ATTAC Consulting Group--Health Care Solutions Business Results.

Medicare Advantage (MA) Plans
An MA plan or Part D Benefit is more than simply a "product line" - launching and operating a Medicare Advantage program or Medicare Part D drug program requires focus on the unique details, operational and compliance requirements of the program, both for the plan itself as well as monitoring its subcontractors.

Operations

Business processes engineering for enrollment and reconciliation, claims, pay as Medicare pays, appeals and grievance programs, UM/QI programs, model of care implementation, customer service management and training, provider management and payment systems, subcontractor and vendor contracting and oversight

Quality Improvement & Medical Management

HEDIS®, CAHPS, HOS, Customer Service and other CMS Star measures are the new keys to maintaining revenue for MA plans in 2012.  Work to implement interventions now to impact your revenue at the launch of new MA revenue model.

Compliance

Compliance program development, monitoring and training for Medicare Part C and Part D, including standard CMS compliance audits, financial audits, MIPPA implementation, Fraud, Waste and Abuse program development and implementation, policy and procedure development, beneficiary material review, grievance and appeal program training, sales and marketing training and oversight, staff and external training support, delegation and downstream contractor oversight programs and data validation

Provider Networks

MA provider network contracting for all provider types for new programs and Service Area Expansions for CCP, PPO and PFFS Conversions

Outsourcing

Evaluation and selection of back office administration vendors (claims, enrollment and billing) along with project management for implementation

Application Support

Application completion, project coordination and management for CCP (HMO/POS), PPO, MA/PD and PDP.