Worried About Getting Audited?

Turn to Technology to Reduce Your Compliance Risks and Increase Employee Satisfaction As a healthcare payer, you work hard to process claims, manage appeals and grievances, and satisfy your members. But, despite your best compliance efforts, the risk of an…

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New CMS Guidance

As part of an initiative to streamline the Medicare Advantage and Prescription Drug appeals and grievance processes, CMS has consolidated Chapter 13 of the Medicare Managed Care Manual and Chapter 18 of the Prescription Drug Benefit Manual into one comprehensive…

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How Painful is Your Contracting Process?

Does your contracting process take forever? Can it take weeks, even months to bring a contract from creation, through negotiation and finally to execution? What causes the bottlenecks and how can they be fixed? First, let’s identify some common hurdles…

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Member Communication: Less Is Not More.

There is no way to sugar coat it – Medicare Advantage plans are not meeting their customer satisfaction goals. Surveys prove it, with satisfaction having dropped from 2017 to 2018. One of the main drivers for the discouraging results is…

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