system, or bundled as the newest component to Wipro's Member360 comprehensive suite of products. The Member360 product line focuses on membership enrollment and management, correspondence automation and generation, Transaction Reply Report (TRR) and CMS file reconciliation, and premium billing.
Wipro's A&G360 product is designed to help MAOs address their goal of improving their CMS Star Rating. Medicare plans that earn a rating of three or higher are eligible to receive federal bonus payments and those earning a five-star rating, in addition to the bonus payments, will be eligible for continuous enrollment and the ability to market their products year-round.
