Posts Tagged ‘Medicare’

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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Are you Outsourcing your ANOC and EOC Creation to the Best People for the Job?

Preparing materials for the Annual Enrollment Period (AEP) – namely Annual Notice of Changes (ANOC), Evidence of Coverage (EOC), and Summary of Benefits (SB) documents – can be a time-consuming, labor-intensive process wrought with compliance risk. As a result, many health plans opt to outsource the creation of these documents to a third-party vendor. There…

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6 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…

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3 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…

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Start Now for an Easier ANOCs and EOCs Creation Season Next Year

Every year, the people who produce marketing materials for their Medicare members are extremely busy from April through September. Deadlines are tight and timelines are aggressive for creating, printing and mailing the Annual Notice of Changes (ANOCs), Evidence of Coverage (EOCs) and Summary of Benefits (SBs) documents. Very few people in these roles take vacation…

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Errors in ANOCs and EOCs could cost up to $55 per affected enrollee

Over the last several years, The Centers for Medicare and Medicaid Services (CMS) has taken an increasingly tough stance on health plans that distribute Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) documents with unclear and/or inaccurate benefit information. CMS is no longer sending health plans warnings for these errors; they are imposing…

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For MA Plans: Increased Payments will mean Increased Compliance

By now, it is safe to assume that health plans across the nation have thoroughly read and examined CMS’ Final Medicare Advantage (MA) Rate Announcement and Call Letter for 2016. I think we all heard a collective sigh of relief with the announcement that reimbursements would increase, rather than decrease, in the coming year.

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