Category Archives: Materials CreationWhat Does CMS’s New Rule Regarding Electronic EOCs Mean for Health Plans?
In its 2019 annual notice, The Centers for Medicare & Medicaid Services (CMS) issued regulatory changes that impact how and when health plans must provide Evidence of Coverage (EOC) documents to members.
What the Rule Allows
The rule brings the following major changes to Medicare Advantage Organizations (MAOs), Medicare Prescription Drug Plans (PDPs), and section 1876 Cost Plans:
- The Annual Notice of Change (ANOC) and the Evidence of Coverage (EOC) documents are now two independent documents with different delivery requirements and flexibilities. Beginning with Contract Year 2019, ANOCs and EOCs no longer need to be combined in the mailing due to members by September 30.
- Health plans may now share EOCs electronically rather than printing and mailing the documents
- Health plans will now have until October 15 to either ensure receipt of the EOC by members, or provide EOCs electronically
Category Archives: Materials CreationCan Outsourcing Your Member Marketing Materials Production Pay for Itself?
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?
Category Archives: Materials CreationAre 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 »
Category Archives: Materials Creation6 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 »
Category Archives: Materials CreationHow 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.
Category Archives: Materials Creation3 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 »
Category Archives: Materials CreationStart 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 »
Category Archives: Materials CreationErrors 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 »
Category Archives: Materials CreationDocument Accuracy Assessment helps identify errors before CMS
The creation of your Annual Notice of Changes (ANOC) and Evidence of Coverage (EOC) document is a very challenging process and can be a strain on already over-taxed resources. Ensuring the accuracy of these documents is extremely important, as CMS has taken an increasingly tough stance on plans that distribute documents with unclear and/or inaccurate benefit information.
If you’re like most health plans, you could use a few extra set of eyes to review your final materials to ensure accuracy.
Backed by our team of model document experts, our Document Accuracy Assessment services can identify inconsistencies and errors in your plan documents that could negatively impact members and cause CMS to take action against your plan. Cody’s Document Accuracy Assessment service allows you time to self-report these errors before CMS’ Oct. 31 deadline for self-reporting. Read more »
Category Archives: Materials CreationCodySoft® Adds Markup Tool to its List of Features
CodySoft® has added a Markup Tool feature to its Collateral Management Module®, making it easier for users to make, review and accept edits to health plan member marketing materials, such as Annual Notice of Changes (ANOC), Evidence of Coverage (EOC) and Summary of Benefits (SB) documents.
“In a typical scenario, health plans may pass one document around to 30 different people for review via email, and then have to make sense of the edits made to 30 different files,” said Brian Yavorsky, vice president of technology at Cody. “Our Markup Tool lets all users make their suggested edits in one document that’s kept in the Collateral Management Module, eliminating all that legwork and decreasing the chance of errors.”