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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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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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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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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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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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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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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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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With a new year right around the corner, we asked our team of experts: What can health plans expect in 2018? Listed below are a few issues health plans should be aware of and keep an eye on as we move into the new year. These cover the areas of compliance, technology, and member marketing…

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Any time health plans prepare an electronic document that will be posted online or distributed via e-mail, the material needs to meet current Section 508 standards of the Rehabilitation Act. This is true of both internal and external documents. Failing to meet these requirements can result in fines and sanctions from the Centers for Medicare…

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