By Jane Anderson The following is an article from AIS Health’s Health Plan Weekly. It was published as part of the AIS Report on Blue Cross and Blue Shield Plans. The AIS…
Blending Network Strategy & Product Strategy
As more and more health systems and provider organizations successfully manage the shift from volume-based patient care to value-based population health management, health plan strategic planning should be blending network strategy with…
Three Ways to Retain Your Members for 2020
It’s the Annual Election Period (AEP) and now is a really difficult time to turn your thoughts away from what’s right in front of you, but a strong retention program can be…
Compliant Coding and Documentation: Minimize Compliance Risk with CMS through HCC audit programs
Was your plan selected for this year’s Medicare Part C Contract-Level Risk Adjustment Data Validation (RADV) audit of 2014 dates of service? Have you participated in a Department of Health & Human…
New Membership Preparation From a Clinical Perspective
How do plans get ready for new membership as the new enrollment period starts? When you are trying to plan for the future at times it is best to look back at…
In the Midst of AEP…Don’t Lose Sight of the Upcoming Application Season Compliance Solutions
In mid-October, CMS will release the online Calendar Year 2021 Notice of Intent to Apply (NOIA). The NOIA must be submitted to CMS by November 12, 2019 if organizations plan to submit…
Four Potential Failures of Your Member’s Experience
It’s the Annual Election Period (AEP) for Medicare Advantage (MA), and like many health plans, those of us in the industry are often busy. I was very fortunate early in my career. …
