TMG Health Enhances Proprietary Technologies

KING OF PRUSSIA, Pa., Aug. 20 /PRNewswire/ — TMG Health, the leading national provider of Business Process Outsourcing (BPO) services for the managed Medicare, Medicaid and retiree health plan markets, announces significant enhancements to their suite of Business Process Outsourcing services. These highly tailored modules and features address the challenging requirements of health plans serving the Medicare Advantage marketplace. Based on their dedication to this market, TMG Health has been able to successfully develop several proprietary systems and services focused on the unique operational and compliance demands associated with Medicare Advantage plan administration.

TMG Health’s most important internally developed application streamlines the processing of enrollment applications by automatically applying over 280 CMS and specific plan eligibility business rules. These front-end process rules flag duplicate members, ensure county-to-r plan (PBP) matches, and verify CMS eligibility in real-time. The overall advantage is more streamlined timely and accurate enrollment resulting in a 98% TRR total acceptance/total codes rate within specific CMS guidelines.

TMG also developed a web based tracking and work flow software application named Resolve designed to automate and better manage CMS TRR reports. Resolve provides details of TRR data, acceptance/rejection/maintenance codes, aging and processor performance. TMG automates a series of TRR codes which are translated into Resolve as completed or “worked” when the TRR is loaded. The result of the automation is accurate and compliant processing of the TRR.

Additionally, TMG recently enhanced its internal document control procedures in the development of LRP. LRP is a complete end-to-end process creating a closed loop system for all letter mailings. This process provides enhanced quality control by tracking all correspondence requests, real-time correspondence processing, document imaging, and insures that proper invoicing of all associated correspondence costs are generated. It reinforces TMG Health’s SAS 70 internal control requirements.

About TMG Health

TMG Health is the leading provider of Business Process Outsourcing (BPO) services to the Medicare, Medicaid and retiree health plan markets. TMG provides operational outsourcing solutions and systems for health plans, providers and insurers. TMG is the most experienced vendor in the market and has the broadest solution set serving over 30 health plans in all 50 states. Benefits of partnering with TMG Health include low, fixed operational costs, reduced capital costs, uniquely designed, state-of-the-art systems, rapid implementations and proven regulatory compliance.

TMG Health is a privately held corporation located in suburban Philadelphia with a National Operations Center in Northeastern Pennsylvania. For more information, please visit http://www.tmghealth.com/.

   Media Contact:   Judy Cohen   (610) 304-5470   jcohen@tmghealth.com  

TMG Health

CONTACT: Judy Cohen of TMG Health, +1-610-304-5470,jcohen@tmghealth.com

Web site: http://www.tmghealth.com/