Universe Scrubber helps health plans review ODAG, CDAG, FA, CPE, and SNP-MOC universes monthly, quarterly, or ad hoc to determine compliance with CMS audit protocols.
Top industry thought and health plan leaders gathered to discuss the direction Medicare and Medicaid will take under the new administration.
Webcast Replay: Medicare Enrollment – Going Digital Increasingly, CMS is moving digital and directing payers to do the same. Hear from Dick Warren, our Enrollment subject matter expert to learn about real-time APIs for the Online Enrollment Center, the real-time Beneficiary on the Cloud (BIC) – Beneficiary Eligibility Query (BEQ) and how APIs are being…
Health Evolution | March 29, 2021 Beacon Healthcare Systems is working to apply data science and analytics to appeals and grievances technology and information in the payer space. Why? Because CEO Ken Stockman envisions gleaning insights from appeals and grievances data to create unique industry KPIs that inform payers about what they should be striving to…
Webcast Replay: Utilizing RPA in VAM Hear from guest speaker John Voelker, Sr Business Process Analyst from IBC, on how robotic process automation in Virtual Appeals Manager has reduced reporting discrepancies and enabled faster uploads to their IRO for matched specialty review.
Regulatory Updates Week Ending 01/29/2021 Download the full CMS HPMS Memo Summaries Here
Webcast Replay: Expectations and Readiness for 2021 CMS Medicare Parts C and D Program Audits Watch this roundtable on Expectations and Readiness for 2021 CMS Medicare Parts C and D Program Audits hosted by John Tanner, our Chief Compliance Officer, and select thought leaders in the industry. CMS has announced they will start sending Program Audit engagement letters to Medicare…
Appeals & Grievance Data is Critical in Identifying Changes to Enhance Member Satisfaction By Laurie Delgado As the health insurance marketplace becomes more and more competitive, insurers have become increasingly aware that customer satisfaction is often a key differentiator in distinguishing one plan from another. This is especially true in the Medicare arena as constricting…
Using Appeals And Grievance Data To Improve Member Satisfaction November 25, 2020 | 2:00 PM – 3:00 PM ET | Online REGISTER NOW As health insurance providers prioritize the goal of bringing the voice of the consumer to the forefront of their decision-making process, the analysis of CMS’s Complaint Tracking Module (CTM) appeals and grievance…
Webcast Replay: New Supplemental Benefits Demo One plan had 2,000 cases alone in the first week. Watch a tour of our new Supplemental Benefits Module by Jared Zagorski, Director of Product & Implementations.
Alan Krigstein of Independence Health Group Appointed to Board of Directors of Beacon Healthcare Systems Former EVP and CFO of Independence Blue Cross of Philadelphia Joins Health Care Industry’s Leading Compliance and Risk Management Technologies Company (HUNTINGTON BEACH, Calif. – Sept. 22, 2020) — Alan Krigstein, former executive vice president, chief financial officer and…
Seven Healthcare Compliance Escalation Scenarios By John Tanner What most CEOs lack more than anything else is time. Many wake up each morning feeling as if there are a thousand things to be done and simply not enough time or hands to adequately fulfill the broad expectations of directors, shareholders, customers, and employees. That is…
Innovation By Bevann K. Moreland It has often been said that all motion is relative. If that is true, then standing still is actually stepping backwards in a world that is constantly evolving, developing and moving forward at lightning speed. Never has this been truer than it is today, with the current crisis caused by…
Pamela Raley Promoted to Senior Vice President at Beacon Healthcare Systems (HUNTINGTON BEACH, Calif. – Aug. 6, 2020) — Beacon Healthcare Systems announced today the promotion of Pamela Raley to the position of senior vice president, revenue and client management. Beacon is home to the healthcare industry’s leading compliance and risk management technologies. Over her…
Lisa Rubino Appointed to Board of Directors of Beacon Healthcare Systems Former President of Molina Healthcare of California and Senior VP of Blue Shield of California Joins Industry’s Leading Compliance and Risk Management Organization (HUNTINGTON BEACH, Calif. – June 30, 2020) — Healthcare management executive Lisa Rubino, who has held leadership positions with some…
