Mira Mace offers Medicare‑covered healthcare advocacy services that connect patients with a dedicated care advocate via phone or text. The advocates handle insurance navigation, pre‑authorization appeals, care coordination, and billing reviews to reduce surprise costs and streamline chronic‑illness management. Revenue is generated through Medicare‑reimbursed fees for the non‑clinical administrative support they provide.
Funding
Funding not disclosed
Founders
Product
Problem
Medicare beneficiaries often face fragmented insurance processes, including opaque coverage rules, delayed pre‑authorizations, and unexpected medical bills. Navigating provider networks and coordinating chronic‑illness care adds administrative burden that can compromise timely treatment and increase out‑of‑pocket costs.
Solution
Mira Mace delivers a Medicare‑covered healthcare advocacy service that centralizes insurance navigation, care coordination, and billing dispute resolution. Members connect to a dedicated advocate through secure SMS or voice calls, receiving real‑time guidance on eligibility, pre‑authorization status, and in‑network provider selection. The platform aggregates medical records and automates submission of authorization requests, reducing delays and minimizing manual paperwork. For chronic‑illness patients, advocates proactively monitor care plans, schedule follow‑ups, and ensure all required documentation is in place. When unexpected charges arise, the advocacy team audits the claim, identifies billing errors, and negotiates adjustments on the member’s behalf. All interactions are protected by HIPAA‑compliant encryption and logged in a patient portal that provides transparent status updates.
Target Audience
The primary customers are Medicare‑eligible individuals—particularly seniors and caregivers managing chronic conditions—who need streamlined insurance support and coordinated care assistance.
Features
- Dedicated care advocate reachable 24/7 via encrypted text or voice call
- Real‑time insurance eligibility engine that cross‑references Medicare Advantage and Part D formularies
- Automated pre‑authorization workflow that populates required fields and tracks submission status
- Provider‑matching algorithm that identifies in‑network specialists and in‑home support services based on clinical criteria
- Chronic disease management module that schedules appointments, monitors medication adherence, and flags pending approvals
- Integrated medical‑record aggregation tool that consolidates PDFs, lab results, and imaging into a unified view
- Billing audit service that parses Explanation of Benefits (EOBs), detects overcharges, and initiates appeal processes
- Secure patient portal with dashboard displaying claim status, upcoming appointments, and actionable alerts