MA plans have adopted more restrictive criteria commonly used by commercial health insurance carriers, found consulting firm Crowe.

Medicare Advantage plans denying more inpatient claims

MA plans have adopted more restrictive criteria commonly used by commercial health insurance carriers, found consulting firm Crowe

Healthcare systems have found themselves in precarious financial standing due to a dramatic increase in the number of inpatient claims being denied by health insurers based on the lack of medical necessity, according to data collected by accounting and technology firm Crowe. These level-of-care reimbursement disputes are especially rising in frequency among Medicare Advantage plans. Read the full story by clicking the link below.

https://www.healthcarefinancenews.com/news/medicare-advantage-plans-denying-more-inpatient-claims

As always if you have any questions or concerns about Medicare health plans or this bulletin in particular, please reach out to your Total Benefit Solutions, Inc. Medicare health insurance specialists at (215)355-2121