End-Stage Renal Disease (ESRD) Premium Restoration Archives

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ESRD Premium Restoration Can Have a Large Impact Despite Small Number of ESRD Patients

ESRD premium restoration solutions help ensure Medicare Advantage plans are properly reimbursed for ESRD patients by identifying members with missing ESRD statuses and restoring the premiums. However, because of the low number of ESRD patients, small healthplans often underestimate the potential impact of using an ESRD premium restoration solution and decide against using one. This article explains why they should reconsider.

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The value of machine learning in the ESRD Premium Restoration process

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Success with MSP and ESRD Premium Restoration

We explain the many revenue integrity challenges health plans face and walk through a variety of client examples illustrating the breadth of value obtained in premium restoration from our Medicare Secondary Payer Validation and End-Stage Renal Disease Premium Restoration solutions for our health plan clients with varying member sizes.

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How the ESRD process works. And why it sometimes doesn’t.

Members with End-Stage Renal Disease (ESRD) significantly impact your Medicare Advantage plan—learn how to navigate the complex process for recovering millions in underpaid premiums.

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Protecting payment integrity through client-centered support

Claritev has built a solid reputation for providing value to health plans by helping to solve their payment integrity challenges. We owe our success to our exceptional people, culture of accountability, and client-centric approach.

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Enhancing premium restoration in four steps

Ensuring accurate premium payments for your Medicare Advantage members requires the right people, processes, and technology. Find out which four steps you can take to capture underpaid Medicare Secondary Payer(MSP) & End-Stage Renal Disease (ESRD) premiums and ensure accurate premium payments going forward for your Medicare Advantage members.

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Infographic: Fixing payment integrity at the source

Are member eligibility errors impacting your payment integrity approach? This infographic identifies the top three causes of eligibility errors and illustrates what they might be costing your plan.

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Fixing payment integrity at the source— eligibility data

Now is the time to evaluate how well your health plan is maximizing recovery opportunities, improving cost avoidance strategies, and exploring premium restoration possibilities. To do this, you need to start at the source of your payment and revenue integrity challenges: eligibility data. Find out how eligibility management and a connected payment integrity approach can strengthen your payment and revenue integrity efforts.

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ESRD: Finding and restoring underpaid CMS premiums in 5 steps

Members with End-Stage Renal Disease (ESRD) account for a disproportionate amount of medical expenses. Learn what you can do by following these five steps to ensure your Medicare Advantage plan doesn’t miss out on millions of medical premiums from the Center for Medicare and Medicaid Services (CMS) for members with End-Stage Renal Disease (ESRD).

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Category: End-Stage Renal Disease (ESRD) Premium Restoration