Beacon Healthcare Systems Virtual Appeals Manager to Sponsor Rise Appeals and Grievances Summit The 5th Annual Optimizing Appeals & Grievances Summit To Feature a Moderated Session by John Tanner, Beacon’s Chief Compliance Officer Don’t miss John Tanner, Chief Compliance Officer at Beacon Healthcare Systems, and David Reid, Sr Director, Operational Performance & Regulatory Support, Florida…
Webcast Replay: Support Audit Staff with Tools for Effective and Consistent Auditing Watch John Tanner, Chief Compliance Officer at Beacon Healthcare Systems to learn how well-constructed auditing tools can be used to reinforce audit standards for seasoned auditors, and provide further real-time training to less seasoned auditors to conduct consistent and effective audits. https://beaconhcs.com/wp-content/uploads/2020/06/Support-Audit-Staff-with-Tools-for-Effective-and-Consistent-Auditing.mp4
Beacon Healthcare Systems Unveils New Appeals and Grievances Product for Small to Midsize Health Plans “VAM Out of the Box” Will Launch at HealthTeam Advantage in North Carolina (LOS ANGELES – June 4, 2020) — Beacon Healthcare Systems announced today the introduction of a new appeals and grievances product designed expressly for small to…
Dennis Gray Named Vice President of Sales for Beacon Healthcare Systems (LOS ANGELES – May 18, 2020) — Longtime healthcare veteran Dennis Gray has been named vice president of sales for Beacon Healthcare Systems, effective immediately. Beacon is home to the healthcare industry’s leading compliance and risk management technologies. Gray brings to Beacon more than…
Cara Dillon Named Vice President of Product Delivery At Beacon Healthcare Systems (LOS ANGELES – May 4, 2020) — Beacon Healthcare Systems announced today the appointment of Cara Dillon to the newly-created position of vice president of product delivery. Beacon is home to the healthcare industry’s leading compliance and risk management technologies. Dillon joins Beacon…
Webcast Replay: STARs Timeliness Measures Watch Beacon Healthcare Systems and Independence Blue Cross cover a case study in STARs Timeliness Measure. https://beaconhcs.com/wp-content/uploads/2020/05/2020-05-13-10.01-STARs-Timeliness-Measures.mp4
Beacon Healthcare Systems named Manish Nautiyal Senior Vice President of IT Development and Infrastructure (LOS ANGELES – April 29, 2020) — Beacon Healthcare Systems announced today the appointment of Manish Nautiyal as its new senior vice president of IT development and infrastructure. Beacon is home to the healthcare industry’s leading compliance and risk management technologies.…
Webcast Replay: Today’s A&G Landscape with Case Studies and CARES Update Watch Beacon Healthcare Systems plus guest speakers from Highmark Health and Deloitte & Touche LLP cover Appeals & Grievances Cases studies, operating model challenges and lessons learned. We also covered the regulatory update on potential plan implications of the CARES Act and related guidance…
Beacon Healthcare Systems Introduces New Medicare Supplemental Benefits Module (LOS ANGELES – April 23, 2020) — Beacon Healthcare Systems has introduced a new Medicare Supplemental Benefits module expressly designed to help Medicare Advantage health plans with the approval and delivery of supplemental benefits for their members. Beacon is home to the healthcare industry’s leading compliance…
John Tanner Named Chief Compliance Officer for Beacon Healthcare Systems (LOS ANGELES – April 6, 2020) — Beacon Healthcare Systems announced today the appointment of John Tanner as its chief compliance officer, effective immediately. Beacon is home to the healthcare industry’s leading compliance and risk management technologies. In his new role Tanner will have the…
Beacon Healthcare Systems Names Bevann Moreland Senior Vice President of Payer Product Innovation (LOS ANGELES – April 1, 2020) — Beacon Healthcare Systems announced today the appointment of Bevann Moreland as its new senior vice president of payer product innovation, effective immediately. Beacon is home to the healthcare industry’s leading compliance and risk management technologies.…
New Study From Beacon Healthcare Systems Shows Significant Improvement in Star Ratings for Health Plans Using Virtual Appeals Manager (LOS ANGELES – March 23, 2020) — A new study from Beacon Healthcare Systems revealed that health plan clients using Beacon’s Virtual Appeals Manager (VAM) are seeing measurable performance improvement in their appeals and grievances star…
