Coming Soon – CY23 Model Materials

In May, CMS expects to release the Contract Year (CY) 2023 model materials. These will be posted on the CMS site, CMS Marketing Models, and will include: Annual Notice of Change (ANOC) Evidence of Coverage (EOC) ANOC and EOC standardized model instructions Provider Directory Also expected to be released in May are the CY23 Part…

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CodySoft® Allied Central Dashboard™ (ACD) FAQs

Creating, managing, and tracking recurring orders for mandated member materials fulfillment can be complex and time-consuming. Not to mention, file and data validation, SLA management, and tracking errors, issues, and processing audits—adds even more to manage. To ease the burden, that’s where the CodySoft® Allied Central Dashboard™ (ACD) comes in. By leveraging automation, the ACD…

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How to be a Rising Star—What Ratings Mean and How to Improve Them

It’s no secret that Star Ratings can have a significant impact on a health plan’s membership and bottom line. As competition increases, it’s essential to have strategies in place to elevate or maintain a 4+ star rating. The Centers for Medicare and Medicaid Services (CMS) recently released Highlights of Contract Performance in 2021 Star Ratings.…

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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,…

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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…

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Can Medicare Advantage Cure America’s Healthcare Crisis?

The face of America is changing. Race relations are evolving. Social interaction has been altered, perhaps forever. The economy is transforming. And our healthcare crisis is ripe for disruption. Is this revolution going to be painful or painless, bloody or bloodless? Are you prepared for seismic shifts in the way our country provides healthcare? Forbes…

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Why Virtual Workplaces Work

In an age of uncertainty, some things are certain. Virtual Workplaces can and do work. CODY has been a virtual company since inception. We are innovators, not just in the marketplace, but in how we operate internally. Our culture embraces automation and we are constantly increasing our productivity.  We believe in bottom line ROI results…

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What Health Plans Can Expect from CMS in 2019

In 2018, The Centers for Medicare & Medicaid Services (CMS) announced regulatory changes that impacted how and when health plans must provide Evidence of Coverage (EOC) documents to members. Uncoupling the EOC from the Annual Notice of Change (ANOC) document mailing, allowing for electronic delivery of the EOC and extending the EOC delivery deadline to…

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PERSPECTIVES: Combining Medicare and Medicaid into One Program

The status quo of government-sponsored health programs is beginning to fail. The government recently reported that Medicare will run out of money in less than 20 years unless drastic changes are made. But how can our health care system be altered to correct deficiencies and adjust to changing conditions, avoid a huge financial crisis in…

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Dealing with Change in the Medicare World

The healthcare world and Medicare health coverage are in a state of rapid and uncertain change. What can health plans and those serving health plans, such as pharmacy benefit managers and even consultants, do to be ready for both anticipated and unanticipated changes? Here are some of the issues facing the industry in today’s turbulent…

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