After a CMS audit identified CAPs for a health carrier with 4 million members, we developed a Regulatory Matrix and helped mitigate and get CMS approval for all CAPs. Approximately 75 findings were identified with proposed solutions. The plan's CMS Star Rating increased by 1 point in most categories and an overall star rating of 4.5
Open enrollment activities are a true performance test of your company’s systems and processes. Garnet River Healthcare can get you 2024 CMS program audit ready.
CMS released the updated PCUG 17.4v for Medicare Advantage and Prescription Drug Plans. Changes are minimal, but the release is always a good time for you to revisit what you're doing.
On August 30, CMS sent a letter to all 50 states, requiring a review of their eligibility systems. The impetus for this letter: CMS determined some states’ Medicaid and CHIP eligibility systems are incorrectly configured.
On August 15, CMS released the updated guidance for Part C and Part D enrollment and eligibility. Included with the policy and technical changes was a new MA model enrollment request form.
To prepare for Annual Election Period, Medicare Advantage Plans and BPOs need to do more than cover cost and treatment. They need to elevate member experience.
From 2022 to 2023, ratings for MAPs have dropped, with less than half of plans receiving a good rating. Here's you you can increase your CMS star ratings.
Open enrollment activities are a true performance test of your company’s systems and processes. Garnet River Healthcare can get you 2023 CMS program audit ready.
This baby elephant not wanting to leave the side of its mom reminds us of a lesson about caring. A good intention with a bad approach can lead to a poor result.
Open enrollments come and go quickly. To ensure customer expectations and compliance requirements are met, here are five questions health carriers should ask.
60 Railroad Place, Suite 501
Saratoga Springs, NY 12866
(518) 275-4800
© 2000 - 2024 | Garnet River, LLC | All Rights Reserved
60 Railroad Place
Suite 501
Saratoga Springs, NY 12866
(518) 275-4800
© 2000 - 2024 | Garnet River, LLC | All Rights Reserved