The following is an article from AIS Health’s RADAR on Medicare Advantage, a publication dedicated…
Blues Plans Strive To Earn Higher Star Ratings in MA, MA-PD Plans
By Jane Anderson The following is an article from AIS Health’s Health Plan Weekly. It…
Rejected Claims Review: Just As Important As Ever In 2019
Are you confident in your current process to review and identify non-compliant rejected claims? Rejected…
Four Potential Failures of Your Member’s Experience
It’s the Annual Election Period (AEP) for Medicare Advantage (MA), and like many health plans,…
Part D Benefit Administration Impacts Audit Experience
In the newly released 2018 Part C and D Program Audit and Enforcement Report, CMS…
2020 Operational Readiness Prep – Ensure Comprehensive Processes in the New Year
I was recently flying to a client site. The Southwest plane was just boarding, and…
Wrapping Your Arms Around the Medical Benefit Drug Spend
Prescription drugs are covered through a health plan’s pharmacy or medical benefit. This determination depends…
Focus on the Entire Iceberg, Less on Individual Members
“What we do and accomplish is only the tip of the iceberg of what’s possible…
2020 Opioid Overutilization Strategy
The Centers for Medicare & Medicaid Services (CMS) has stated its goals to improve access…
Medicare Advantage Implementation – It’s All About Asking the Right Questions
The famous economist Paul Samuelson stated, “Good questions outrank easy answers.” That is true in…