Tag: Medicare Advantage Plan

Medical Coding Strategies to Prevent Payer Denials

As a former emergency department physician from the U.K., this individual was well aware of claim denials and rejections, with payers frequently withholding or reducing payments. However, it was only when his personal insurance company, denied his medical claim for a vitamin D test that he decided to delve deeper into the issue. He found […]
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The Medicare Advantage Bill Was Crafted In Response To Complaints

The bill was crafted partly in response to rising complaints among seniors over aggressive marketing practices for Medicare Advantage plans. U.S. Sens. Maggie Hassan, D-N.H., and Dr. Roger Marshall, R-Kansas, have introduced the bipartisan Medicare & You Handbook Improvement Act, which is meant to ensure that when seniors assess their Medicare coverage options, they have the necessary […]
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Key Advantages of Medicare Advantage Plans Versus FFS Medicare

Medicare Advantage plans draw a more diverse beneficiary population and can result in lower healthcare spending for low-income beneficiaries. Medicare Advantage plans may provide better access to care and lower healthcare spending for enrollees, compared to fee-for-service Medicare, according to a study from ATI Advisory conducted on behalf of Better Medicare Alliance (BMA). “Medicare Advantage […]
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Cyber Technology for Medicare Audits

This is what providers can expect in 2022 in the form of new technology audits. During 2022, healthcare providers will see more options to exploit cyber technologies designed to aid them in management of Medicare audits. Below we review the informational challenges of managing an audit, and then turn to the types of cyber solutions […]
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Providers Share Benefits of Medicare Advantage During COVID-19

Providers’ experiences with Medicare Advantage plans’ capitated payment models, supplemental benefits, and overall influence gave them recommendations for CMS. There has been a lot of valuable conversation around the benefits that Medicare Advantage health plans can offer to consumers, but now providers have offered their perspectives on this form of health insurance in Better Medicare […]
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Most Medicare beneficiaries don’t compare coverage options during open enrollment

Since not shopping around can have an impact on enrollees’ coverage and costs, CMS recommends they review and compare plans each year. The numbers are similar across both Medicare Advantage and traditional Medicare, with 68% of MA beneficiaries saying they don’t compare medical plans, and 73% of those in traditional Medicare claiming the same. The […]
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Medicare Advantage Plan Denials: Is That Convoluted or What?

Medicare Advantage Plan contracts are “take-it-or-leave-it” agreements Many questions are swirling about regarding Medicare Advantage Plan (MAP) denials asking what to do about the increasing number and given reasons.  I’ve heard or read some amazing stories where payers have gone to astounding lengths to deny claims.  Answers are also swirling about based on understandings of […]
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