What are the top trends driving provider network innovation and how are provider networks changing? We explore how payers are adapting.
Tag: Medicare Advantage
HHS OIG recommends that CMS require MAOs to submit NPIs for ordering providers. Explore the reasons why this information would be helpful to prevent FWA, and the concerns from payers in regard to the accuracy of CMS encounter data.
It's finally here. Learn all about the new CMS Preclusion List, what it is, who is included, how to monitor it, and how to prepare your organization.
Are you monitoring your First Tier, Downstream, and Related Entities (FDRs)? Read on to find out how to automate exclusion screening for FDRs.