Description: CPT, NCCI, ICD, CCI, DRG, APC, PTP – understanding healthcare claims involve a dizzying array of code sets and payment methodologies, and yet the claim form is the intersection of health plan affordability, provider payment, and data analysis. This webcast will cover: • The code sets used in medical coding • Types of correct coding policies implemented by CMS and commercial payers • Payment integrity strategies to drive health plan affordability • Data analytics approaches leveraging medical coding knowledge

Description: Dive into the approach and adverse effects of the regulation of 3rd parties and advance consent by the proposed NAIC Consumer Privacy Protection Model Law #674. The regulation of 3rd parties through their contracts with insurers will be explained. Specifics will be provided on the negative effect on companies contracting with 3rd parties. The requirement for advance consent for use of personal data for actuarial and marketing studies will be explained, and two potential solutions will be presented.

Description: Walk through real-life examples of how artificial intelligence (AI) can be used to drive insights and aide actuaries in improving the management of their company's inforce book of business. Hear a panel of experts go step-by-step through case studies, showing how practitioners leveraged predictive analytics for solutions to tap further into their data and draw improved insights.Leave the session with knowledge of how to partner advanced machine learning techniques with the actuarial skills and insights to better understand policyholders' behavior to more efficiently enable accelerating revenue and further profit realization.

Description: Become informed about the approach and adverse effects of the regulation of third parties and advance consent by the proposed NAIC Consumer Privacy Protection Model Law #674. You will hear an explanation of the regulation of third parties through their contracts with insurers. Learn specifics on the negative effect on companies contracting with third parties. Find out more about the requirement for advance consent for use of personal data for actuarial and marketing studies, and hear two potential solutions .At the conclusion of this session, you should be able to explain concerns about contracting with third parties for external data under the Model Law and learn potential solutions to using personal data for actuarial and marketing studies.

Description: Explore a general overview of the Medicare Advantage VBID hospice model, including program goal and a brief review of available information on plan participation in 2021 and 2022. Join us to learn how the program can support other elements related to health equity and address social determinants of health. You will be able to focus on how to improve quality of life and care using palliative, concurrent and/or transitional care and hospice services. Elevate your understanding with a summary of publicly available hospice experience data published by CMS, as well as a review of published research by the SOA and others related to hospice and end of life care. Finally, expect technical guidance regarding VBID model financial implications and proposed enhancements to the program as CMS transitions from the current model due to expire at end of 2024.