Go Back

Insurance Companies Must Not Take Shortcuts with Medicare Advantage Record Keeping

Medicare Advantage has allegedly overcharged Medicare by $1,000 per policyholder. Melanie Musson, an insurance expert with ExpertInsuranceReviews.com, says, “Medicare Advantage insurance providers must prepare to justify their charges by keeping accurate records and documentation.”

Medicare Advantage plans are increasing in popularity, but this private insurance alternative to government-run Original Medicare must be careful to be transparent or keep accurate records, or they’ll pay the price.

Kaiser Health News recently reported on a trend of Medicare Advantage providers dodging auditors and overcharging taxpayers through billing Medicare.

Medicare Advantage Audit Failures Are Nothing New

In 2011, Blue Cross of Minnesota couldn’t locate records of podiatry patients who were treated at a podiatry clinic accepting Medicare. Federal audits revealed a combined care cost that exceeded $20,000. Due to circumstances surrounding that case and the podiatry clinic facing fraud allegations, the insurance provider was granted a hardship exemption.

But as demands for transparency increase, these exemptions may be harder to obtain, making it vitally important for Medicare Advantage providers to keep their own records and not depend on healthcare providers to give them documentation if needed for an audit.

The Cost of Medicare Advantage Failures

Medicare Advantage plans charge policyholders a premium, and they work with Medicare for payment for Medicare-covered services. Federal audits revealed that Medicare Advantage plans had overcharged Medicare for services averaging $1,000 per Medicare Advantage policyholder.

That equates to millions of dollars overcharged to Medicare. Those costs are passed down to taxpayers.

Medicare Advantage Should Prepare for More Oversight

The federal government has been working to demand repayment for overcharges from Medicare Advantage plan providers. So, these providers must prepare to back up all their charges with the proper documentation to avoid additional repayments or penalties.

Car insurance providers proved their commitment to fair compensation by issuing auto insurance givebacks in the midst of COVID-19 shutdowns. Medicare Advantage providers should take note and prepare to pay back the federal government if necessary.

Whether or not Medicare Advantage actually overcharged Medicare and, thereby, American Taxpayers is a moot point. With proper documentation and record-keeping, insurance providers can prove the legitimacy of their charges.

Medicare Advantage providers must resist the urge to save money by cutting corners and must instead keep organized records and follow the governmental red tape associated with the medicare program.

By doing so, insurance providers can protect themselves and regain the trust of their policyholders and the American taxpayers.

Fields with ( * ) are required

To submit a comment, please provide your name and email or sign in at MarketScale.com

200

Recent Posts

ICOM at IWCE 2024: IP730 is the Solution to Scalable and Effective Communication Systems for Critical Services ICOM at IWCE 2024: IP730 is the Solution to Scalable and Effective Communication Systems for Critical Services Articles - Mar 28, 2024

At the International Wireless Communication Expo (IWCE) trade show in Orlando, the spotlight was on the latest advancements in communication technology, crucial for sectors like the military, emergency services, and public transportation. This event is a vital meeting point for professionals seeking innovative solutions to enhance their operational communication capabilities across vast distances.

Stepping into the Future at Shoptalk 2024: Creating a Flagship Brand Experience with APL Stepping into the Future at Shoptalk 2024: Creating a Flagship Brand Experience with APL Articles - Mar 28, 2024

The customers of today are no longer satisfied with mere products; they crave brands that provide immersive, distinctive, and tailored brand experiences.Athletic Propulsion Labs (APL) epitomizes this shift, setting a new standard in the luxury performance market with its innovative athletic footwear.

Routines, Rituals and a Mission-Driven Approach: MarketScale’s CRO Tim Maitland on Balancing Professional Growth and Personal Well-Being Routines, Rituals and a Mission-Driven Approach: MarketScale’s CRO Tim Maitland on Balancing Professional Growth and Personal Well-Being Articles - Mar 28, 2024

In a world that often demands the relentless pursuit of success, finding the sweet spot between professional growth and personal well-being can seem like an elusive goal. As we navigate the complexities of modern work-life dynamics, the conversation around maintaining this balance has become more pertinent than ever.

Register to MarketScale.com for Melanie Musson episodes, events, and more.


Already have an account?