Category: Revenue Integrity

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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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    eBook: Restoring millions for your Medicare Advantage plan

    Discover how Medicare Advantage plans can recover lost revenue and strengthen financial performance through effective premium restoration strategies. This ebook explores proven approaches, data-driven insights, and practical steps to help payors identify opportunities, improve accuracy, and restore millions in premiums.

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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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    2021 brings changes to Medicare Advantage plans

    Given the many changes in 2021, Medicare Advantage plans and their members will need to adjust. These changes are positive for members—for health plans, these changes can have a profound impact and will require the health plans to keep a close eye on cost-containment strategies.

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    Three ways to tackle the high cost of waste

    Administrative complexity continues to drive the high level of waste in healthcare threatening the viability of organizations throughout the healthcare ecosystem. With a holistic, connected payment integrity strategy built around these three tenets, your organization can improve operational efficiencies and achieve financial integrity.

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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.