Posts Tagged ‘MedicareAdvantage Consulting’
Leading the Medicare Member Materials Creation Process
Now is the time to start getting ready for the upcoming 2025 Annual Enrollment Period (AEP) by identifying your resource needs and planning for system changes. Don’t wait until July to start these activities. CODY’s communications and marketing consultants support health plans by providing experienced, cross-trained experts to assist in project management, variable language, and…
Read MoreEnhancing Health Plan Compliance Through Comprehensive Risk Assessment and Management: Navigating New Guidelines and Expectations
While risk assessment has always been a core component of compliance programs, recently the Office of Inspector General (OIG), Centers for Medicare and Medicaid Services (CMS) and the compliance community have emphasized the importance of a formal risk assessment in prioritizing resources and developing work plans. The Office of Inspector General (OIG) released guidance at…
Read MoreThe Bridge — Volume 12
Madena™ and CODY® Merge to Expand Technology and Consulting Capabilities CODY® Acquires Madena Madena has been acquired by CODY®, a leading healthcare technology and consulting firm. The combined offerings and decades of industry expertise provide Medicare, Medicaid, and Commercial health plans an ‘end-to-end integrated solution’ previously unavailable in the marketplace. CODY® works with over 60…
Read MoreThe Bridge — Volume 12
Madena™ and CODY® Merge to Expand Technology and Consulting Capabilities CODY® Acquires Madena Madena has been acquired by CODY®, leading healthcare technology and consulting firm. The combined offerings and decades of industry expertise provide Medicare, Medicaid, and Commercial health plans an ‘end-to-end integrated solution’ previously unavailable in the marketplace. CODY® works with over 60 government-funded,…
Read MoreMedicare 2021 Timeliness Monitoring Project
In October CMS issued a memo regarding the 2020 Timeliness Monitoring Project (TMP). As in previous years, CMS will once again be conducting an industry-wide monitoring project in 2021. What’s changed? Beginning with the 2021 TMP, CMS will no longer collect the Part D Coverage Determination Appeals and Grievances universes used to evaluate these measures.…
Read MoreCMS Program Audits – Preparation Is Critical
Comprehensive preparation is critical to producing accurate universes and achieving a successful CMS Program Audit. Madena’s experts have dozens of years of experience and can help Part C and D plans with all aspects of the Audit process. How Madena Can Help With Your CMS Program Audit Development and implementation support of universe design – we…
Read MoreMedicare Part C and D Data Validation Audit
Medicare Part C and D Data Validation Audits (DVA) are required by the regulations (42 CFR 422,516, 422.514, CMS-4085-F) implemented by the Centers for Medicare and Medicare Services (CMS). In order to ensure the independence of the Data Validation Audit, organizations cannot use their own staff to conduct it. Instead, Medicare Advantage Organizations (MAO) and…
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