by Danica Chapman | Sep 16, 2021 | Current Notes
Prevent fraud with our software from Ensure Data Solutions is perfect because Fraud in managed care programs increases costs for the government – sometimes substantially. As the amount of taxpayer money spent on managed care increases, so does the importance of...
by Danica Chapman | Aug 19, 2021 | Current Notes
Ensure Data Solutions always said that utilization has become a key factor when we talk about reducing cost of healthcare and prescription drug expenses is big part of it. Overutilization leads directly to higher health care costs. There are many reasons...
by Danica Chapman | Apr 30, 2021 | Current Notes
The greatest uncertainty is members’ health status, which could impact MA organizations’ bidding submission process for 2022. Fortunately, fully vaccinated members are likely to resume in-person care this year, which means MA plans can expect a more consistent...
by Danica Chapman | Mar 16, 2021 | Current Notes
Can a patient have and not have diabetes at the same time? According to private insurers participating in the Medicare Advantage program, the answer is yes. The data architecture of Medicare Advantage is vulnerable to fraud perpetrated by the Medicare Advantage...
by Danica Chapman | Mar 12, 2021 | Current Notes
Today, the Centers for Medicare & Medicaid Services announced the final list of participants approved to take part in CMS’ Emergency Triage, Treat, and Transport (ET3) Model, a payment model that aims to provide greater flexibility to ambulance care teams to...
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