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Improving your CMS Universe

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Learn how to automatically and accurately generate ODAG & CDAG universes with the Kiriworks Appeals & Grievances Solution.

Published in: Healthcare
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Improving your CMS Universe

  1. 1. Jon Swisher, Solution & Product Development Manager Pat Goetz, Senior Account Executive Improving your CMS Universe
  2. 2. What the average person thinks of when they hear the term universe!
  3. 3. How a Healthcare Payer feels when they hear the term universe!
  4. 4. But why do you feel that way? • You don’t have enough time? • Data is hard to find? • Data is in too many locations? • You rely on other departments? • Data is difficult to manage? • Data isn’t complete?
  5. 5. Poll # 1
  6. 6. Maybe time isn’t your only issue…
  7. 7. Common Universe data problems: • Misclassification of cases • Duplicate cases • Insufficient or inaccurate date tracking • CMS required formatting • Locating supporting documentation • No single source of truth
  8. 8. Poll # 2
  9. 9. Consequences of failures: • Poor audit score • Civil Money Penalties (CMPs) • Intermediate sanctions • Termination of program • Adversely affect STAR ratings
  10. 10. Recap • Quickly and easily generate universe reports • Ensure reporting data is accurate • Meet CMS required formatting • One solution
  11. 11. SAVE DATE “Advanced Reporting & Analytics” October 18, 2016 2 PM Eastern
  12. 12. Poll # 3
  13. 13. Thank you!

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