Independent Validation Audits

What’s Possible After a Program Audit? by Sue Dahlkamp, Interim Compliance Officer & Senior Consultant CMS requires that sponsoring organizations undergo an Independent Validation Audit (IVA) if they receive a number of ICARs or CARs on their Program Audit to demonstrate correction of all reported audit conditions. CMS then determines when the audit can be…

Read More

Six Reasons Why Consolidating Software Applications Makes Sense

In today’s rapidly changing environment, health plans operating in silos or with dated legacy systems are struggling to keep up. As competition increases and technology evolves, companies are searching for answers—should they purchase software applications individually or buy a suite or bundle? IT purchasing managers face difficult challenges as business needs grow, software solutions change,…

Read More

The Bridge – Volume 9

[vc_row][vc_column][vc_column_text] October/November CMS Software Release: Impacts to Plans   The October CMS Software HPMS memo dated 9/1/2020 has some interesting changes, and the implementation time frames are compressed. Health plans must implement the additional data elements for Preferred Language and Accessible Format by 10/15/2020. Any new 2021 enrollment (TC61) will need to include these data…

Read More

Can Artificial Intelligence (AI) Change the Future of Healthcare Operations?

Artificial Intelligence (AI) will become a larger factor in all facets of life soon… …in everything from self-driving cars to industrial manufacturing to the way we entertain ourselves. These changes will impact every part of healthcare also, from diagnosis through treatment and even into administrative and operational functions. CMS has started two initiatives directly related…

Read More