PECOS (the Provider Enrollment, Chain, and Ownership System) is an online platform healthcare providers and suppliers use to submit and manage their Medicare enrollment information. This allows them to register to provide services for patients with Medicare. The only other option for these groups of...
According to the CMS press release,Medicare Advantage premiums continue to decline while plan choices and benefits increase in 2019; Medicare Advantage average monthly premiums will decrease 6% from 2018, falling to $28. Enrollment is projected to experience 11.5% growth over 2018. In addition, over...
Payers can also strengthen provider relationships by developing digital provider-enablement tools that offer near-real-time member data. These capabilities will become increasingly critical as clinical Star measures become more time-bound (for example, requiring member-level follow-ups within 30 days afte...
Associated with each step of the pre-enrollment and enrollment process. Letter Image Retention USPS, CASS, and NCOA Processing Automated Letter Triggering, Data Population, and Customization Mail Stream Tracking Pre-sort Processing / Discounts Return Mail Barcoding Fulfillment Quality Control Inv...
Tracking the Response to the Balanced Budget Act if 1997: Impact on Medicare Managed Care Enrollment in Rural Counties. Primary Authors: Timothy D. McBride, Keith Mueller. August 25, 1998. (P98-4)McBride TD, Mueller KJ. Tracking the response to the Balanced Budget Act of 1997: impact on ...
Step therapy or fail first methods are built into many Part D formularies. Patients oftenmust trya plan’s preferred medicine and fail before receiving authorization to take the original medication a provider prescribed. Not only can this lower patient adherence to medication, but it ...
Lastly, we determined if a patient was enrolled in Medicare Advantage vs Fee-for-Service using the Medicare Enrollment Database. We treated dialysis modality and Medicare Advantage status as time varying in our analysis. Additional references for data sources can be found in the eAppendix in the...
Outcomes Surveys (HOS), as well as pharmacy measures.4Clinical activities will thus most likely replace member experience as the main arena for plans vying for a 4+ rating. This suggests that leaders should focus on building better provider partnerships and improving member engagement in their own...
Outcomes Surveys (HOS), as well as pharmacy measures.4Clinical activities will thus most likely replace member experience as the main arena for plans vying for a 4+ rating. This suggests that leaders should focus on building better provider partnerships and improving member engagement in their own...