Do you know if your delegates are on the straight & narrow?

CMS, CCIIO, state Medicaid agencies and state Insurance Departments hold plans including Medicare Advantage, Part D, Medicaid Plans and Qualified Health Plans (QHPs) accountable for the performance and compliance of their First Tier, Downstream and Related entities (FDR) for services they are delegated. ATTAC Consulting Group provides multiple solutions to plans  to enhance delegate oversight and assure downstream compliance.

ACG can provide solutions in developing your organization’s auditing and oversight programs for: 

  • Delegate data capture and testing

  • Delegate training and standard tool development

  • Design and implementation of critical delegate reporting and process oversight

  • Creation of dashboards and key performance metrics

  • Design of delegate audit tools and training of Plan staff in auditing

ACG’s solutions cover oversight programs for delegates such as:

  • Outsourced Enrollment Operations

  • Outsourced Claims Operations

  • Delegated Credentialing for IPAs and Medical Groups

  • Delegated Utilization Management for IPAs and Medical Groups

  • Pharmacy Benefit Managers (PBMs)

  • Field Marketing Organizations (FMOs) and Sales Agents

  • Fulfillment Operations

  • Dental and Vision Sub-Contractors

  • Hearing Sub-Contractors

  • Social Determinant Sub-Contractors

To enhance the reach of your staff to conduct compliance and performance audits, ATTAC Consulting Group can also perform routine audits of your delegates on your behalf. It’s a cost-effective solution to enhance your oversight program.