Optimizing Centers for Medicare and Medicaid Services (CMS)-regulated Correspondence

For payers that offer Medicare, Medicaid and hybrid government-sponsored plans, the regulations established by the Centers for Medicare and Medicaid Services present significant challenges in generating customer communications that are compliant, as well as effective.

In the case of printed correspondence, health plans are required to strictly follow Centers for Medicare and Medicaid Services (CMS) models that define how and where to format information and the penalties for non-compliance are costly.

The risk of penalties isn’t the only burden. Since regulatory oversight was established long before today’s modern technologies, health insurers’ predominantly manual workflows for updating Centers for Medicare and Medicaid Services (CMS) models have been adapted over time, which continues to add to even more manual process overhead.’

Many organizations assign a full-time document owner to a specific model or document type. These are staff members that have expertise in the regulations that apply to their model and hold the responsibility for updating the templates, testing all of the possible versions, confirming the physical page layout is correct, and securing Centers for Medicare and Medicaid Services (CMS) approval by the October deadline. (read the complete article below)

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