Premium Billing

Accurate Member and Group Billing Made Simple

Managing your Medicare Advantage and Part D billing has never been easier. The Premium Billing module integrates up-to-the minute member subsidies and Late Enrollment Penalties (LEP) with complete tracking of prospective and retroactive enrollment actions to provide simple, compliant billing and premium management.

The Premium Billing module allows Plans to restrict user access, allowing them to access only the information they need to perform their work. This complies with HIPAA and SOX security and privacy requirements.

Dynamic’s Solution Can Help You With

Operational Efficiency

  • Full Support for Billing Individuals, Employers, and Third-Party Payers
  • Integrates up-to-the minute Member Subsidies and Late Enrollment Penalties (LEP)
  • Ability to handle Multiple Billing Schedules Monthly, Quarterly, Semi-Annual, and Annual
  • Compliance

  • The inclusion of a Delinquency Process based on CMS Guidance
  • Generate CMS Model Notice for non-payment of Premium
  • Invoice Members Accurate Premium Amounts, LEPs, and LICS on CMS Approved Invoice Templates
  • Premium Billing Features

    • Calculate member premiums and refunds
    • Retroactive adjustments for enrollment/disenrollment activity
    • Reconcile SSA Premium Withhold
    • Invoices, statements and coupons, with re-prints
    • Manage SPAP and other third-party payors with split bills
    • Employer groups
    • Low income subsidies
    • Late Enrollment Penalties
    • Auto-draft/direct debit with pre-notes
    • Grace periods and late payment arrangements
    • Age outstanding balances and manage delinquencies
    • Trial bills
    • Customized GL exports
    • Lockbox remittances with automatic or manual allocation