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

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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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    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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    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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    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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