Edifecs to Host a Webinar: How to Meet Edge Server Deadlines

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Health plans must adhere to strict submission guidelines or risk significant revenue loss

Edifecs, Inc., a global health information technology solutions company, will host a webinar to discuss strategies for meeting the Centers for Medicare and Medicaid Services (CMS) deadline for Edge Server policy. Edifecs experts will share strategies for having an Edge Server solution in place in just 30 days. The panelists will also focus on minimizing the threat of significant revenue loss due to inaccurate reinsurance and risk adjustment payments.

The Edge Server policy was sparked by recent healthcare reform legislation from the U.S. Department of Health and Human Services (HHS) requiring health plans to upload de-identified enrollment data, medical claims data and pharmacy claims data to their Edge Servers. The data will be used to calculate risk scores for its risk adjustment and reinsurance programs. HHS will either accept or reject the uploaded data based on certain validations. Rejected data would need to be investigated further by the health insurers, then fixed and reprocessed in order to ensure the calculations are correct. The potential revenue loss and business impact of rejected data are huge.

Who:

  •     Amrinder Arora, associate vice president, member solutions & services implementations

Arora is a computer scientist and adjunct professor at George Washington University specializing in data analysis in algorithms. He has architected the FDA’s PREDICT risk targeting solution as well as HIX solutions and has led the implementation of numerous risk targeting projects.

  •     Dawn Carter, director, product analysis & financial management

Carter is a noted industry speaker and subject matter expert in claims and EDI management.

  •     Kevin Day, senior solutions architect

Day is an expert in addressing critical needs of CORE compliance, federally facilitated marketplace participation and Edge Server reporting.

What: Edifecs experts detail how to meet Edge Server deadlines and avoid the threat of revenue loss due to inaccurate reinsurance and risk adjustment payments. They will discuss:

  •     Why participation in premium stabilization programs is more than a simple IT development effort.
  •     How to mitigate financial risk using Edge Server data for risk adjustment through accurate, reconciled submissions and the analysis and management of data quality.

When: Wednesday, September 17, 2014 at 2:00 p.m. ET

To register, please visit: http://bit.ly/EdgeServerWebinar

About Edifecs, Inc.
Edifecs is a leader in developing innovative, cost-cutting solutions to transform the global healthcare marketplace. Since 1996, Edifecs has provided technology that automates many administrative functions in order to trim waste and reduce costs as well as increase revenues, collaboration and operational performance. Customers who have benefited include healthcare providers, insurers, pharmacy benefit management companies, and other trading partners. More than 350 healthcare customers today use Edifecs solutions to simplify and unify financial, clinical and administrative transactions. They also use Edifecs technology to automate manual business processes (e.g., enrollment, claims and payment management) and to support compliance for HIPAA, Operating Rules and ICD-10 mandates. In addition, Edifecs develops supply chain management solutions to support worldwide customers in non-healthcare industry segments. Edifecs is based in Bellevue, WA, with operations internationally. Learn more about us at edifecs.com.

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Kara Lundberg

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