Best Practices for Reporting on Plan Oversight of Agents

For Medicare Advantage Organizations (MAOs), Part D Plans and Cost Plans, reporting on “Plan Oversight of Agents” can be a labor-intensive and time-consuming process that presents a number of challenges along the way.

As a result, a number of organizations are re-evaluating their current data collection and tracking processes, and seeking solutions to streamline investigations and reporting. An effective tool will help health plans:

1. Collect required data during compliance investigations

Using a best-in-class methodology and related toolset will help identify all pieces of important data at critical points in an investigation process. By having a workflow that is mapped to the proper data capture tool, health plans can ensure that the right people are capturing the right data at the right time.

2. Centralize, pull and validate data frequently

Because these tools provide a central source to capture and store data, health plans can automatically pull and review the reporting data as needed. Thus, allowing for the correction of errors on an as-you-go basis.

In addition, having all data captured in one place provides everyone in the organization with visibility for a real-time view of all aspects of investigations throughout the process.

3. Generate reports on time and in compliance

The best solutions, which are tailored for investigations within an MAO, will capture the appropriate agent identifier data, match it to the beneficiary data, and produce the Part C and Part D reporting elements exactly as CMS requires for submission.

This eliminates much of the manual data manipulation and greatly reduces the time involved in pulling, reviewing and validating data for submission.

One such tool is the CodySoft® Incident Management Module®, the first-of-its-kind full-cycle tool that allows health plans to manage investigation issues, from reporting to resolution. Contact us today to learn more.