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.
The old tried and true approach to coordination of benefits isn’t enough anymore. Claritev’s Coordination of Benefits (COB) solution blends the right people, processes, and tech, allowing our team and clients to work smarter rather than harder.
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.
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 discusses what is in store for the future of payment integrity and how the company is helping clients make the transition from retrospective to prospective programs.
For today’s health plans, clinical audits play a critical role in payment accuracy and ensuring the financial health of the organization. They can help a plan control costs, comply with government regulations, and meet financial requirements. Transparent communication and education are key to positively impacting the provider experience during clinical audits.
This comprehensive ebook explores the fundamentals of coordination of benefits (COB) and how health plans can optimize processes to reduce costs and improve payment accuracy. Learn best practices, common challenges, and actionable strategies to streamline claims coordination and enhance financial performance.
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.