Penstock

Are pharmaceutical reporting mismatches costing your health plan? 💊 Even small errors in pharmaceutical reporting can lead to denied claims, patient frustration and wasted resources. With U.S. pharmaceutical spending exceeding $722 billion in 2023, it's time for health plans to tackle these challenges head-on. In our newest article, Dr. Robert Haskey, M.D., F.A.C.S., Penstock's Chief Medical Officer, explores the hidden risks of reporting mismatches and shares actionable strategies to improve payment integrity. Don’t let mismatches derail your plan’s success—read on to learn more. #HealthPlans #PaymentIntegrity #Pharmaceuticals

Sometimes, one vendor just isn’t enough—especially when it comes to payment integrity. Relying on a single vendor can leave gaps in your process, missed savings and unaddressed complexities. That’s where vendor stacking comes in. By strategically partnering with multiple vendors, health plans can uncover hidden savings, adapt to evolving claims and ensure every dollar is accounted for. Ready to rethink your approach? Swipe through to see how vendor stacking can elevate your payment integrity program. #HealthPlans #PaymentIntegrity #VendorStacking

We know there’s a lot of stress for regulatory teams as we enter the new year, coordinating submission schedules, validating annual enrollment data and more! That’s why our ClearFile experts are sharing their top tips to simplify your 2025 filings. From smarter planning to avoiding common pitfalls, this carousel is packed with advice to help you stay ahead. Swipe through, take a deep breath and tackle 2025 with confidence! #HealthPlans #RegulatoryFiling #ACA Pat Cain | Bryan Connole | Jen Huffman

States are shifting gears. Is your health plan keeping up? 🤔 In the latest episode of Regulatory Joe, Joe Boyle unpacks the growing trend of state-based marketplaces operating on the federal platform (SBM-FPs)—a pivotal step for states transitioning from federally facilitated marketplaces. Here’s what we cover: ✅ Why more states are shifting to SBMs ✅ New CMS guidance on operating as an SBM-FP for at least one year prior to becoming an SBM ✅ How your health plan can navigate these changes effectively ✅ And more! Let’s talk—what’s your take on SBM-FPs? Drop your thoughts below! #HealthPlans #HealthPlanAdministration #SBM

Stop making the same overpayments over and over —start getting it right. Our audit and recovery services empower health plans to move from pay and chase on systemic overpayments to paying right the first time. With systemic error detection and reporting, Penstock helps increase payment accuracy and strengthen provider relationships. Elevate your audit recovery today—send us a message to learn more! #HealthPlans #PaymentIntegrity #HealthcareSolutions

Your clients count on you—don’t let TPA licensing hold you back. Managing Life and Health Administrator licenses can be overwhelming, with requirements varying across states. Missing a deadline, filing incomplete applications, or overlooking details can mean delays, penalties, and missed opportunities. Penstock’s regulatory experts take the stress out of the process. From start to finish, we ensure your TPA’s applications are accurate, compliant, and on time—so you can focus on what you do best: serving your clients. Simplify your licensing process today: https://lnkd.in/eJFKen-X #TPA #BenefitsAdministration

The most critical RBIS update for 2025? A new two-step URL submission process! Issuers now need to navigate approvals through MPMS and then convert data into the RBIS-specific template for validation. In the latest episode of #RegulatoryJoe, Joe Boyle breaks down everything you need to know to submit with confidence. #HealthPlans #RegulatoryFiling #RBIS

Regulatory filing for health plans is getting smarter. 🧠 Automation, smarter data integration and cloud-based tools are rewriting the rules, helping teams file with confidence and precision. This shift isn’t just about speed—it’s about empowering teams to work smarter. Swipe through the carousel to see how technology is changing regulatory filing for health plans. #RegulatoryFiling #HealthPlans #HealthPlanManagement

Precision in RBIS submissions sets the stage for open enrollment success. With CMS introducing new standards for 2025, getting your submissions right is more important than ever. Ensuring your cost shares, copays, and benefits data align across templates and uploads will be key to a seamless healthcare.gov display and compliance. Dive into our new episode of #RegulatoryJoe to get all the insights you need on the latest RBIS updates! #RegulatoryFiling #HealthPlans #RBIS

What sets high-performing payment integrity teams apart? 💡 From leveraging data effectively to building stronger internal partnerships, success in payment integrity requires strategy, collaboration and continuous improvement. Our experts are sharing 5 practical secrets that can help your team recover more, prevent overpayments and deliver better results—without extra burden. #PaymentIntegrity #HealthPlans #HealthPlanManagement