How Health Plans Can Get a Head Start on the APCD Boom
For more than a decade, experts and pioneering states have built the case for the state level All Payer Claims Database (APCD). Eighteen states have implemented APCD solutions, proving value, and providing lessons learned. And now, the ‘surprise’ catalyst that is expected to light the fire for those states not yet legislated for APCD, the No Surprises Act.
Medicare Advantage Plans Could See Payments Drop in 2021 Due to COVID-19, Analysis Finds
COVID-19 will impact risk score factors for MA plans in 2021 and cause them to get paid less for their enrollees than projected. There could be an industry wide impact on overall profitability unless plans capitalize on powerful Risk Adjustment tools. Solutions, such as Babel Health’s integrated RA tool, will play a significant role in helping plans maximize what does make it to/through their claim processing.
CMS Halts RADV Audits Due to COVID-19 Concerns
The March 30 memo from Centers for Medicare & [...]
Health Plans Must Make Encounter Submissions a Top Priority in 2020
From Health IT Answers (formerly RCM Answers) — 1/27/2020: [...]
CMS Rule Changes: Now’s the Time for Medicare Advantage Plans to Get Serious
From Health IT Answers (formerly RCM Answers) — 10/16/2019: [...]
CMS Wants More Encounter Data for Medicare Advantage Payments
From Modern Healthcare — 01/06/2020: CMS wants to [...]
HHS Risk Adjustment Case Gets a Win From Appeals Court
From Healthcare Dive — 01/03/2020: In win for [...]