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Medicare Advantage Underpayment Recoveries

MCare provides Transfer DRG Reimbursement Recovery Services for Medicare Advantage accounts. 

Nationally, Medicare Advantage enrollment is 22.5% of total Medicare enrollment and there are 562 total Medicare Advantage contracts nationwide.  Consequently, determining reimbursement for Medicare Advantage accounts is much like finding an even smaller needle in an even bigger haystack than Medicare fee-for-service claims. 

Medicare Advantage payers typically require a hard copy submission for each claim that is to be adjusted.  MCare has worked out specific guidelines and processes to allow the more laborious nature of these submissions to become as streamlined as possible.  While the submission of hard copy claims does take a bit longer, MCare submits hard copy claims and performs all re-billing and follow-up services on behalf of client hospitals.

MCare has found that the underpayment recoveries that a hospital receives when we provide transfer DRG reimbursement recovery services for Medicare Advantage claims more than compensates for MCare contingency fees associated with the Medicare fee-for-service claims services.