<0> Clear Vision Information SystemsRoss Goldberg, 818-597-8453, x-1 </0>
and announced today the introduction of a comprehensive software-as-a-service solution designed to help Medicare Advantage plans comply with the ever changing guidelines and requirements of the Centers for Medicare and Medicaid (CMS).
The cloud-based service, , provides simplified and automated action planning and ongoing expert analysis that gives Medicare Advantage plans the strategic advantage and confidence they need when it comes to compliance and transparency. Clockwork Compliance is the result of combined efforts between Clear Vision and Hoverstate, a Los Angeles-based digital-solutions agency that produces “innovative digital experiences with measureable results” for the health and pharmaceutical industries.
“Fines and lost business as a result of lack of compliance can add up to millions of dollars, and that makes compliance critical to the ongoing success of any Medicare Advantage plan,” says Tom Peterson, president and CEO of Clear Vision. “Clockwork Compliance is a resource that takes the burden from a health plan’s staff and helps to make sure that the entire organization is doing its part with instant accountability. It also provides a simple way to report status to executive management and boards.”
Clockwork Compliance simplifies the process of staying compliant with CMS Health Plan Management System (HPMS) memos while also offering an unparalleled level of transparency and accountability. It is built upon decades of experience in the fields of compliance and technology and, says Peterson, “includes features that are sharply focused on health plans that offer Medicare Advantage.”
Clear Vision’s certified healthcare compliance professionals have more than 20 years of experience working in compliance and operations for major carriers, implementing CMS guidelines and expectations. As part of Clockwork Compliance, these experts provide pinpoint analysis and a concise summary of complex HPMS memos and then assign action items to impacted departments. Compliance managers log into Clockwork Compliance to see all HPMS-issued memos, open action items, the department-assigned action items, and track progress being made in implementing new CMS requirements.
Clockwork Compliance is fully hosted and runs on the secure Pega Cloud, meaning that a Medicare Advantage plan that utilizes Clockwork Compliance doesn’t need to invest in any additional hardware or IT personnel to use the service. Pega Systems is an industry leader in secure process automation software and carries the highest security certifications in the industry. Robert Fauver, chief strategy officer at Hoverstate explained that the company chose Pega because of “the ease with which we could build the complex workflow necessary for timely CMS compliance. This is a system that any plan can easily start and grow with over time.”
As part of the massive changes taking place in healthcare with the implementation of the Affordable Care Act, CMS is being more assertive than ever in making sure that all health plans selling Medicare Advantage plans are in full compliance. In addition to more aggressive reviews, penalties for non-compliance have increased, including more severe sanctions and fines where fraud, abuse or waste is found. “That makes it more important than ever that health plans have practices in place to maintain an effective compliance program,” Peterson says.
Clear Vision Information Systems provides Medicare Advantage risk adjustment solutions and strategies to health plans and providers nationwide. Leveraging decades of experience at the forefront of Medicare policy, the Clear Vision team offers an integrated mix of risk adjustment analytics, continuity-of-care strategies, and compliance consulting tailored to the individual needs of each client. The “20/20 clarity” and easy-to-implement, high-impact tools Clear Vision brings result in revenue optimization and improved quality of care for health plans.
Hoverstate has a proven record within the health insurance, life sciences and medical industries, working to deliver mobile applications, innovative Web experiences, and Web-based applications for its clients. Founded by Fauver and Kyung Ahn in 2008, Hoverstate counts world-renowned health insurance companies among its roster of clients.
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