Posts Tagged ‘Medicaid’
CMS 2023 Final Notice & Updates for D-SNPs — What Should Plans Do Now?
In May, CMS published the 2023 Final Rule in the Federal Register. The rule includes many changes related to different areas, including marketing and communications, past performance, Star Ratings, network adequacy, medical loss ratio reporting, special requirements during disasters or public emergencies, and pharmacy price concessions; however, there are a number of changes related to…
Read MoreCodySoft® 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…
Read MorePERSPECTIVES: 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…
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 More3 Ways your Health Plan is Overspending – And How to Stop
Health plans today are feeling more pressure than ever before to do more with less. With increased scrutiny from The Centers for Medicare and Medicaid Services (CMS) and decreased budgets, leadership is constantly looking for ways to save money. Doing so might be easier than you think. Below are three ways that health plans are…
Read MoreBest Practices for Reporting on Plan Oversight of Agents
For Medicare Advantage Organizations (MAOs), Part D Plans and Cost Plans, reporting on “Plan Oversight of Agents” can be a labor-intensive and time-consuming process that presents a number of challenges along the way.
Read More3 Challenges to Reporting on Plan Oversight of Agents
Each year, Medicare Advantage Organizations (MAOs), Part D Plans and Cost Plans are required to submit data on their Part C and D plans to The Centers for Medicare and Medicaid Services (CMS) for the previous calendar year.
Read MoreUsing Technology to Streamline Your Policies and Procedures
Policies and procedures are an important part of health plans’ day-to-day operations. However, if these are not documented and managed properly – including being updated each year – health plans may be subject to costly fines and corrective action plans from the state.
Read More3 Ways Mismanaged Policies and Procedures can Cost you Money and Members
Behind every health plan are a number of policies and procedures that serve as a framework for the organization and the care of its members. These policies include all aspects of operation, from payment and authorization to coordination of benefits.
Read MoreCODY® Experts Share Insights on Increased Government Oversight in MHPA Webinar
In September, Cody Consulting hosted the webinar “Increasing Federal Government Oversight…And How Medicaid Plans Can Prepare” as part of the Medicaid Health Plans of America (MHPA) Wednesday Webinar series. The presentation, which can now be viewed on the MPHA website, shared with attendees an overview of the type and level of oversight that the states…
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