Medicare Advantage plans like yours could be missing millions in CMS premiums for members with end-stage renal disease (ESRD). Representing a small percentage of MA plan membership, members with ESRD account for a disproportionate amount of medical expenses. It’s critical for your plan to secure correct premiums to cover the cost of care for these members.

ESRD by the numbers

Our solution

Discovery Health Partners’ ESRD Premium Restoration solution helps Medicare Advantage plans find and restore additional premiums from CMS for members with missing ESRD diagnoses.

Following your team’s efforts, we use advanced data integration and analytic methods to search multiple data sources for additional missed diagnoses. We identify premiums that have been underpaid to your plan, work through third-party service providers to correct ESRD-related patient information, and assist in the recoupment of premium payments from CMS.

  • Restore millions in underpaid ESRD premiums
  • Secure accurate premium payments going forward
  • Enjoy our no-risk contingency fee model

Our difference

  • We’re the leader in ESRD premium restoration services—already serving many Medicare Advantage plans since launching the solution
  • Discovery uses precise data mining that is designed specifically for surfacing ESRD premium restoration opportunities. Our solution scans hundreds of thousands of claims and MMR records to surface every opportunity
  • Our experienced outreach team successfully remediates underpaid premiums with dialysis centers

Our technology

HIPAA compliant

Advanced analytics

Industry-leading security

Insightful reporting

Cloud-based platform

Automated workflow

Learn more

Underpaid premiums for ESRD members have a major impact on Medicare Advantage financials. This infographic shows why MA plans are underpaid and how Discovery helps restore underpaid premiums.

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.

To help Medicare Advantage plans find and restore premiums they have not received for members with ESRD, Discovery offers our ESRD Premium Restoration solution.

By our estimation, underpaid premiums for members with ESRD cost Medicare Advantage plans $600 million. Watch this webinar to learn how you can restore premiums up to $7k per month for members with ESRD.

Discovery Health PartnersESRD Premium Restoration