Premium Restoration

Restore and protect your premium dollars

Get in touch

Add 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

Infographic

Medicare Secondary Payer (MSP) validation and restoration

We’ve worked with over fifty MA plans to get the most updated status on their members and restore underpaid CMS premiums. In every case, we recovered more than the plan could on their own. Click to see examples of the millions in savings that you could be adding to your bottom line.

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.

Solution overview brochure

 

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.

Solution overview brochure

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

Contact us today for more information on accelerating your payment integrity results

Get in touch
Discovery Health PartnersPremium Restoration