Simplifying CMS Reporting

Concord Capability

Data Solutions

Tools

Business Partner

Project Overview

Achieving and maintaining compliance with the Centers for Medicare & Medicaid Services (CMS) is no easy task.

Our healthcare payer client must demonstrate compliance with organizational determinations (ODAG) for service requests and provider claims. Unfortunately, the necessary data elements span multiple systems and third parties, and the organization lacked a unified place to store, manage, and report on these elements.

To remove barriers to compliance, Concord developed a foundational, centralized compliance database to deliver ODAG reports. The compliance reporting database houses all the data elements from disparate sources and includes a BI tool to access and generate required reports. The new reporting system helps the business quickly access and create reports based on pertinent data.

Results

Thanks to the new system, CMS reporting is easier than ever. The new compliance database allows our client to manage CMS data elements in one centralized location. More importantly, they reduced reporting cycle time by an average of twelve days after the close of a reporting period, reduced audit requests by 27% per year, and significantly reduced the overall labor costs on the effort.  

This new reporting system helps the business:

· Manage CMS data universal elements in one location

· Maintain compliance with CMS reporting requirements

‍