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
Reduce your costs and maintain compliance by automating your member eligibility verification using the CMS-endorsed and recommended BEQ process. Automate your letter generation, election adjudication (up to 98% adjudication rates) and TRR processing.
Dynamic helps health plans by providing easy-to-use Medicare Secondary Payer (MSP) and Coordination of Benefits (COB) tools which health plans optimize revenue, maintain compliance, and achieve operational efficiency.
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.
Dynamic’s revenue reconciliation module allows a Plan to easily load their membership, bid information and MMR to quickly identify member, special status and payment discrepancies.
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.
Dynamic’s Risk Adjustment Processing Systems (RAPS) solution provides Medicare Advantage health plans with a turn-key solution including customizable RAPS “Gold Standard” filtering logic supported by Dynamic’s subject matter experts.
The nature of EDPS means it is more important than ever to closely watch data sent to CMS and have a clear method of managing the entire process to reach that goal, during parallel submission and beyond.
Dynamic’s HCC Analytics module examines all source data to identify suspect, missing or incorrectly coded diagnosis codes — the foundation of your risk adjustment factors.
Our deep experience in government healthcare, coupled with a proven track record, makes Dynamic a premier solutions provider that you can count on over the long term.