Webinar recap diving into what’s going on in the Medicare Advantage world and why your health plan should be paying close attention to your premium restoration strategies.
In the past year, we’ve seen an increase in ESRD form submission errors because of COVID. The result is missed premiums for Medicare Advantage plans that manage members with ESRD.
Discovery takes an innovative approach to ESRD validation, combining machine learning and human intervention to help our clients identify and restore premium dollars for this costly care.
Innovations in AI and machine learning unlock opportunities to eliminate waste, reduce costs, and make healthcare more affordable. Discovery offers the best of both machine power and human power to help MA 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 challenges it brings for health plans.
The Q4 2020 Accountability in Action award goes to Tonya Mondelli, in recognition of her accomplishments as technical project manager.
With the long-standing impact the pandemic has made on the entire healthcare ecosystem, Discovery is keeping a close eye on payment integrity market trends to help customers drive efficiencies and manage costs in 2021.
This blog offers thoughts from Discovery’s VP of Human Resources about creating a culture of accountability and leadership development.
2021 will bring significant changes that will affect Medicare Advantage plans and their members.
This blog explains the challenges with Medicare Secondary Payer and End-Stage Renal Disease and illustrates the value of premium restoration for health plans.
Justin DeMoss, Discovery’s most recent Accountability in Action award winner, is recognized for his work on the company’s ReThink platform
Answers to some of the common questions we get from health plans as they look to build or expand data mining capabilities for their organizations.
Three innovative ideas to help healthcare leaders improve productivity and support their employees during the pandemic and beyond.
Provider-sponsored health plans (PSHPs), many of which are part of integrated delivery systems, are experiencing some unique challenges due to the pandemic.
The old tried and true approach to coordination of benefits isn’t enough anymore. Discovery’s COB solution blends the right people, processes, and technology allowing our team and clients to work smarter rather than harder.
How healthcare leaders should think and act differently as the pandemic, the political environment, and social unrest continue to change the healthcare industry.
Despite the limitations the pandemic brings to Halloween this year, Discovery remains committed to celebrating it’s employees.
Despite the pandemic, hackers are busy stealing patient and personal data. Here’s a summary of recent cybersecurity breaches and tips for staying cybersecure.
Learn about the future of healthcare, “covidomics,” and recent trends with health policy analyst Susan Dentzer.
Displaying accountability in her work, Irena Trajkovski, senior technical project manager at Discovery, is a winner of this quarter’s Accountability in Action award.
Discovery’s Accountability in Action award recognizes employees who go above and beyond to contribute to key results. This quarter’s award recipient is Christine Garcia, Senior Director of Shared Services and Quality Management.
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.
Discovery addresses some of the frequently asked questions regarding End-Stage Renal Disease (ESRD) and explains how ESRD validation works.
Discovery addresses some of the frequently asked questions around Medicare Secondary Payer (MSP) validation and explains how Medicare Advantage plans can ensure accurate premiums from CMS.
Research shows that the vast majority of medical bills contain errors—health plans can use DRG validation audits to improve the accuracy and validity of claims payments.
Telehealth has become a lifeline during the pandemic, but the potential for improper coding and documentation is high. Health plans are wise to include telehealth claims in their clinical audit programs.
Our Medical Director discusses the role physician oversight plays in conducting medically sound audits that reduce provider abrasion and ensure defensible recoveries.
As we meet with health plans across the country, we get asked about the COB process, vendor selection, and working with internal COB teams. We share some common questions and answers.
Discovery is helping health plans transition to a more proactive, data-driven payment integrity approach.
Transparent communication and education are key to positively impacting the provider experience during clinical audits.
Discovery’s accountability culture motivates employees to work at a higher level for their own success and help the company achieve its key results. The Accountability in Action award has been given to Beverly Orwig, MSP Recovery Specialist.
Discovery Health Partners celebrates National Subro Professionals’ Dy by highlighting subrogation experts who make a difference in delivering client value.
In celebration of National Subro Professionals’ Day, we spotlight Subrogation Team Lead Lisa Baldwin and hear why Subro is a perfect professional fit for her.