Recap: Premium restoration webinar’s biggest takeaways
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.
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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
eBook
Restoring millions for your Medicare Advantage plan
Correctly paid Medicare Advantage premiums are a critical source of revenue for many health plans. Incorrectly paid premiums can result in millions of dollars in lost revenue. Download our eBook to find out how you can take charge of your premium revenue.
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
Webinar: Market forces impacting Medicare Advantage plans + why premium restoration is essential
View our on-demand webinar to learn about major Medicare Advantage market factors and why your health plan needs an iron-clad premium restoration strategy.
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COVID’s effect on ESRD premiums
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.
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The value of machine learning in the ESRD Premium Restoration process
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.
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New technologies drive Premium Restoration innovation
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.
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Discovery Health Partners delivers significant ROI to health plan clients using Premium Restoration solutions
Discovery restored over $61M in underpaid CMS premiums for a regional Blue Cross Blue Shield health plan with 36,000 Medicare Advantage members. Discovery’s robust Premium Restoration solution set has delivered quick ROI to over half of the MA plans in the U.S.
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Premium restoration in an era of Medicare Advantage growth
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.
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Jason Brown on 2021 payment integrity market trends
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.
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MultiPlan to acquire Discovery
MultiPlan’s acquisition of Discovery will create a comprehensive and scalable platform for healthcare payers seeking to improve the effectiveness and reach of their payment and revenue integrity programs.
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2021 to bring changes to Medicare Advantage plans
2021 will bring significant changes that will affect Medicare Advantage plans and their members.
Read MoreContact us today for more information on accelerating your payment integrity results
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