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.

Streamlining these processes should be a top priority for Medicaid plans, particularly in the wake of CMS’s proposed Medicaid MCO regulations that are expected to lead to additional scrutiny of health plan operations.

The good news is the right technology solution can help eliminate much of the legwork and guesswork required for documenting and updating policies and procedures. An effective tool will help health plans:

  1. Create policy and procedure materials quickly and efficiently

Collaborative tools streamline the creation, approval, distribution, communication, comprehension and certification of health plan’s policies and procedures documents. In addition, those that allow for multiple reviews at the same time and simultaneously capture all review content streamlines the entire process.

  1. Ensure that all materials are current and compliant  

By tagging all policy documents with a review and expiration date, users are proactively notified of required scheduled updates to ensure that all policies are current and compliant.

  1. Effectively communicate policy information throughout the organization

Using these tools, heath plans can distribute policy documents to the appropriate audience and track and confirm that each individual has read and understood the policy or procedure through their signed acknowledgement, or via testing.

To address this need in the managed care industry, we have developed the CodySoft® Policy and Procedure Module®.

If you’d like to receive more information about the Policy and Procedure Module™ when it’s available, please sign up for our e-mail list.