Many health plans are currently considering how to manage creation and distribution of marketing materials due to members September 30. The reality is, health plans have two options:
- Develop materials in-house, and outsource printing and fulfillment to a vendor; or
- Outsource the entire materials production process – materials creation, and print and fulfillment – to a vendor
The prospect of not having to create materials in-house may appeal to many marketing directors. However, with health plans operating on tight budgets, many may think that outsourcing the entire process would be too costly.
But, if outsourcing your member materials production could pay for itself, wouldn’t it be worth considering?
Are you Outsourcing your ANOC and EOC Creation to the Best People for the Job?
Preparing materials for the Annual Enrollment Period (AEP) – namely Annual Notice of Changes (ANOC), Evidence of Coverage (EOC), and Summary of Benefits (SB) documents – can be a time-consuming, labor-intensive process wrought with compliance risk. As a result, many health plans opt to outsource the creation of these documents to a third-party vendor.
There are several benefits to outsourcing the creation of ANOC, EOC and SB documents. But not all vendors are created equally. Below are three things to look for when hiring a third-party vendor to create your ANOC and EOC documents. Read more »
How to Avoid FDR Oversight Issues in a CMS CPE Audit
First Tier, Downstream or Related Entity (FDR) Oversight continues to be a hot topic for the Centers for Medicare and Medicaid Services (CMS) and plan sponsors. CMS auditors annually find deficiencies in FDR oversight and monitoring activities in program audits, with poor oversight of FDRs trending as a common condition in yearly audits.
Many plan sponsors consider an FDR as a risk only if a problem materializes. This is a mistake. All FDRs are operational and compliance risks. The extent of the risk exists in the type of functions the FDR performs, potential and actual member impact, and FDR issues.
6 Traits of a Great Consulting Partner
In the world of Medicare and Medicaid, choosing a consulting partner to help streamline your health plan’s operations can be tricky. While a company or individual may be well-versed in best practices for project management or operational efficiency, they may not understand the unique requirements of the payer market – making them less than effective at addressing your needs.
With that in mind, below are six traits to look for when choosing a consulting partner to work with your health plan: Read more »
How CodySoft’s® Collateral Management Module® Compares to Other Project Management Tools
Our experts have seen it all when it comes to how health plan project managers handle the creation of required member marketing materials. Usually, it involves manually tracking projects using spreadsheets and email, using a generic, out-of-the-box project management software, or a combination of both.
Manual tracking can be extremely time-intensive and highly prone to errors. And even very robust software solutions can be overly complex while still missing the mark on what health plans really need to manage their projects.
What Health Plans can Expect in 2018
With a new year right around the corner, we asked our team of experts: What can health plans expect in 2018?
Listed below are a few issues health plans should be aware of and keep an eye on as we move into the new year. These cover the areas of compliance, technology, and member marketing materials creation and production.
3 Ways your Health Plan is Overspending – And How to Stop
Health plans today are feeling more pressure than ever before to do more with less. With increased scrutiny from The Centers for Medicare and Medicaid Services (CMS) and decreased budgets, leadership is constantly looking for ways to save money. Doing so might be easier than you think.
Below are three ways that health plans are overspending, and how they can stop: Read more »
Start Now for an Easier ANOCs and EOCs Creation Season Next Year
Every year, the people who produce marketing materials for their Medicare members are extremely busy from April through September. Deadlines are tight and timelines are aggressive for creating, printing and mailing the Annual Notice of Changes (ANOCs), Evidence of Coverage (EOCs) and Summary of Benefits (SBs) documents. Very few people in these roles take vacation over the summer because they are rushing to get materials in their members’ hands by September 30.
Even though this is typical for most health plans, it doesn’t have to be case. By spreading production of these materials over the calendar year, health plans can avoid the bottlenecks and summertime peaks that increase the risk of compliance errors and missed deadlines, not to mention run teams ragged. Read more »
Errors in ANOCs and EOCs could cost up to $55 per affected enrollee
Over the last several years, The Centers for Medicare and Medicaid Services (CMS) has taken an increasingly tough stance on health plans that distribute Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) documents with unclear and/or inaccurate benefit information.
CMS is no longer sending health plans warnings for these errors; they are imposing civil money penalties (CMPs) for thousands of dollars that health plans must pay. For instance, CMS recently imposed a CMP in the amount of $132,000 to a health plan for failing to provide accurate benefit information to 2,400 enrollees in its Contract Year (CY) 2017 ANOC and EOC documents. For larger health plans, fines can quickly add up to millions of dollars.
CMS’s reasoning behind these fines is that if members receive inaccurate information related to premiums, deductibles and co-pays, they may enroll in a plan under false expectations. Read more »
Are Your Materials Section 508 Compliant?
Any time health plans prepare an electronic document that will be posted online or distributed via e-mail, the material needs to meet current Section 508 standards of the Rehabilitation Act. This is true of both internal and external documents. Failing to meet these requirements can result in fines and sanctions from the Centers for Medicare & Medicaid Services (CMS).
While most health plan compliance and marketing professionals understand the basics of Section 508, many are not up to date with the specific requirements of the recent 508 Standards Refresh.