Healthcare risk adjustment
EDGE ASSIST
ACA data submissions are complex, frustrating, and prone to errors.
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.
Full-service ACA EDGE submissions backed by a transparent, proven approach
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.
Expertise
Milliman has the expertise to maintain your EDGE server, including contracting, configuring, acquiring CMS provisioning software, and registering. Upon successful completion of data processing and reconciliation, we will complete the submission process by properly transforming the data and loading it into the EDGE production environment.
Continuous process
We have a continuous process for reviewing and reconciling EDGE submissions and will work with you to ensure each submission passes our daily quality standards. We will also help you track your data over time and identify patterns, before your data reaches EDGE, to uncover signals of systemic weaknesses in your overall data management process.
Clarity
Additionally, Milliman brings clarity to error reports through precise summaries of these errors paired with direct action items as part of a larger strategic plan for correcting errors and improving data quality. We can identify the errors offering the most potential risk score value to help your team effectively deploy and allocate resources.
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Contact us
We’re here to help you break through complex challenges and achieve next-level success.
Contact us
We’re here to help you break through complex challenges and achieve next-level success.