Evensun Health Inc.
Member Level: BronzeVendor Overview
Description of Services: Evensun is a consulting and services firm focused on the Affordable Care Act Individual Marketplace strategy and operations. In addition to consulting services, we also offer products to support your ACA plan:
-EDGE server submissions
-Tools for maximizing your risk adjustment opportunities -Tools for ensuring the integrity of your risk adjustment data
-APTC reconciliation
-Risk Adjustment RFPs
-Vendor evaluations
-Fractional / interim executive services for finance and risk adjustment leadership
Primary Service: Financial Operations
Secondary Service: Consulting
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100 N Hamilton St
Ste 200
Dalton, GA 30720
404-760-2781
https://www.evensun.com
Documents
Presentation: ACA and Exchanges
What is the outlook for the Exchanges? Evensun presents at the Commercial & ACA Products Fly-In, April 23, 2025.
Recording: APTC Audit Results: How do you stack up?
The ACA market continues to grow, and recent Advanced Premium Tax Credit (APTC) audits released by CMS suggests that health plans may be leaving more than $100 million in APTC on the table due to issues in their enrollment, billing, and reconciliation processes. Evensun Consulting analyzed all 108 audits and presents key findings. Learn from Evensun how you can minimize your audit risk and maximize your APTC revenue.
Report: ATPC Audit Summary
The ACA market continues to grow, and recent Advanced Premium Tax Credit (APTC) audits released by CMS suggests that health plans may be leaving more than $100 million in APTC on the table due to issues in their enrollment, billing, and reconciliation processes. Evensun Consulting analyzed all 108 audits and presents key findings. Learn from Evensun how you can minimize your audit risk and maximize your APTC revenue.
Presentation: APTC Audit Results: How do you stack up?
The ACA market continues to grow, and recent Advanced Premium Tax Credit (APTC) audits released by CMS suggests that health plans may be leaving more than $100 million in APTC on the table due to issues in their enrollment, billing, and reconciliation processes. Evensun Consulting analyzed all 108 audits and presents key findings. Learn from Evensun how you can minimize your audit risk and maximize your APTC revenue.
APTC Audit Presentation
Evensun Health presents findings from the APTC audits released by CMS in 2024.
APTC Audit Summary
CMS recently released to the public audit reports for Advanced Premium Tax Credit payments made to health plans selling in the federal marketplace in 2018 and 2019. Evensun analyzed the results and found that the average health plan is putting nearly $1 PMPM at risk due to issues in their enrollment, reconciliation, and HICS processes.
APTC Audit Reports
Last month, CMS released audit reports on the APTC payments for more than 100 health plans who offered coverage in the ACA market in 2018 and 2019. These reports suggest that carriers may be leaving $100 million a year in APTC on the table due to issues in their enrollment, billing, and reconciliation processes. This report provides a deep dive on the audit results and areas that health plans should evaluate to ensure they are minimizing audit risk and maximizing their APTC receipts.