Accessibility Statement Skip Navigation
  • Why PRWeb
  • How It Works
  • Who Uses It
  • Pricing
  • Login
  • GDPR
  • Create a Free Account
Return to PRWeb homepage
  • News
  • Resources
  • Contact
When typing in this field, a list of search results will appear and be automatically updated as you type.

Searching for your content...

No results found. Please change your search terms and try again.
  • News in Focus
      • Browse News Releases

      • All News Releases
      • Multimedia Gallery

      • All Multimedia
      • All Photos
      • All Videos
  • Business & Money
      • Auto & Transportation

      • Aerospace, Defense
      • Air Freight
      • Airlines & Aviation
      • Automotive
      • Maritime & Shipbuilding
      • Railroads and Intermodal Transportation
      • Supply Chain/Logistics
      • Transportation, Trucking & Railroad
      • Travel
      • Trucking and Road Transportation
      • View All Auto & Transportation

      • Business Technology

      • Blockchain
      • Broadcast Tech
      • Computer & Electronics
      • Computer Hardware
      • Computer Software
      • Data Analytics
      • Electronic Commerce
      • Electronic Components
      • Electronic Design Automation
      • Financial Technology
      • High Tech Security
      • Internet Technology
      • Nanotechnology
      • Networks
      • Peripherals
      • Semiconductors
      • View All Business Technology

      • Entertain­ment & Media

      • Advertising
      • Art
      • Books
      • Entertainment
      • Film and Motion Picture
      • Magazines
      • Music
      • Publishing & Information Services
      • Radio & Podcast
      • Television
      • View All Entertain­ment & Media

      • Financial Services & Investing

      • Accounting News & Issues
      • Acquisitions, Mergers and Takeovers
      • Banking & Financial Services
      • Bankruptcy
      • Bond & Stock Ratings
      • Conference Call Announcements
      • Contracts
      • Cryptocurrency
      • Dividends
      • Earnings
      • Earnings Forecasts & Projections
      • Financing Agreements
      • Insurance
      • Investments Opinions
      • Joint Ventures
      • Mutual Funds
      • Private Placement
      • Real Estate
      • Restructuring & Recapitalization
      • Sales Reports
      • Shareholder Activism
      • Shareholder Meetings
      • Stock Offering
      • Stock Split
      • Venture Capital
      • View All Financial Services & Investing

      • General Business

      • Awards
      • Commercial Real Estate
      • Corporate Expansion
      • Earnings
      • Environmental, Social and Governance (ESG)
      • Human Resource & Workforce Management
      • Licensing
      • New Products & Services
      • Obituaries
      • Outsourcing Businesses
      • Overseas Real Estate (non-US)
      • Personnel Announcements
      • Real Estate Transactions
      • Residential Real Estate
      • Small Business Services
      • Socially Responsible Investing
      • Surveys, Polls and Research
      • Trade Show News
      • View All General Business

  • Science & Tech
      • Consumer Technology

      • Artificial Intelligence
      • Blockchain
      • Cloud Computing/Internet of Things
      • Computer Electronics
      • Computer Hardware
      • Computer Software
      • Consumer Electronics
      • Cryptocurrency
      • Data Analytics
      • Electronic Commerce
      • Electronic Gaming
      • Financial Technology
      • Mobile Entertainment
      • Multimedia & Internet
      • Peripherals
      • Social Media
      • STEM (Science, Tech, Engineering, Math)
      • Supply Chain/Logistics
      • Wireless Communications
      • View All Consumer Technology

      • Energy & Natural Resources

      • Alternative Energies
      • Chemical
      • Electrical Utilities
      • Gas
      • General Manufacturing
      • Mining
      • Mining & Metals
      • Oil & Energy
      • Oil and Gas Discoveries
      • Utilities
      • Water Utilities
      • View All Energy & Natural Resources

      • Environ­ment

      • Conservation & Recycling
      • Environmental Issues
      • Environmental Policy
      • Environmental Products & Services
      • Green Technology
      • Natural Disasters
      • View All Environ­ment

      • Heavy Industry & Manufacturing

      • Aerospace & Defense
      • Agriculture
      • Chemical
      • Construction & Building
      • General Manufacturing
      • HVAC (Heating, Ventilation and Air-Conditioning)
      • Machinery
      • Machine Tools, Metalworking and Metallurgy
      • Mining
      • Mining & Metals
      • Paper, Forest Products & Containers
      • Precious Metals
      • Textiles
      • Tobacco
      • View All Heavy Industry & Manufacturing

