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Medicare Advantage experience data: pitfalls and concerns beyond ASOP #23
Medicare Advantage experience data: pitfalls and concerns beyond ASOP #23 Medicare Advantage ... accurately complete such an allocation. MAOs must take care to comply with CMS guidance. This will minimize ...- Authors: Michelle Wahab, Shelby Weber
- Date: Mar 2019
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health information technology; Social Insurance>Medicare; Technology & Applications>Data warehousing
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Operational Considerations in Predictive Modeling
Operational Considerations in Predictive Modeling This article summarizes some of the operational ... appropriate exposure unit and matched together by a primary key. Now let’s add external data. It could take ...- Authors: Christine Hofbeck
- Date: May 2014
- Competency: Results-Oriented Solutions>Actionable recommendations; Results-Oriented Solutions>Assess decision effectiveness
- Publication Name: Health Watch
- Topics: Technology & Applications>Analytics and informatics; Technology & Applications>Business intelligence
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The Actuarial Memorandum in Support of the Health Statement
The Actuarial Memorandum in Support of the Health Statement Preparing an effective actuarial ... rebate liability • No documentation of $0 Affordable Care Act (ACA) risk- adjustment amounts • The company ...- Authors: Annette James, Nancy Hubler
- Date: Oct 2018
- Competency: Communication>Written communication; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>General business skills; Professional Values>Practice expertise
- Publication Name: Health Watch
- Topics: Actuarial Profession>Best practices; Actuarial Profession>Standards of practice; Financial Reporting & Accounting>Statutory accounting; Health & Disability>Health insurance
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A Modern Approach to Traditional Reserving
A Modern Approach to Traditional Reserving This article relates to health insurance actuarial ... allocations for provider bonus accruals 3. Affordable Care Act (ACA) 3Rs—reinsur- ance and allocating claims ...- Date: May 2015
- Publication Name: Health Watch
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Incurred Health Claims:One Lag Report is Not Enough
What’s Normal vs. What’s Perfect Practicing health care actuaries know that there are many factors influencing ... 5 and in the actuarial liter- ature. The health care actuary who attempts to employ the development method ...- Authors: Henry Frantz
- Date: Apr 2003
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability; Modeling & Statistical Methods