Medicare Advantage Plans
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PremiumAssist Dual Eligibility - Outreach & Retention Services: 1)
inform Medicare Advantage plan members of potential eligibility for Medicare
Savings Programs, 2) help members with filing applications to determine
eligibility (and thereafter each year to ensure continued coverage), and 3)
enable participating plans to get a higher monthly capitation from the Centers
for Medicare and Medicaid Services (CMS).
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PremiumAssist Dual Eligibility - Documentation and Adjustment Services:
assure that our Medicare Advantage health plan clients receive the proper,
increased capitation for dual eligible plan members. Because there can be
frequent processing issues between state and federal agencies, disconnects
commonly result. Our service works to 1) identify these kinds of discrepancies
and then 2) provide all documentation that allows the plan to submit data to
receive reimbursement at the right payment level and get retrospective
adjustments.
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Part D Solutions: Human Arc introduces
Part D Solutions to help Medicare Advantage and prescription drug plans educate
members about their Medicare Part D benefits and explore potential eligibility
for subsidization to pay all or part of their Part D premium and related costs.
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"Serving the Dual Eligible Population"
is the timely presentation made by Human Arc Vice President of Business
Development, Jill Spencer, in February 2007 to attendees of the Medicare
Advantage Plans 101 and 102
conference hosted by Financial Research Associates, LLC, in Las Vegas, Nevada.
In her presentation, Ms. Spencer emphasizes the need for health plans to
establish strong communication initiatives focused on lower income members in
order to optimize operational success and member retention.
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"Building a Dual Special Needs Retention Strategy" is the
presentation delivered by
Human Arc Vice President of Business Development, Jill Spencer, in January 2008
to the Special Needs Plans (Maximizing Enrollment and Retention)
conference hosted by Financial Research Associates, LLC, in Atlanta, Georgia.
In her presentation, Ms. Spencer concentrates on three critical SNP success
strategies: well-planned member communications, dual re-determination support
and social outreach programs for members.
Medicaid Health Plans
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Best Benefits for the Aged, Blind and Disabled: helps Medicaid managed
care health plans to identify their members with disabilities and then gain the
disability approvals to which they are entitled. When done in those states in
which state governments pay higher capitation rates for the ABD populations,
this both increases payments to those members and increases capitation to the
health plans.
Relevant Links
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America's Health Insurance Plans : America's Health Insurance Plans is a
national association representing nearly 1,300 member entities that provide
health benefits to more than 200 million Americans. AHIP and its predecessor
organizations have advocated on behalf of health insurance plans for more than
six decades.
2008 Federal Poverty Level Guidelines
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2008 Federal Poverty Level calculations by family size, broken out into
annual, monthly and hourly terms, and also presented in multiplied form (120%,
135%, 150%, 200%, 250%, 300%, 350, 400%).
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