CMS Model Materials—Significant Changes for CY23

Wow! The CMS model materials were released weeks earlier than previous years, and we’re thankful for that! There are significant changes for CY23: most notably the reduction in length, reorganization, and reduction of tables and language. View the CY23 Models here: https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/MarketngModelsStandardDocumentsandEducationalMaterial CMS Model Materials Notable Changes Annual Notice of Change (ANOC)—Notable Changes (applies to…

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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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How to Produce AEP Documents & Manage Plan Benefits with Compressed Timelines

The second post in our AEP Best Practices series focuses on the critical path of the Annual Enrollment Period—how to produce AEP documents efficiently & manage plan benefits effectively with compressed timelines. It’s important to understand the risks and challenges with compressed timelines for health plans with several Plan Benefit Packages (PBPs). Here’s a graphic…

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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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