Quick Hits for September Sweeps

Daniel Weinrieb

Unfortunately, Risk Adjustment does not have the luxury of taking the summer off. As CMS continues to stress the criticality of submitting complete, timely and accurate data to support plan payments related to Risk Adjustment, health plans must have year-round processes in place to ensure compliance as well as accurate payment from the government.

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CMS to Monitor Access to Care, Defines Provider Network Adequacy Pilot Program

Elena Martin

During the Centers for Medicare & Medicaid Services (CMS) Audit & Enforcement Conference & Webinar held on June 16, …

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Game Changer: Key Reforms Proposed in CMS Medicaid Rule

Mayling Naputi

You’ve got your nose to the grind stone working to meet all the waves of operational changes and …

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Financial Impacts of Unscrubbed Data

Glenn Ellerbe

We have written many articles on the importance of maintaining accurate, reliable data. Data is everywhere and in …

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CMS 2015 Oversight and Enforcement Conference – Compliance Edition

Regan Pennypacker

The pessimist complains about the wind.  The optimist expects it to change.  The realist adjusts the sail. -William …

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AEP Begins in 120 Days. Are your agents ready?

April Fleming

It’s so much more than training. GHG’s fully-automated Sales Sentinel™ can take your agents from zero to ready-to-sell in …

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Takeaways from Accountable Physician Groups’ Annual Summit

John Gorman

Twice a year I get the honor of speaking to the California Association of Physician Groups’ (CAPG) annual …

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