Posts Tagged ‘health plans’
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…
Read More6 Traits of a Great Consulting Partner
In the world of Medicare and Medicaid, choosing a consulting partner to help streamline your health plan’s operations can be tricky. While a company or individual may be well-versed in best practices for project management or operational efficiency, they may not understand the unique requirements of the payer market – making them less than effective…
Read MoreCodySoft® Adds Part C and Part D Reporting Feature
CodySoft® has added a new feature to its Investigations Module®, making it easier for health plans to pull their Part C and Part D reports on plan oversight of agents. Even though the Centers for Medicare & Medicaid Services (CMS) no longer requires this report in the annual Part C and D reports, health plans…
Read MoreThe Secret to Simplifying Health Plans’ Member Marketing Material Translations: A Parallel Project Path
We’ve seen first-hand the frustrations health plan project managers experience in translating their member marketing materials – including Annual Notice of Coverage (ANOC), Evidence of Coverage (EOC), Drug Formulary and Summary of Benefits (SB) – to additional languages. The question for our CodyPrint® team became: What would give project managers visibility to the translation process,…
Read MoreIndustry Alert: Is Your Health Plan the Target of CMS’s New Audit Focus?
Vikki Ahern, CMS Director for Medicare Part C/D Oversight and Enforcement Group (MOEG), spoke at this week’s 2017 HCCA Managed Care Compliance Conference. It served as a wake-up call for compliance professionals in attendance. Although an explanation of CMS’s reasoning was not provided, Vicki Ahern stated that CMS will specifically target small parent plans for…
Read MoreHow Accurate ANOCs and EOCs can Help Health Plans Retain Members
The Henry J. Kaiser Family Foundation recently published an Issue Brief on its website titled “Medicare Advantage Plan Switching: Exception or Norm?” The brief shared that 11 percent of Medicare Advantage plan enrollees in 2013 voluntarily switched to another plan in 2014. It also addressed various factors that impacted switches to other plans, such as…
Read More3 Predictions in the Wake of Recent Health Plan Mergers
In case you missed it, Aetna and Anthem recently signed deals to merge with health insurance giants Humana and CIGNA, respectively. These mergers have created quite a stir in the insurance market, with many experts left questioning what this will mean for the managed care and commercial market in the years to come.
Read MoreMA and Part D Plans: Jumpstart Your CY2016 ANOC and EOC Documents Creation
In late January, CMS released the “CY 2016 PBP/SB Software List of Changes and Known Issues,” which includes a summary of the changes to the Plan Benefit Package (PBP) software that Medicare Advantage and Part D plans will use to upload their 2016 AEP materials bid submissions to CMS later this year.
Read More