Innovations in AI and machine learning unlock opportunities to eliminate waste, reduce costs, and make healthcare more affordable. Claritev offers the best of both machine power and human power to help Medicare Adavantage plans ensure the accuracy of CMS premiums.
Expanding on one of the top payment integrity trends for 2021, this blog post focuses on growth in Medicare Advantage enrollment and the revenue integrity challenges it brings for health plans.
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.
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.
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.
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.
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.
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.
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.
