Conquer the Skill of Creating an Accurate Universe
Jun 23, 2020 8:10am ‐ Jun 23, 2020 8:55am
Identification: TUE02
Learning Objectives:
- Comb through your current universes to discover inaccuracies related to CMS requirements for ODAG and CDAG universes and tables
- Create and implement new approaches to universe construction to avoid pitfalls in the future
- Monitor universe accuracy on a monthly basis through universe pull and inspection to find errors
Strategies for Managing FDR Expectations
Jun 23, 2020 9:10am ‐ Jun 23, 2020 9:55am
Identification: TUE03
Learning Objectives:
- Incorporate monthly education practices for all FDRs that highlight the expectations of the FDR, communication best practices, and documentation
- Include FDRs in all mock audits in preparation for the CMS Audit and incorporate feedback into training exercises in areas to improve
- Generate a strong partnership by understanding what your FDRs are dealing with and how you can help them achieve goals for both entities
Preparation for the 2020 Medicare Timeliness Monitoring Project
Jun 23, 2020 10:10am ‐ Jun 23, 2020 10:55am
Identification: TUE04
Learning Objectives:
- Assess how the CMS TMP will affect your operation and what you need to do in advance to be prepared
- Formulate a plan to perform reviews of your current systems, evaluate accuracy within your universes, analyze your timeliness standards related to CMS guidelines, to determine current benchmarks
- Bridge the Gap: Create a plan of action on how you can improve current benchmarks, including evaluating vendor solutions that can guide you through the process
Strategies to Improve Quality and Mitigate Risk
Jun 23, 2020 11:30am ‐ Jun 23, 2020 12:15pm
Identification: TUE05
Learning Objectives:
- Incorporate a grievance approach to patient centered care
- Enhance quality improvement by utilizing grievances
- Overview of grievances and risk mitigation to improve your processes
Reaching for the STARS: Improving Plan Performance Through CTM Analysis
Jun 23, 2020 12:30pm ‐ Jun 23, 2020 1:15pm
Identification: TUE06
Learning Objectives:
- Examine how root cause analysis of 1-800-Medicare CTM cases can have impact on member experience
- Discuss the continuous improvement cycle needed in order to maintain Complaints About the Health plan STAR metrics and beyond
- Establish and discuss best practices for documentation and casework handling to drive stellar performance
