Out-of-Area Mandate Solutions for Blue Plans

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Out-of-Area Mandate Solutions for Blue Plans

The Out-of-Area Mandate is here.

Struggling with compliance? Searching for a solution?

BCBSA has rolled out the Out-of-Area Mandate that establishes requirements for sharing information about group members between home and host plans to identify and help close quality gaps in care and risk adjustment diagnosis code gaps, and manage medical record retrieval. Early adopter programs rolled out in September and implementation begins January 1.

Advantasure’s turnkey solutions are built on proven provider engagement strategies and deep expertise with Blues plans.

Our solutions help deliver on the objectives of the Out-of-Area Mandate:

  • Reduce gaps in care
  • Improve member and provider experience
  • Improve star ratings and risk score accuracy
  • Align incentives

You can do more than just meet the requirements. Our unique Provider Engagement Coordination (PEC) solutions already help dozens of clients boost risk-score accuracy, improve Star ratings and reduce audit risk. The program provides the ideal launch pad for meeting Out-of-Area Mandate requirements.

If you are an Advantasure PEC client

Leverage your existing PEC solutions – easily add our Out-of-Area Mandate products. Our knowledge of your business and solutions priced to fit within BCBSA’s funding parameters provide a path for fulfilling mandate requirements.

If you are an Advantasure client

We can streamline your Out-of-Area Mandate program – implementing solutions quickly, easily and without the need to add additional vendors.

If you are a plan in search of a solution

Our Out-of-Area Mandate solutions were built on solid provider engagement experience and are ready to implement. Our expertise with the Blues environment can deliver a program that’s right for your plan’s needs.

We have a solution for you

No matter your situation, if you’ve been affected by the Out-of-Area Mandate, we have compliant solutions to help your plan. Give us a call, and let’s figure out how we can help.


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