The two-day livestreaming event will take place December 5-6 and will offer a deep-dive into membership and revenue reconciliation. Sessions will explore the evolving regulatory landscape, the growing Medicare Advantage market share, and the future of member accounting and reconciliation.
Here’s a look at the 10 sessions we’ve planned:
Navigating the regulatory landscape: Updates on CMS actions that are likely to affect Medicare Advantage plans
Join Howard Weiss, VP, public policy and government engagement, Emblem Health, for a look at new regulatory initiatives of interest to Medicare Advantage plans, issues that Centers for Medicare & Medicaid Services (CMS) will likely consider in the future, and how these actions could affect your work.
Mastering Medicare secondary payer: Strategies and insights: Consultant, subrogation, and other payer liability
Brian Bargender, MSLS, CSRP, Humana, will provide an overview of CMS expectations for Medicare secondary payer enforcement by plans. He’ll help attendees understand the data that CMS sends to plans for enforcement and gain insight into issues when primary payers are non-group health plans. Bargendar will also discuss special considerations for enforcement by Medicare Advantage prescription drug plans (MA-PD) and Part D plans.
Deep dive look at ESRD revenue challenges and solutions
During this session, Denise Weston, director product performance-government programs, Sentara Health, will explain how to maximize End-Stage Renal Disease (ESRD) revenue, identify members who have ESRD, and offer tips on how to reconcile with CMS.
Post-COVID Medicaid recertification challenges & strategies—How does this impact MA plans?
Rafael Gonzalez, Esq., partner, Cattie & Gonzalez, PLLC and Casey Ryan, vice president-eligibility and financial determination, InnovAge, will discuss a PACE plan’s end of public health emergency preparation and challenges with Medicaid renewals. They’ll provide a Medicaid renewal case study and offer strategies to help Medicare Advantage plans with alleviating gaps in Medicaid eligibility.
Case study: Best practices for member billing and payments process
This session will highlight best practices to ensure transparent presentation of charges, services, and adjustments, empowering members to comprehend their financial responsibilities within the plan. The speaker, to be announced, will explore efficient payment options that cater to member preferences, such as online portals, automatic deductions, and mobile payment platforms.
Enhancing member engagement: Strategies for optimizing communication and experience in Medicare Advantage accounting and reconciliation
During this session, Dr. Shannon I. Decker, principal, VBC One, will discuss the importance of member experience in Medicare Advantage plans. She’ll share strategies for clear communication to help resolve member billing inquiries and offer tips on how to ensure a positive member experience throughout the reconciliation process.
Lessons learned in operational efficiency
This presentation will offer insights into process improvements and resource allocation. Cheryl Alford, associate director, risk adjustment, VNS Health Plans, will highlight the significance of data integrity in achieving operational efficiency and the importance of fostering a culture of continuous improvement within Medicare Advantage organizations.
Reconciling dual status on risk payments
This presentation will explore the complexities of reconciling risk payments for Medicare Advantage members with dual eligibility (Medicare and Medicaid). The speaker, to be announced, will present innovative solutions and technologies that facilitate seamless data sharing and integration between Medicare and Medicaid systems. Attendees will learn strategies for proactive auditing, documentation, and reporting that minimize compliance risks, ensuring accurate payment reconciliation and avoiding potential penalties or disputes.
Case Study: Navigating the maze of COB: How to eliminate provider and payer pain points
Sherri Richardson, COB strategy & program director, Carelon, will explore why coordination of benefits (COB) processing is so painful. She’ll go over why it’s important that payers use COB tools and work efficiently with COB data. Attendees will learn how Carelon has successfully minimized pain points and how payers can work together to eliminate pain points.
Revolutionizing Medicare Advantage accounting: Leveraging technology and automation for streamlined member reconciliation
During this session, attendees will learn how cutting-edge technology can analyze vast amounts of member data, identifying discrepancies and anomalies for efficient reconciliation. The speaker, to be announced, will offer strategies to integrate automated processes that accelerate member accounting, reduce errors, and enhance overall efficiency. Attendees will learn about implementing robust cybersecurity measures to safeguard sensitive Medicare Advantage member information as automation becomes integral to reconciliation processes.
The Medicare Advantage Member Accounting and Reconciliation Summit will take place virtually 10 a.m. to 4:35 p.m. EST, Tuesday, December 5, and 10 a.m. to 3:40 p.m. EST, Wednesday, December 6. Click here for more information, including how to register for the event.