Spring Cleaning: Have you thoroughly examined your MSP records yet?

April 16, 2014
|In Performance Optimization
|By GHG Advisors

Spring cleaning normally consists of taking a look around our homes and conducting a deep clean. It’s a time when we can no longer ignore those often neglected, out of sight jobs that we know we must do in order to maintain a clutter-free, and healthy home.

In the government health care space, there is also room for a fresh start. Spring is the time CMS sends each Part D plan a full replacement COB file that includes records that would normally be included in the daily COB notification files and the full replacement COB data for all enrollees with other coverage. CMS released a recent HPMS memo on March 25th, which stated the COB file would be sent to plan sponsors during the week of April 7Th.

What does this mean for Plans?  It creates an opportunity to thoroughly go through your MSP records, clean them up, and get them up to date.  It means NOW is the BEST time to take a long look at your MSP data and perform an MSP spring cleaning! Yes, it’s a big job, but well worth the effort as GHG MSP Analysts just recovered over $20M dollars for one of our clients (their expected A/R, plus millions more).

GHG has experienced MSP analysts and consultants that can do the work for you. Think of us as the “Merry Maids of MSP.”

Find our Spring cleaning checklist below. (You can choose to perform one or all of the following.)

  1. Perform validation and clean-up of prior or current MSP and COB data with GHI and within internal systems.
  2. Analytics on current state process effectiveness, creating Business Process Redesign plans, and Project Management of a Robust MSP process.
  3. Training of Finance, Operations and Claim teams on processing and applying MSP and COB data.
  4. Working with GHI and CMS Central Office on rejections or appeals for payment beyond 36 months.
  5. Validation of P&L between validated CMS data and internal claim systems.
  6. Analysis and business process redesign of commercial Section 111 reporting process that may be negatively  impacting MSP.

Think how good it feels when your home is sparkling clean.That’s how good it will feel when you know your MSP data is clean and accurate, but better yet when you recover unexpected A/R!

A small investment can realize a huge recovery. Contact us today.

 

Resources

Join Gorman Health Group May 1 — 2 at the Red Rock Casino and Resort in Las Vegas for the 2014 GHG Forum where GHG experts will dive into the MSP validation process. This two-day event builds on the success of past GHG Forums and is designed to provide best practices for the decision makers of organizations serving Medicare members, Exchange beneficiaries, and the Dual eligible population. Register now >>

The Final Rate Announcement webinar hosted by Gorman Health Group Founder and Executive Chairman John Gorman, financial expert and former health plan CFO, Bill MacBain, and former regulator and industry-renowned policy expert Jean LeMasurier is now on the GHG website. View the webinar now>>