Medicare Advantage Health Plans


Dynamic Healthcare Systems offers products and services that help solve the operational, compliance and revenue management challenges of healthcare organizations who provide Medicare services.

Our team of industry experts brings decades of experience starting, managing and growing managed care services and organizations. Our software products are intentionally designed to solve the challenges that the implementation of the Medical Modernization Act of 2003 has imposed on the industry. Contact us today if you are facing the challenges of overwhelming expectations and required changes to begin enrolling and managing your healthcare business.


Enrollment & Eligibility

Dynamic provides software systems that help solve the operational, compliance, and revenue management challenges of healthcare organizations that provide Medicare services. The Enrollment solution works as a flow automation tool for Managed Care organizations along with CMS intermediary capabilities.
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MSP/COB

Dynamic’s COB – OHI – MSP solution helps plan accurately identify primary MSP members.  Store critical MSP and COB information at a member level, including imported CMS files.  Send and receive automatic updates through batch file submissions to the COB Contractor (Electronic Correspondence Referral System (ECRS)).  Enable centralized source of COB primary and supplemental data to assist in True Out-of-Pocket (TrOOP) management and recovery research.
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Premium Billing

The Premium Billing module integrates up-to-the minute member subsidies and Late Enrollment Penalties (LEP) with complete tracking of prospective and retroactive enrollment actions to provide simple, compliant billing and premium management.
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Revenue Reconciliation

Dynamic’s revenue reconciliation solution provides a managed care organization the ability reconcile member and financial data against the government entity. It identifies and provides an integrated functionality to manage all discrepancies that are member and payment related.

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PDE

Dynamic’s PDE Management and Audit module can confidently attest to the completeness and accuracy of a Plan’s PDE data, while having the ability to effectively audit what CMS reports as stored vs. what the Plan believes should be stored.
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RAPS

Dynamic’s Risk Adjustment Processing Systems (RAPS) solution provides Medicare Advantage health plans with a turn-key solution including flexible and configurable RAPS  filtering logic to support your business needs. Solution encompasses CMS regulatory updates, submission auditing capabilities and real-time BI reporting.
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EDPS

Dynamic’s Encounter Data Processing System (EDPS) module enables you to submit professional, institutional, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) encounter data to the Centers for Medicare and Medicaid Services (CMS). The EDPS module enables you to focus on reviewing and understanding encounter data errors rather than managing, reading, and deciphering various response formats.
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HCC Analytics

HCC Analytics Optimize revenue and mitigate risk by generating and comparing monthly or quarterly risk adjustment reports. Also, identify suspected risk or revenue opportunities by data mining within the reporting and UI capabilities.
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Professional Services

In addition to our software solutions, we offer several programs which allow Plans to leverage the expertise of our experienced team of accomplished healthcare professionals and are designed to provide clients with a deep understanding of their program gaps, as well as a clear plan to reach their desired goals.  Areas of expertise include Risk Adjustment, Reconciliation, Compliance and Quality Measures.
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