insurance

The Winter Olympics are here! If you’re like me, you’re looking forward to the excitement and thrills of international competition! I am a snowboarder so I have a personal love for winter sports and will be glued to my TV and social media feeds watching the events and keeping medal counts. There is such an inspirational culture built at the Olympics with athletes, as both teammates and competitors, pushing each other to be their best.
So why am I bringing up the Olympics? Two words: DETERMINATION & TRAINING. These exceptional athletes don’t just roll out of bed and suddenly they’re the best. They work hard – harder and smarter than anyone else. They train, plan, fail, learn, push, excel and do what it takes to be better than the competition in hopes that the long hours of preparing and executing a training plan will pay off. When the pressure mounts, these athletes will feel reassured that they’ve done enough to take their place on the podium.

Healthcare payers should have this same determined mentality when dealing with their Provider Networks. We all know that CMS is cracking down on the accuracy of Provider Networks and compliance and/or enforcement action is right around the corner. It’s time to evaluate your current processes, learn what’s worked and what hasn’t, develop an action plan and then train your team on how to support that strategy to ensure your Provider Data is up-to-date and accurate. Once you achieve that goal, it will take the same consistent effort and commitment to manage that data so it remains in compliance. Athletes have weights, cardio workouts, diet, a team of trainers and sponsor partnerships to keep them strong and competitive. Healthcare Payers have technology, experience, skilled employees and resourceful executives to keep them strong and competitive. Using solutions to monitor provider data and automatically execute provider outreach to verify data is how payers can train for their gold medal. You can’t sit idly or settle for what you’ve always done and expect to swiftly pass an audit when CMS calls. Times are changing and so should your business strategy. Make a choice to be the exceptional athlete in your industry and work hard, train, be a leader and surround yourself with a talented, knowledgeable team to help ensure success.

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Building a Strong Network: It Takes an Empowered Team

Life is full of different experiences. Take a moment to think about the last really good experience you had. What was it about the experience that made it so positive? Now think about the last horrible experience you had. What was it that made the experience so poor? I’m betting that the factors behind why your experience was positive or […]

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The Secret to Improving Member Experience? Hint: It’s Probably Not What You Think.

Life is full of different experiences. Take a moment to think about the last really good experience you had. What was it about the experience that made it so positive? Now think about the last horrible experience you had. What was it that made the experience so poor? I’m betting the factors behind why the experience was positive or negative […]

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Digital Transformation in Manufacturing: Getting You Ready For Race Day

A couple years ago when I started thinking about running my first half marathon I knew it was going to be a real project and a real commitment. See, running doesn’t come easily or naturally to me and I don’t hesitate to say I’m usually bringing up the rear in most of my races. Although I’ve been an athlete my […]

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Bad Data Is No Different Than No Data.

Imagine if each time you entered an address into your GPS you only had a 50% shot that you would arrive at your correct location. You would be pretty upset if you weren’t in the 50% that made it to their destination. That is precisely what CMS has uncovered during round two of the online provider directory review. The average […]

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February 9, 2018

Be an Olympic Athlete in the Work Place

The Winter Olympics are here! If you’re like me, you’re looking forward to the excitement and thrills of international competition! I am a snowboarder so I have a personal love for winter sports and will be glued to my TV and social media feeds watching the events and keeping medal counts. There is such an inspirational culture built at the […]
April 20, 2014

Best of Breed is the Best Approach for Insurance Document Management

How many of you have purchased a new policy administration or claims management system from a vendor that said, “Oh, you don’t need an ECM system, we have built-in document management…” Now I’m not going to say that they’re lying, but there’s a HUGE difference between just manually attaching an electronic image to a policy detail screen or an activity record […]