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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What Do CMS’s Final Rule Updates Mean for Medicare Advantage Programs?

Every year, the Centers for Medicare and Medicaid Services (CMS) updates its Final Rule document that codifies the regulations for Medicare and Medicaid programs. After analyzing the complete 272-page Final Rule document—here are important regulatory CY22 changes worth noting: Medicare Communications and Marketing Guidelines (MCMG) document: While CMS believes it would be duplicative to produce…

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