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Experts at Altegra Health are developing new ways to meet the needs of the healthcare industry. Read their insights here.

2017 CMS Final Notice – Highlights from an Executive’s Perspective

On April 4, 2016, the CMS Final Notice confirmed a number of changes with significant impact to the market. To understand this impact, we sat down with Kevin Barrett, President Altegra Health and [...]

May 26th, 2016|Altegra Health, Medicaid, Medicare|Comments Off on 2017 CMS Final Notice – Highlights from an Executive’s Perspective

Will 2016 be the Year of Revenue Cycle Integration?

As electronic health records (EHRs) were implemented nationwide, healthcare provider organizations simultaneously attempted, and continue, to integrate health information systems across their enterprises so they could effectively and efficiently exchange data between providers and analyze [...]

January 6th, 2016|Altegra Health|Comments Off on Will 2016 be the Year of Revenue Cycle Integration?

3 Ways to Help your Star Ratings Shine in 2016

In October, the Centers for Medicare and Medicaid Services (CMS) released its 2016 Star Ratings for Medicare Advantage (MA) plans. The good news is the Star Ratings for plans with prescription drug coverage (MA-PDs) climbed [...]

December 22nd, 2015|Uncategorized|Comments Off on 3 Ways to Help your Star Ratings Shine in 2016

How Did 2015 Impact Your Revenue Cycle Management?

Just when you thought you had a firm grasp on the revenue cycle operations at your provider organization, 2015 comes along and changes everything. ICD-10, Affordable Care Act (ACA) plans and, perhaps, a merger or [...]

December 15th, 2015|Uncategorized|Comments Off on How Did 2015 Impact Your Revenue Cycle Management?

Accurately Identifying Risk Requires Better Data and Smarter Math

Despite the vast amount of electronic data available to health plans and providers to determine member or patient risk levels, accurate and timely stratification is actually becoming more complex. That’s because more data doesn’t necessarily [...]

December 8th, 2015|Uncategorized|Comments Off on Accurately Identifying Risk Requires Better Data and Smarter Math

5 Tips to Beat Next Year’s CMS Encounter Data Submission

Next year, the Centers for Medicare and Medicaid Services (CMS) will begin transitioning how it adjusts risk scores for beneficiaries of Medicare, Medicare Advantage, Medicaid and other plans. CMS will base 90 percent of the [...]

November 24th, 2015|Uncategorized|Comments Off on 5 Tips to Beat Next Year’s CMS Encounter Data Submission

Despite ACA-RADV IVA Delay, a Mock Audit is a Smart Move

The U.S. Department of Health and Human Services (HHS) was supposed to send the first Affordable Care Act (ACA) risk adjustment data validation (RADV) audit sample to issuers this summer, but, as often happens in [...]

November 19th, 2015|Uncategorized|Comments Off on Despite ACA-RADV IVA Delay, a Mock Audit is a Smart Move

Three Essential Elements of Provider-Chart Retrieval and Coding Reviews

Provider-chart retrieval and risk-adjustment coding reviews used to be time-consuming, occasionally antagonistic, projects. Providers were suspicious of payer representatives in their practice or department digging through charts and analyzing documentation, while payers struggled to find [...]

November 16th, 2015|Uncategorized|Comments Off on Three Essential Elements of Provider-Chart Retrieval and Coding Reviews

Altegra Health (Virtual) Employee Spotlight: MaryBeth

As accountable care and other value-based payment programs expand across the nation, the demand for care managers has never been greater for both provider and payer organizations. Both types of organizations share similar care management [...]

November 12th, 2015|Uncategorized|Comments Off on Altegra Health (Virtual) Employee Spotlight: MaryBeth
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