Learning Objectives:

• Hear best practices for timely and accurate reconciliation for membership pipeline from application to CMS approval to MMR. 
• Understand how to manage the enrollment process to ensure your handling of special need members such as D-SNPs are optimized. 
• Gain an overview of the membership pipeline from application to CMS approval to ensure you are getting the right payments for the right claims.

Learning Objectives:

• Review the statutory provisions permitting Medicare Advantage plans the right to seek reimbursement from NGHP.
• Understand the regulations and policy provisions allowing Medicare Advantage plans the right to seek reimbursement from NGHP. 
• Explore the Federal district court and appeals decisions affecting Medicare Advantage plans right of reimbursement from NGHP.

Learning Objectives:

• Review case samples in which the US Department of the Treasury has offset beneficiaries’ benefits or responsible plans’ monies due. 
• Analyze case samples in which the US Department of Justice has collected monies due from attorneys representing injured parties. 
• Understand proposed rules on mandatory reporting civil money penalties to be imposed for responsible reporting entity’s noncompliance. 

Learning Objectives:

• Hear how the changes by CMS to hospice reporting can impact payments to your plan.
• Understand how best to deal with hospice claims and ensure you aren’t paying claims for hospice members within this uncertain landscape.
• Overcome operational challenges of dealing with hospice claims to ensure changes don’t impact your bottom line.

Learning Objectives:

• Discuss the latest CMS regulatory changes. 
• Understand more deeply the model for calculating risk score. 
• Get to grips with Risk Adjustment Data Validation (RADV) audits terminology and definitions.
• Learn the Do’s and don’ts – How to effectively manage emerging risk areas.

Learning Objectives:

• Dive deeper into CMS data around reconciliation and best practice
  
• Refresh on reconciliation points around co-ordination of benefits (COB) recovery
• Analyse membership opportunities around data trends

Learning Objectives:

• Hear how to streamline processes, whether you are reconciling daily, weekly, or monthly. 
• Get best practice on technologies and processes that can support your reconciliation no matter what size your plan is. 
• Learn how to administer inventory management optimally when you don’t have technology or automation systems in place.