Codyconsulting.com

What Does CMS’s New Rule Regarding Electronic EOCs Mean for …

WEBBenefits for Health Plans. CMS estimates this new rule has the potential to save health plans $54 million a year. These savings will come from eliminating or significantly …

Actived: 9 days ago

URL: https://codyconsulting.com/what-does-cmss-new-rule-regarding-electronic-eocs-mean-for-health-plans/

CMS’s Plan Benefit Package (PBP) Software—Technical Redesign …

WEBGoing live on April 7, 2023—the new web-based Plan Benefit Package (PBP) Software Technical Redesign will live within the Health Plan Management System (HPMS) and …

Category: Health Go Health

New CMS Guidelines for Individuals Not Lawfully Present

WEBWe are making systems changes for lawfully present status to the Batch Eligibility Query (BEQ) process, and Daily Transaction Reply Report (DTRR). Through …

Category: Health Go Health

The Medicare Timeliness Monitoring Project (TMP)—What to …

WEBJune 8, 2022. CMS continues to conduct an industry-wide Timeliness Monitoring Project (TMP). This project is a retrospective review of 2022 data. It allows CMS to collect data …

Category: Health Go Health

Case Study: Leading Health Plan Manages the Entire Lifecycle of …

WEBThe Health Plan. A leading Medicare Advantage & Commercial Group Plan, located in the Southwest with 52 hospitals, more than 800 patient care sites, 7,300 active physicians, …

Category: Health Go Health

Combining Medicare and Medicaid into One Program

WEBThe status quo of government-sponsored health programs is beginning to fail. The government recently reported that Medicare will run out of money in less than …

Category: Health Go Health

Are Your Systems Ready to Properly Process the CMS Annual …

WEBThe CMS Annual COB-OHI process is quickly approaching, and health plans must be prepared to complete mandatory processes to remain compliant. The …

Category: Health Go Health

Provider Directory Accuracy—Why is it Important

WEBAbout CODY: CODY ® works with over 70 government-funded, commercial, and ACA health plans across 50 states and Puerto Rico. We help align internal …

Category: Health Go Health

How to Ensure a Successful Triennial Network Adequacy Review

WEBEvery three years, CMS monitors compliance with Network Adequacy Standard. Plans upload full-contract-level networks into the Network Management …

Category: Health Go Health

Consolidating COB & MSP Data

WEBThe Centers for Medicare and Medicaid Services (CMS) requires MA and PDP health plans to update systems timely and accurately. Consolidating and analyzing …

Category: Health Go Health

2024 Oversight Activities – Utilization Management Changes

WEB2024 Oversight Activities – Utilization Management Changes. November 20, 2023. CMS notified Medicare Advantage Organizations (MAOs) on October 24, 2023, …

Category: Health Go Health

An Inside Look at Plan Benefit Package (PBP) Software

WEBThe PBP module was developed to provide health plans with a single Centralized Source of Truth™ and allow for real-time, enterprise-wide benefit data …

Category: Health Go Health

CMS 2023 Final Notice & Updates for D-SNPs

WEBAugust 8, 2022. In May, CMS published the 2023 Final Rule in the Federal Register. The rule includes many changes related to different areas, including marketing and …

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AEP Enrollment Processing Tips—Do’s & Don’ts from End-to-End …

WEBDO: Audit your enrollment forms and train agents on their correct use: Ensure the correct plan year enrollment form is used to avoid unnecessary denials. …

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CODY® expands health plan technology and consulting …

WEBMerger will combine deep experience of healthcare industry veterans nationwide. TAMPA, Fla. (Jan. 27, 2021) – CODY ®, a Tampa, Fla-based healthcare …

Category: Health Go Health

4 Ways to Help Maintain Version Control

WEB4 Ways to Help Maintain Version Control. January 30, 2019. Health plans struggle to keep track of the different iterations of documents as they build and produce …

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