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Archive for September, 2013

HighRoads Launches Medicare Advantage Governance Solution for Health Insurance Payers

HighRoadsan industry leader in benefits plan management and health care compliance, today launched the HighRoads Medicare Advantage Governance Solution specifically designed for Medicare Advantage payers. The centralized, software-as-a-service solution based on The Source by HighRoads produces a comprehensive system of record for all benefits plan data which simplifies and speeds the production of compliant Medicare Advantage participant documents and Centers for Medicare & Medicaid Services (CMS) submissions.

“Tight deadlines to meet annual CMS bid process material submissions along with increasingly stringent requirements to produce and deliver accurate compliance documents for plan participants have put increasing strain on Medicare Advantage payers,” said Lori Dustin, chief marketing officer, HighRoads. “Now, Medicare Advantage providers can eliminate the costly risk of human error with a centralized system of record for all of their benefits plan data, assuring the reliable and compliant delivery of all required materials.”

Based on HighRoads’ proven benefits plan management system, The Source®, the HighRoads Medicare Advantage Governance Solution uses a patented benefits Extract Transform and Load (ETL) technology to create normalized plan designs that include both the plan benefit package data required to be submitted to CMS as well as the additional variable data needed to produce Medicare Advantage materials including Annual Notice of Changes (ANOC), Evidence of Coverage (EOC) and Summary of Benefits (SB) documents. Through consistent benefits plan data the HighRoads Medicare Advantage Governance Solution also helps payers reliably produce CMS Bid Pricing Tool (BPT) materials for more accurate and timely submissions.

Featuring built in business process workflow, the HighRoads Medicare Advantage Governance Solution ensures that all benefits plan data is accurate and approved by marketing, compliance and other required subject matter experts – with compliant log files and chain of approval tracking records.

“For years Medicare Advantage Payers have struggled with the timely and accurate production of compliant documents and CMS materials, relying almost entirely on costly and error prone manual processes,” said Edward J. Novinski, former UnitedHealth Group (UHG) executive responsible for UHG’s Commercial Medicare and Medicaid networks and HighRoads board of director. “Now, HighRoads is enabling Medicare payers to have a central record of truth for all Medicare Advantage plan data which improves the efficiency and accuracy of
every required plan document eliminating the cost and risk of human error.”

HighRoads’ SaaS-based Medicare Advantage Governance Solution:

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