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LINK – Illinois Posts Medicaid Managed Care Performance Report

Managed Medicaid program oversite is simply impossible without complete and accurate data. What is seen here is a perfect example ...
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LINK – Medicare Advantage Risk-Adjustment Proposal Causes Alarm

I agree that there are still systemic issues with CMS using encounter data for risk adjustment, however... MA plans have ...
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Possible MCO Storm Approaching

While I recently published an article discussing the seriousness of attestation (Article here), we believe it is important enough to ...
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Encounter Certification and Attestation

THE TOP 2 “MUST ASK” QUESTIONS FOR HEALTH PLAN CEOs & CFOs 1.      Are you the CEO or CFO for a ...
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What Problem with the Encounter Data?

A Day in the Life of the Encounter Manager If you manage encounter data for a health plan, you probably ...
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Medicaid Encounter Operations and the New CMS Proposed Rules

CMS has proposed new rules regarding Medicaid Managed Care, the first change in over a decade.  These rules cover a ...
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Are Your Medicaid and Medicare Encounter Data on an Unhealthy Diet?

Just like a star athlete, your encounter data require a healthy diet to achieve their maximum potential. This diet being ...
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