Much of the discussion last week at the Optimizing Appeals & Grievances and Improving ODAG & CDAG Outcomes Conference centered around accountability and company culture. There was also a great deal of attention given towards the ability to pull Universes on demand. These topics along with better ways to manage your day to day workloads are common challenges we hear from health plans all the time. How do we better manage the process, report on it and hold our team accountable – while creating a culture where employees thrive and member service is the highest priority? It’s easier said than done but it starts with a very simple focus – “you can’t manage what you can’t see.”
We know it doesn’t just stop there. In the world of Healthcare Payers and Appeals & Grievances, reporting demands change and evolve all the time. We’ve already started on the 2019 Universe table changes and as your partner we are committed to keeping you one step ahead. Your success is our focus. I’d like to close up my thoughts by thanking Tim and Audrey of RISE, all of the presenters, and the conference sponsors. We were honored to be a part of the event and to continue offering you dialogue, ideas and solutions to your biggest process challenges. On behalf Jon and Matt, we had a wonderful time and look forward to seeing everyone next year.
Appointment of Representative, (aka the AOR) always seems to be a topic of conversation in the healthcare payer space. Every show we attend, every customer we talk with and every industry function we attend, there are intense conversations and differing opinions on what is required by CMS. Do you only submit an AOR once? Do you need to submit a […]
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 guidance document. They are doing this to better align and provider a more defined, straightforward and non-repetitive understanding of […]
5…4…3… 2…1 🚀, it’s time to move forward and discover the power of you! This is the message behind the 5 Second Rule by Mel Robbins. It’s a cool, powerful self-help concept I was introduced to while listening to Mel speak recently at Hyland Software’s CommunityLive event in Nashville, TN. Embracing that concept I say 5…4…3… 2…1 it’s time to […]
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 within the contracting process. Once identified, we can implement a contracting management solution to address those issues and reduce contracting […]