Initiatives - Overview
Claims Performance Metrics
Development and piloting of consistent metrics that accurately and consistently measure the performance of the provider payment systems in Massachusetts.
Intake Edits Workgroup
Documentation of Massachusetts' payers requirements with regard to data fields on UB-92 (hospital) claims and HCFA-1500 (service provider) claims
Process Flow Improvements
In 2004, a workgroup of the Operations Forum has begun examining the overall revenue cycle and claims operation process, with the goal of identifying and recommending best practices for providers and payers.
During 2005, the workgroup attempted to identify process flow improvements with regard to Coordination of Benefits (COB) practices for payers and providers.
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