      • Telecomm­unications

      • Carriers and Services
      • Mobile Entertainment
      • Networks
      • Peripherals
      • Telecommunications Equipment
      • Telecommunications Industry
      • VoIP (Voice over Internet Protocol)
      • Wireless Communications
      • View All Telecomm­unications

  • Lifestyle & Health
      • Consumer Products & Retail

      • Animals & Pets
      • Beers, Wines and Spirits
      • Beverages
      • Bridal Services
      • Cannabis
      • Cosmetics and Personal Care
      • Fashion
      • Food & Beverages
      • Furniture and Furnishings
      • Home Improvement
      • Household, Consumer & Cosmetics
      • Household Products
      • Jewelry
      • Non-Alcoholic Beverages
      • Office Products
      • Organic Food
      • Product Recalls
      • Restaurants
      • Retail
      • Supermarkets
      • Toys
      • View All Consumer Products & Retail

      • Entertain­ment & Media

      • Advertising
      • Art
      • Books
      • Entertainment
      • Film and Motion Picture
      • Magazines
      • Music
      • Publishing & Information Services
      • Radio & Podcast
      • Television
      • View All Entertain­ment & Media

      • Health

      • Biometrics
      • Biotechnology
      • Clinical Trials & Medical Discoveries
      • Dentistry
      • FDA Approval
      • Fitness/Wellness
      • Health Care & Hospitals
      • Health Insurance
      • Infection Control
      • International Medical Approval
      • Medical Equipment
      • Medical Pharmaceuticals
      • Mental Health
      • Pharmaceuticals
      • Supplementary Medicine
      • View All Health

      • Sports

      • General Sports
      • Outdoors, Camping & Hiking
      • Sporting Events
      • Sports Equipment & Accessories
      • View All Sports

      • Travel

      • Amusement Parks and Tourist Attractions
      • Gambling & Casinos
      • Hotels and Resorts
      • Leisure & Tourism
      • Outdoors, Camping & Hiking
      • Passenger Aviation
      • Travel Industry
      • View All Travel

  • Policy & Public Interest
      • Policy & Public Interest

      • Advocacy Group Opinion
      • Animal Welfare
      • Congressional & Presidential Campaigns
      • Corporate Social Responsibility
      • Domestic Policy
      • Economic News, Trends, Analysis
      • Education
      • Environmental
      • European Government
      • FDA Approval
      • Federal and State Legislation
      • Federal Executive Branch & Agency
      • Foreign Policy & International Affairs
      • Homeland Security
      • Labor & Union
      • Legal Issues
      • Natural Disasters
      • Not For Profit
      • Patent Law
      • Public Safety
      • Trade Policy
      • U.S. State Policy
      • View All Policy & Public Interest

  • People & Culture
      • People & Culture

      • Aboriginal, First Nations & Native American
      • African American
      • Asian American
      • Children
      • Diversity, Equity & Inclusion
      • Hispanic
      • Lesbian, Gay & Bisexual
      • Men's Interest
      • People with Disabilities
      • Religion
      • Senior Citizens
      • Veterans
      • Women
      • View All People & Culture

  • Hamburger menu
  • Cision PRWeb provides efficient communication tools to continuously engage with target audiences across multiple online channels
  • Create a Free Account
    • ALL CONTACT INFO
    • Contact Us


      11AM ET Sunday – 8PM ET Friday

  • Send a Release
  • Sign up
  • Log in
  • Resources
  • RSS
  • GDPR
  • News in Focus
    • Browse All News
    • Multimedia Gallery
  • Business & Money
    • Auto & Transportation
    • Business Technology
    • Entertain­ment & Media
    • Financial Services & Investing
    • General Business
  • Science & Tech
    • Consumer Technology
    • Energy & Natural Resources
    • Environ­ment
    • Heavy Industry & Manufacturing
    • Telecomm­unications
  • Lifestyle & Health
    • Consumer Products & Retail
    • Entertain­ment & Media
    • Health
    • Sports
    • Travel
  • Policy & Public Interest
  • People & Culture
    • People & Culture
  • Send a Release
  • Sign up
  • Log in
  • Resources
  • RSS
  • GDPR
  • Send a Release
  • Sign up
  • Log in
  • Resources
  • RSS
  • GDPR
  • Send a Release
  • Sign up
  • Log in
  • Resources
  • RSS
  • GDPR

Discovery Health Partners delivers significant ROI to health plan clients using Premium Restoration solutions

Flexible approach, ongoing investments in analytics, and deep relationship with CMS drive tremendous results


News provided by

Discovery Health Partners

Feb 26, 2021, 08:00 ET

Share this article

Share toX

Share this article

Share toX

Discovery ESRD Premium Restoration
Discovery ESRD Premium Restoration

ITASCA, Ill., Feb. 26, 2021 /PRNewswire-PRWeb/ -- Discovery Health Partners announces it recently restored over $61 million in underpaid CMS premiums for a regional Blue Cross and Blue Shield health plan client with 36,000 Medicare Advantage members. The market leader in the premium restoration space, Discovery offers a robust and growing Premium Restoration solution set—including Medicare Secondary Payer (MSP) Validation, End-Stage Renal Disease (ESRD) Premium Restoration, and Part D OHI services—that has delivered large, quick, ongoing ROI to more than half of the Medicare Advantage plans across the U.S.        

