As we saw in this year’s Centers for Medicare & Medicaid Services (CMS) regulations, Medicare…
How to Avoid Network Development & Expansion Pitfalls
Network management, directory accuracy, service area expansions (SAEs), and the new triennial review process have…
Blending Network Strategy and Product Strategy
As more and more health systems and provider organizations successfully manage the shift from patient…
CMS June Network Submission Deadline Fast Approaching
In early February, there was a bit of a scramble when several plans received notices…
CMS Reports Medicare Advantage Provider Directories Continue to be Plagued with Inaccuracies
The Centers for Medicare & Medicaid Services (CMS) issued its Round Two online provider directory…
CMS Announces Changes to the Network Review Process for Medicare Advantage Organizations
As anticipated, the Office of Management and Budget (OMB) approved the Centers for Medicare &…
Provider Network Management New Year’s Resolutions for 2018
Many of you and your teams are in the frantic, end-of-year trenches renegotiating current provider…
Three-Year Network Adequacy Review for Medicare Advantage Plans
If the Centers for Medicare & Medicaid Services (CMS) knocked on your door today, would…
New Challenges in Network Development
The summer sun is shining and vacation season is in full swing! While our Health…
Network Exceptions: Why Coordination Between Provider Network Operations & Compliance is Key
As we approach the holiday weekend, health plan Network and Product teams alike are breathing…