Medicare Part D

Argus Connects the elements of a strong Part D program

Argus has been successfully processing Medicare Part D claims since January 1, 2006. In 2010, Argus led the industry, processing nearly 20% of the nation's Medicare Part D claims. Through our infrastructure programs with our customers, we support 5.3 million beneficiaries for 14 Medicare Part D sponsors. Claim volume for 2010 was 264.8 million.

Our expertise fully supports your Healthcare Reform outcomes

• Industry experts on hand for Part D processes and compliance consultation
• Full suite of Part D products to ensure successful operations
• Leading the way on industry standards such as EOB and PDE

Argus Ranked # 1

Argus' end-to-end Medicare Part D program support has allowed us to gain significant efficiencies in PDE processing and reconciliation. Argus leads the industry for PDE Acceptance rates at 99.85% for 2009, which includes eligibility and non-eligibility errors, with initial acceptance rate of 99.20%. Separating errors that Argus has primary responsibility for initiating resolution, the acceptance rate is even higher at 99.99% for 2009. In 2006 when the industry was struggling to meet PDE Acceptance Rates of 88%, Argus' average was 98.97%.

Argus supports 20 Part D programs, both national as well as regional. The Argus support of the Part D program is based upon an intense focus on regulatory compliance. Beginning in 2004 when we started to lay the groundwork for ArgusRx, the Argus discount drug card program which was the precursor to the Part D program, we have focused on building and maintaining strong working relationships with CMS. We made the commitment to provide our customers with end-to-end Part D and government program support. One critical component to this support is the Argus CMS Program Office.

Compliance focus is built in to our model

With a specific Regulatory Compliance team, we have been able to employ a focused approach to guidance review and interpretation. Our primary objective is to maintain compliance and to assure our customers that they are well supported. Compliance focus was built into our model.

1. Intelligence gathering . CMS Regulatory Compliance continually monitors and reviews the voluminous documentation produced by CMS and other government entities. Topics include legislative, regulatory, administrative, and guidance chapter reconciliation. CMS Regulatory Compliance then communicates relevant information to Argus and its customers and assists in any follow-up projects and activities required to maintain compliance.
2. Planning - global planning and prioritization process. This includes development of an annual compliance work plan; a monthly risk analysis report of realized and potential concerns; and issue management.
3. Proof - Policies & Procedures; monitoring and measuring program effectiveness via CMS data review; audit support; customer attestations; performance guarantees and project rework percentages.

Put our suite of comprehensive services to work for you

• Argus has invested significant resources to support our customers' Part D programs. That investment includes a fully staffed department (the CPO) dedicated to the Part D program.
• Argus provides the expertise necessary to support the complexity of the CMS programs, both Medicare and Medicaid. Given the very short development lifecycle for the annual Part D program as well as the emphasis on compliance, our customers rely on the CMS Program Office as a proven partner in helping to interpret guidance and to develop innovative and compliant solutions for their Part D programs.