Beacon Healthcare Systems Virtual Appeals Manager to be Showcased at Upcoming Health Plan Conference March 25-27 in Nashville (HUNTINGTON BEACH, Calif. – Feb. 26, 2020) — Beacon Healthcare Systems announced today that it will be one of the lead sponsors and exhibitors at the upcoming Insight Exchange Network “Enhancing Appeals & Grievances and Improving ODAG…
Beacon Healthcare Systems Appoints Jeff Flocken to Its Board of Directors (HUNTINGTON BEACH, Calif. – Feb. 24, 2020) — Jeff Flocken, a values-based leader with more than a three-decade track record in healthcare strategy, operations and business development has been appointed to the board of directors of Beacon Healthcare Systems. Beacon is home to the…
Seven Keys to a Successful CMS Audit Progressive thinking organizations are more and more looking at an audit as a verification process to ensure that their compliance and operational procedures are in order and to unearth opportunities for improvement that might lead to more effective management and the minimization of errors in the future. Here…
Beacon Healthcare Systems’ Virtual Compliance Manager to be Showcased at HCCA Meeting Jan. 26-29 in Florida (HUNTINGTON BEACH, Calif. – Jan. 13, 2020) — Beacon Healthcare Systems will be a Silver Sponsor and exhibitor at the HCCA Managed Care Compliance Conference in Lake Buena Vista, FL later this month. Beacon is home to the healthcare…
Beacon Healthcare Systems to Showcase Industry’s Leading Compliance and Risk Management Technologies at Annual ICE Meeting Dec. 9-10 in San Francisco (HUNTINGTON BEACH, Calif. – Nov. 20, 2019) — Beacon Healthcare Systems announced today that it will be a Silver Sponsor and exhibitor at the Industry Collaboration Effort’s (ICE) annual meeting Dec 9-10 in San…
Health Plans Need Analytics More than Ever America’s health plans operate under varying business models, serve different constituencies and concentrate in distinctive markets from coast to coast. But what they all have in common is a desire to improve their overall operational efficiency, provide the best possible care to their members, and enhance their brand…
Beacon Healthcare Systems’ Jessica Sieger to Be Featured Speaker at Healthcare’s Appeals and Grievances Summit (HUNTINGTON BEACH, Calif. – June 10, 2019) — Jessica Sieger, product specialist at Beacon Healthcare Systems, will be one of the featured speakers at the 4th Annual Optimizing Appeals and Grievances Summit—Improving ODAG & CDAG Outcomes—June 16-18 in Washington, D.C. The conference…
Keys to a Successful CMS Audit For individual Americans, the prospect of an IRS audit is intimidating, stressful and life-complicating. People file their taxes each year hoping they never have to face such a reality. For health plans, hospitals and medical groups, the prospects of a CMS audit is simply a way of life. And…
Beacon Healthcare Systems Taps Pamela Cleveland as Vice President, Compliance Product Strategy (HUNTINGTON BEACH, Calif. – April 16, 2019) — Pamela Cleveland, J.D., has been appointed vice president of compliance product strategy for Beacon Healthcare Systems, effective immediately. Beacon is home to the healthcare industry’s leading compliance and risk management technologies. In her new role…
Beacon Healthcare Systems to Showcase Healthcare’s Leading Compliance and Risk Management Technologies at America’s Physician Groups’ Conference (Huntington Beach, Calif. – April 8, 2019) — Beacon Healthcare Systems will showcase the healthcare industry’s leading compliance and risk management technologies at America’s Physician Groups’ Annual Conference April 11-13 in San Diego. The conference will feature industry…
Tom Ellsworth Appointed Chief Administrative Officer for Beacon Healthcare Systems (HUNTINGTON BEACH, Calif. – Nov. 9, 2018) — Tom Ellsworth has been named chief administrative officer for Beacon Healthcare Systems, effective immediately. Beacon is home to the healthcare industry’s leading compliance and risk management technologies. Ellsworth brings to Beacon more than 25 years of experience…
Tim Spaeth Named Chief Revenue Officer at Beacon Healthcare Systems (HUNTINGTON BEACH, Calif. – October 15, 2018) — Tim Spaeth has been named chief revenue officer for Beacon Healthcare Systems, effective immediately. Beacon is home to the healthcare industry’s leading compliance and risk management technologies. In his newly created position, Spaeth will be responsible for…