"Many plans don't realize how much revenue they lose in underpaid premiums," said Jeff Martin, Discovery's VP of Payment Integrity Operations. "Because CMS allows plans to look back 7 years to determine if premiums were underpaid, that can add up to a significant amount of dollars coming back to the health plan. With our combination of advanced analytics, relationships with dialysis clinics and other ESRD care providers, and deep expertise working with CMS, Discovery can deliver tremendous premium restoration results that health plans alone can't achieve."

"With our combination of advanced analytics, relationships with dialysis clinics and other ESRD care providers, and deep expertise working with CMS, Discovery can deliver tremendous premium restoration results that health plans alone can’t achieve.”

Post this

Discovery's Premium Restoration services require very little data lift from health plans, are offered with no-risk contingency pricing, and can be implemented in less than 90 days to deliver value back very quickly to the health plan. In one case, a 1M+ member national health plan with an extensive inhouse team chose Discovery to supplement their MSP operations; working behind the internal team, Discovery was able to restore $36 million in premiums in the first year of the engagement.

Another national health plan outsourced their entire MSP operations to Discovery; to date, Discovery has restored over $137 million on behalf of this client.

MA plans are also experiencing significant value from Discovery's recently launched ESRD solution. Incorrect premium adjustments for Medicare Advantage members with ESRD are common due to the complexity of the process. Discovery's analytics engine accurately finds "needle in the haystack" records for members with ESRD for which the plan is not receiving a higher premium and then works with ESRD care providers and Centers for Medicare and Medicaid Services (CMS) to correct those members' records and restore the additional premium dollars back to the health plan. Discovery has helped over 30 Medicare Advantage plans restore millions in ESRD premiums—a 165,000-member Medicare Advantage plan recovered $8.4 million in underpaid premiums; a 230,000-MA member plan saw $5.9 million in restored premiums; and a 100,000-member Medicare Advantage plan restored $6.5 million in premiums all in the first 18 months of starting the program.

As part of Discovery's Premium Restoration services, Discovery performs over 15,000 updates to CMS' records every year to correct member eligibility information, resulting in accurate premium payments to health plans. To date, Discovery has completed over 500,000 MSP validations on behalf of its health payer clients.

Ensuring accurate premium payments from CMS continues to plague healthcare payers; innovations from Discovery are easing the administrative burden for its payer customers and driving bottom-line value.

For more information on the value of premium restoration for health plans, see Discovery's blog post Success with MSP and ESRD Premium Restoration.

About Discovery Health Partners
Discovery Health Partners' mission is to deliver unique, actionable analytic insights and technology-powered solutions to help healthcare payers improve payment integrity, increase revenue optimization, and maximize efficiencies. Serving more than 80 health plans across the U.S., including nine of the 10 largest U.S. health plans, Discovery has been recognized consistently for its growth and innovation—earning a spot on the Inc. 5000 list seven years in a row, the Crain's Fast 50 four times, and a prestigious FutureEdge 50 Award from IDG for innovations in machine learning. For more information on Discovery Health Partners, please visit http://www.DiscoveryHealthPartners.com.

Media Contact

Mary Dalton, Discovery Health Partners, 224-214-4429, [email protected]

SOURCE Discovery Health Partners

Related Links

http://www.DiscoveryHealthPartners.com

Modal title

Contact PRWeb

  • 11AM ET Sunday – 8PM ET Friday
  • Contact Us

About PRWeb

  • About PRWeb
  • Partners
  • Partnership Programs
  • Editorial Guidelines
  • Resources

Why PRWeb

  • Why PRWeb
  • How It Works
  • Who Uses It
  • Pricing

Accounts

  • Create a Free Account
  • Log in
  • Contact Us

Do not sell or share my personal information:

  • Submit via [email protected] 
  • Call Privacy toll-free: 877-297-8921

Contact Cision

Products

About

My Services
  • All News Releases
  • Online Member Center
  • ProfNet
Cision Distribution Helpline
888-776-0942
  • Legal
  • Site Map
  • RSS
  • Cookie Settings
Copyright © 2025 Cision US Inc.