Discovery discusses how our client-centric approach to account management helps protect payment integrity.
Find out which four steps you can take to capture underpaid premiums and ensure accurate premium payments going forward for your Medicare Advantage members.
Find out how COVID-19 trends are impacting your plan’s payment integrity claims and operations
Discover the reasons why Medicare Advantage plans might be losing millions in Medicare premium revenue and what you can do to ensure premium integrity.
Learn work-from-home best practices from the Discovery team and how to stay connected amid COVID-19
Learn what you can do to ensure your Medicare Advantage plan doesn’t miss out on millions of premiums dollars from CMS for members with end-stage renal disease.
Find out how eligibility management plays a role in maximizing recovery opportunities, improving cost avoidance strategies, and creating premium restoration possibilities.
Health plans face increasing pressure to ensure payment integrity. Discovery CEO Jason Brown explains recent trends and how they’re shaping the new decade.
The new year is upon us and with it comes a new decade. Need to catch up on Discovery Health Partners happenings? Read highlights from our most popular blogs of 2019 to remind you what we’ve been up to all year.
Administrative complexity continues to drive the high level of waste in healthcare. Learn how to reduce improper payments with an optimized payment integrity approach that blends advanced analytics with human expertise.
Digital transformation is constantly evolving and reshaping healthcare. Learn why payers must adapt to the digital era to stay ahead of the competition.
Get insights and advice on recruiting and retaining top-tier subrogation talent, from finding and assessing candidates to training and rewarding employees.
Traditional COB processes are manual and error-prone. Learn how new technologies can help your plan transition from cost recovery to cost avoidance.
Ever feel like you’re living through “A Nightmare on Subro Street?” Healthcare subrogation can be terrifying! Health plans are “afraid…very afraid” of what high costs and low settlements do to their bottom line. Read our spooktacular blog post on turning your subro tricks into bottom-line treats.
Increase the effectiveness of your COB processes with data mining, business intelligence, and analytics.
Selecting the right Coordination of Benefits partner when you can’t afford to be wrong. Questions you need to ask.
Learn three ways Software-as-a-Service (SaaS) improves subrogation recovery.
Every year, plans lose out on millions in revenue due to underpaid ESRD premiums. A systematic process can help plans gain control of ESRD data and restore premium revenue.
CMS pays higher premiums to cover the higher costs of ESRD care. When these members are not correctly identified, plans can miss out on millions in revenue.
Three bad habits that help health payers identify, investigate, and settle healthcare subrogation cases faster and more accurately.
It can be the small, unintentional errors that expose valuable health data to data thieves. Holding your building door open for a delivery person with their hands full. Clicking on an urgent email request from a senior executive.
The future of healthcare coordination of benefits might not be as exciting as humans living on Mars or Oprah for president, but there are some interesting things happening in COB that are changing the way health plans approach this age-old process.
When selecting a COB vendor, health plans are most interested in partnering with experts whose solutions deliver considerable incremental recovery opportunities with minimal disruption to their existing operations. Read our blog to see the most common integration points of alignment between supplemental COB and health plans’ internal efforts.
Medicare Secondary Payer (MSP) is a multi-pronged issue for Medicare Advantage plans. If plans aren’t monitoring the effects of MSP on medical and pharmacy claims as well as premiums from CMS, they could be hurting their bottom line—to the tune of millions of dollars. MSP also introduces compliance responsibilities that plans must regard or else
Recent years have seen some health plans and subrogation vendors experiment with information technology and analytics to help improve the identification of claims with subrogation potential, reduce member abrasion across the subrogation process, and improve settlement rates.
What roles are necessary in your healthcare organization for successful application of your data analytics? Whatever the size, culture and maturity level of your company, I believe there are five key functions your organization needs to develop models that can help drive solutions to real-world problems.
The move to prepay cost avoidance requires a set of skills that health plans need to develop or acquire in order to be successful. These should be considered when calculating the cost.
A closer look at one of 2017’s top payment integrity trends. Health plans are making a concerted effort to focus more of their payment integrity resources on avoiding inaccurate claims payments up front, rather than recovering erroneous payments on the back end.
As cost reduction continues to take center stage, healthcare payment integrity is in the spotlight. Increasingly, health plan executives are recognizing the power of payment integrity functions to add significant value to a health plan’s bottom line by improving the plan’s ability to recover or avoid improper claims payments and improve accuracy of premium revenue.
Advances in data management, analytics, cloud-based software, and digital communications are causing some interesting trends to take shape in the healthcare COB world.
Though MA plans are on the task – attempting to find and correct errors in member eligibility and CMS premium payments – most are still missing millions of dollars due to hidden challenges in the process.
Maintaining a high level of customer service and solution quality is challenging in any industry. And because our customers are in the highly-regulated market of healthcare and health insurance products, the services and outcomes we provide are under almost as much scrutiny as the plans we serve.
This topic has been evolving for more than 10 years as litigation and case law have disputed over the issue of whether the private cause of action for double damages under the Medicare Secondary Payer (“MSP”) Act provides Medicare Advantage (“MA”) Plans with the right to bring suit against primary payers.