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Your solution for accurate ACA EDGE data submissions
Milliman EDGE ASSIST
Effective ACA EDGE server management requires following and understanding mountains of CMS rules, specifications, and guidance—all while hitting deadlines over months of effort. Submitting incomplete or erroneous information can cost millions in revenue.
The EDGE ASSIST process, backed by Milliman’s deep risk-adjustment expertise, maximizes ACA risk transfers while ensuring compliance with CMS regulations. Our transparent solution covers the entire ACA EDGE cycle, including data ingestion and validation, submission, error identification, and assistance with supplemental diagnoses. We support these technical activities and analytics with our vast knowledge of the ACA risk-adjustment program to ensure accurate data and appropriate member risk scores.
Identify and address systematic weaknesses before data enters the server.
Ensure submission quality and avoid compliance issues with our continuous review and reconciliation process, prioritizing corrections to data elements most affecting your risk score.
Rely on Milliman to track CMS rules and maintain your EDGE server throughout the year, allowing your organization to deploy scarce IT resources where they’re needed most.
Partner with the best ACA EDGE data submission vendor and benefit from Milliman’s unique analytical capabilities and risk adjustment expertise.
Pair a solution tailored to your needs with the outstanding level of service you’ve come to expect from Milliman.
We share best practices to maximize submissions for External Data Gathering Environment, a requirement under the Affordable Care Act.
This paper outlines action steps health plans should consider as part of their annual EDGE server submission cycle.
This paper addresses strategies to facilitate an organizational coding completeness initiative and “crack the code” on the tools and methods for increasing risk adjustment management’s success.
An article to introduce the broader concept of risk adjustment management.
This paper introduces the broader concept of risk management adjustment and highlights actions you can take to maintain its long-term success.
This paper explores some of the more useful types of analytics a commercial health plan can leverage to monitor the performance of its Patient Protection and Affordable Care Act block and keep a better risk score.
IMPROVE combines your detailed claim and enrollment information with a proprietary algorithm to uncover opportunities to investigate undocumented or unsupported conditions or encourage enrollees to schedule annual wellness visits.
Manage Medicare, Medicaid, and commercial risk adjustment with our award-winning suite of tools and data.
Adopt the healthcare industry’s leading platform for data warehousing and healthcare analytics.
Ask the tough questions. We’re ready for them.