Restoring Medicare premium revenue during COVID-19
Discover the reasons why Medicare Advantage plans might be losing millions in Medicare premium revenue and what you can do to ensure premium integrity.
Read MoreAdd millions to your bottom line
A key factor in successfully managing Medicare Advantage plans is ensuring you receive accurate premium payments from the Centers for Medicare and Medicaid (CMS). However, ongoing inaccuracies with member eligibility information and disease status markers mean that many health plans don’t get the dollars they’re owed.
As your premium restoration partner, Discovery Health Partners can help you restore and protect the premiums you deserve. Whether optimizing Medicare Advantage revenue or proactively managing disease statuses, we ease the administrative burden of finding errors and making corrections—improving your efficiency and productivity and ultimately restoring millions of additional premium dollars for your plan.
The latest in Premium Restoration
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Restoring Medicare premium revenue during COVID-19
Discovery Health Partners can strengthen your premium integrity efforts by taking a closer look at Medicare Secondary Payer (MSP) validation and members with end-stage renal disease (ESRD). Find out what your Medicare Advantage plan can do to maximize its financial performance amid COVD-19.
Ways we help
Data analytics
Unlock the hidden value in your data and collect the full value of premiums owed to you for managing MA members
Expert process
Achieve clarity, consistency, and improved results with best practices and highly skilled staff to guide you through every step of the restoration process
Improved efficiencies
Reduce the time spent identifying root causes and recovering claims with ongoing support to ensure you continue to receive correct premiums
Our Premium Restoration solutions
Medicare Secondary Payer Validation
Could millions of dollars be hiding in your MSP validation process? On average, 4% of Medicare Advantage members have open MSP records and 50% of those records have premium restoration potential. Our MSP Validation and Premium Restoration solution quickly and accurately validates MSP records, corrects inaccuracies, and restores millions in underpaid premium dollars.
ESRD Premium Restoration
Members with end-stage renal disease (ESRD) account for a disproportionate amount of medical expenses. Without a plan to identify these members, your Medicare Advantage plan could be missing out on millions in additional premium dollars CMS should be paying for your members with ESRD. Our ESRD Premium Restoration solution helps identify members with missing ESRD statuses and restores millions in underpaid ESRD premiums.
Medicare Advantage plans leverage Discovery’s expertise in Premium Restoration to supplement their internal premium reconciliation efforts.
Why Discovery?
Proprietary analytics and data modeling
help identify members with the greatest propensity for inaccuracy and premium restoration potential
Our positive relationship with CMS
helps resolve errors and inaccuracies quickly and painlessly using their tools and processes
Close monitoring of membership and CMS data
offers visibility into premium restorations and the CMS submission and acceptance process
A complete electronic audit trail
of every completed validation and restored premium simplifies compliance and record tracking
Related resources
Transitioning toward data-driven payment integrity solutions
Hear Vice President Subrahmanyam Mantha explain how Discovery is helping health plans transition to a more proactive, data-driven payment integrity approach.
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ESRD: Finding and restoring underpaid CMS premiums in five steps
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.
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Fixing payment integrity at the source
Find out how eligibility management plays a role in maximizing recovery opportunities, improving cost avoidance strategies, and creating premium restoration possibilities.
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Jason Brown on the road ahead for payment integrity
Health plans face increasing pressure to ensure payment integrity. Discovery CEO Jason Brown explains recent trends and how they’re shaping the new decade.
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A year in review: top blogs from 2019
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.
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It’s challenging to identify and restore underpaid ESRD premiums. Here’s how to solve that.
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.
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Infographic: ESRD has a major impact on Medicare Advantage financials
MA plans are challenged with receiving the correct premiums from CMS for members with ESRD. View this infographic to learn more.
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Why Medicare Advantage plans may be losing money on members with ESRD
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.
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Webinar: Restoring underpaid CMS premiums for members with ESRD
The process of identifying and restoring underpaid ESRD premiums is time-consuming and complex. This can stand in the way of maximizing the premiums you deserve for your membership with ESRD. View this on-demand webinar to learn more.
Read MoreContact us today for more information on accelerating your payment integrity results
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