AEP Best Practices – How to Produce Compliant & Effective Member Communications

Planning for AEP (Annual Enrollment Period) As health plans prepare for AEP (Annual Enrollment Period), they face a multitude of challenges—ranging from compliance issues to mitigating risk related to timing, data, and documents. To help navigate these challenges, here are some key strategies and Best Practices for Compliant and Effective Member Communications we recently shared…

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How Can a “Single-Source Solution” Help Manage the Lifecycle of Member Communications?

If you are tasked with the challenge of managing the lifecycle of Member Communications—you likely need an efficient “Single-Source Solution” to help. Managing multiple vendors for document development & creation (ANOCs, EOCs, SBs/SOBs/SBCs, Pre & Post Enrollment materials), translations, Section 508 remediation, directories & formularies, as well as the sourcing of member communications print &…

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An Inside Look at Plan Benefit Package (PBP) Software

Health plans have a variety of uses for plan benefit information: CMS bid review and approval, Medicare Plan Finder, member materials (such as ANOCs, EOCs, and SBs), customer service, sales, appeals and grievances, claims, and more. However, this information is typically housed in multiple locations and managed independently with “no centralized source of truth”, making…

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What Do CMS’s Final Rule Updates Mean for Medicare Advantage Programs?

Every year, the Centers for Medicare and Medicaid Services (CMS) updates its Final Rule document that codifies the regulations for Medicare and Medicaid programs. After analyzing the complete 272-page Final Rule document—here are important regulatory CY22 changes worth noting: Medicare Communications and Marketing Guidelines (MCMG) document: While CMS believes it would be duplicative to produce…

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CMS Skips Another Year on the MCMG

Health plans are wondering “where are my updated Medicare Communications and Marketing Guidelines (MCMG)?” For the second consecutive year, the Centers for Medicare & Medicaid Services (CMS) stated that there will be no updated MCMG for CY2021. Instead, plans are instructed to use the existing MCMG and related memos from CY2020. How will changes be…

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4 Ways to Help Maintain Version Control

Health plans struggle to keep track of the different iterations of documents as they build and produce CMS-required documents such as the Annual Notice of Change (ANOC), Evidence of Coverage (EOC), Summary of Benefits (SB) and other member and provider materials. The good news is, achieving version control is not impossible. In fact, with the…

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4 ways to reduce – or eliminate – errors in your ANOCs and EOCs

The accuracy of Annual Notice of Changes (ANOC) and Evidence of Coverage (EOC) documents is an important requirement for all health plans. The Centers for Medicare and Medicaid Services (CMS) takes errors in these documents very seriously and penalties are given to health plans that distribute documents with errors. CMS recently announced changes to the…

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What Sets CODY Apart from Other Consulting Firms

Health plans have many options when searching for a consulting partner to help streamline operations and/or outsource key business functions – and not all of them are created equally. There are certain traits to look for when hiring a great consulting partner and many will check most or all of these boxes. So, what sets…

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What Does CMS’s New Rule Regarding Electronic EOCs Mean for Health Plans?

In its 2019 annual notice, The Centers for Medicare & Medicaid Services (CMS) issued regulatory changes that impact how and when health plans must provide Evidence of Coverage (EOC) documents to members. What the Rule Allows The rule brings the following major changes to Medicare Advantage Organizations (MAOs), Medicare Prescription Drug Plans (PDPs), and section…

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