Navigating Medicare Advantage: How to optimize payments + claims

Christine Fontaine, Solution Strategist Waystar

As Medicare Advantage (MA) plans grow in popularity, so do the related challenges. Nearly two-thirds (62%) of health systems say Medicare Advantage is "significantly more difficult to work with" than commercial or Medicare plans due to unique clinical policies that create more denials and administrative work.

But there is a way to navigate Medicare Advantage plans successfully — if you create a tactical, proactive plan to submit cleaner claims and optimize revenue.

Join this session to unlock best practices for navigating the intricacies of Medicare Advantage. In just half an hour, learn how to leverage technology to simplify the process and:

• Improve payment accuracy
• Decrease denials that come from more restrictive coverage rules
• Gain full visibility into your revenue cycle
• Reduce administrative burden related to prior authorization and "shadow claims" for inpatient services provided to Medicare beneficiaries in an MA plan

We’ll also clear up the confusion between traditional Medicare, Medicare Advantage, and supplemental Medicare plans by exploring what's covered by each.

Who should join this session?
Practice managers, billing specialists, patient access teams, revenue cycle leaders, and healthcare administrators who want to enhance their MA claims processes and streamline patient entry.

Lower reimbursement linked to sagging margins, healthcare CFOs say. Healthcare Finance. 2024.