The largest segment of our business is focused on health plans and assisting you with compliance, operations and interim staffing solutions. We are a leading Independent Validation Audit (IVA) vendor and have conducted over 150 mock Centers for Medicare and Medicaid Services (CMS) program audits and onsite support projects for clients undergoing actual CMS program audits. We have worked in various capacities with every sanctioned plan since 2010 and understand how to navigate the relationships with both the national and regional CMS offices.
Health Plans
Compliance
CMS Independent Validation Audit
BluePeak staff has worked on both sides of the CMS world – as plan business owners and CMS auditors and regulators. This gives BluePeak the edge of being able to support plans, understanding the business challenges that you face, as well as how CMS will audit you and their processes. This allows for better preparation and maintenance of your compliance programs.
CMS Mock Audits
CMS Audit Support
Independent Auditor (IA) Validation
Sanction Remediation
Policy and Procedure Review and Writing
Staff Training
Healthcare Policy Analysis and Application
Interim Staffing
Oversight and Monitoring Programs
Operations
BluePeak staff has worked in the trenches at health plans and understand the challenges that businesses face with limited resources and increasing CMS demands. Our team can provide subject matter expertise across all operational areas of your business to enhance your business processes, fill in compliance gaps, provide interim staffing and train your staff to enhance their efficiency and effectiveness.
Process Remediation Support
Operational Gap Analysis
Vendor Oversight
STAR Program Assistance
Encounter Data Services
Operational Interim Staffing
Staff Training
Vendor RFP Support
Strategy
BluePeak has seasoned experts who are proficient at product strategy and development. Whether it is assisting plans to go into new markets with new products, providing direction on starting an EGWP or PDP, or providing CMS benefit design and bid assistance, BluePeak can support new and existing plans to help grow their businesses.
CMS New Plan or Service Areas Expansion Applications
New Plan Implementations
Product Strategy