Category: Revenue 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.

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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).