BluePeak Advisors, Author at BluePeak Advisors

CMS Medicaid Medicare PDE

ICYMI – BluePeak’s Articles posted recently on LinkedIn

CMS Account Managers May Contact Plans to Assess New Medicare Card Project Readiness PDE Self-Audits Cost At Least One Plan Over $1 Million in Claims Reversals CMS to Conduct Provider…

BluePeak AdvisorsMarch 6, 2018

CMS HPMS Medicare Uncategorized

Decreased HSD Tables Application Requirement Now Leads to CMS Network Adequacy Review Later

Decreased HSD Tables Application Requirement Now Leads to CMS Network Adequacy Review Later Part C applications may have decreased requirements for the submission of a key management staff organizational chart…

BluePeak AdvisorsNovember 29, 2017

Street signs one stating 2018 and pointing left, the other stating 2019 and pointing right

CMS HPMS Medicare Uncategorized

Getting Ready for Early Application Tasks and Understanding 2019 Application Changes

Submit Notice of Intent to Apply (NOIA) Now Each year, the Centers for Medicare and Medicaid Services (CMS) accepts applications from new plan sponsors, as well as existing Medicare Advantage-Prescription…

BluePeak AdvisorsNovember 27, 2017

Audits CDAG CTM FAA PBM TPMA

New Year’s Day is Ultimate Test of New Part D Plan Year Readiness

While most people are singing Auld Lang Sine at midnight on January 1, those of us in the Medicare world are anxiously awaiting the first claims of the plan year…

BluePeak AdvisorsNovember 27, 2017

Audits CMS CPE FDRs

BluePeak Offers Tips for Developing 2018 Risk Assessments and Monitoring and Auditing Work Plans

Annual risk assessments and associated monitoring and auditing work plans are not only required, but also help to ensure your compliance program is efficiently and effectively monitoring and auditing business…

BluePeak AdvisorsNovember 27, 2017

validation audit under a magnifying glass

CMS IA IVA Validation

BluePeak Service Spotlight: Validation Audit Capabilities

From the time you receive the final Centers for Medicare and Medicaid Services (CMS) audit report, you and your team have 150 days to correct deficiencies found during the audit,…

BluePeak AdvisorsNovember 27, 2017

CDAG CMS CPE FDRs ODAG TPMA

CMS Increases Scrutiny of FDRs, Finds Common Conditions During 2017 Program Audits

During the 2017 audit season, BluePeak observed increased CMS increased scrutiny on plans and their First Tier, Downstream and Related Entities (FDRs), as well as repeated Common Conditions. With limited changes from…

BluePeak AdvisorsNovember 27, 2017

CMS Medicare News Uncategorized

You’re Going to Want BluePeak’s Online Provider Directory Review Service

From February to August, the Centers for Medicare & Medicaid Services (CMS) conducted the second round of online provider directory reviews of 64 Medicare Advantage Organizations (MAOs). CMS reviewed online…

BluePeak AdvisorsSeptember 15, 2017

Compliance Section 1557 Section 504 Section 508

What You Need to Know About Sections 504, 508 and 1557

You likely saw that CMS recently released a FAQ document on Section 504 and Section 1557. This FAQ document provides clarity on requirements that several organizations have been questioning since…

BluePeak AdvisorsJuly 3, 2017