Performant Announces Recently Launched Medicare Advantage Offering Exceeds Four Million Contracted Lives
October 23 2020 - 8:00AM
Business Wire
Performant Financial Corporation (Nasdaq:PFMT), (“the Company”),
a provider of technology-enabled recovery and related analytics
services, today announced that it has contracted over four million
lives for its recently launched Premium Accuracy offering, a
Medicare Secondary Payer (MSP) service for Medicare Advantage
Plans.
Medicare Advantage (MA) is the fastest-growing segment of
private Health insurance with 8% enrollment growth per year. When
MA enrollees have access to primary health coverage outside of
Medicare (such as an employer group health plan), the Centers for
Medicare and Medicaid Services (CMS) reduces the premium payment to
the MA Plan by 80% or more. Yet, industry data on such other
coverage is often inaccurate, causing CMS to record the member as
possessing other primary coverage, when that coverage may be
expired or might have never existed. As a result, MA Plans often
receive greatly reduced premium payments on members for whom they
are bearing the primary medical expense.
“Our Premium Accuracy offering is yet another example of
our aggressive expansion in the Healthcare space, and our drive to
be the leading Healthcare payment integrity provider,” stated
Simeon Kohl, Vice President and General Manager of Healthcare for
Performant. “The identification of other insurance coverage and the
application of primacy rules is complex, with large dollars at
risk. In fact, within the first two months of implementing a
national MA Plan, we successfully identified over $2M in premiums
to be restored. Payers are looking towards trusted partners, like
Performant, to ensure they are receiving the most accurate premiums
for their Medicare Advantage population.”
Through its new Premium Accuracy Offering, the Company leverages
its proprietary technology to identify these data inaccuracies and
then provides resolution through updating CMS records via its
proven workflows. For each correction affected by Performant, the
MA Plan can obtain restored premium payments for every month the
premium was incorrectly reduced.
In addition to restoring the premium payments, Performant’s
Premium Accuracy Offering is holistic and provides detailed
reporting data that can improve multiple areas of MA plan
operations. These include, improved member management, expanded
coordination of benefits, improper payment collection and risk
factor analysis
“Unlike other vendors in the MA premium integrity market,
Performant evidences an exceptionally high level of partnership
with clients, providing full transparency into inventories and
pending cases. This data gives payers actionable insights across
their entire MA operation. Every payer plan is unique, and we
believe that collaborative partnerships are the right way to help
all of our stakeholders achieve their goals,” stated Aaron Seator,
Division Vice President TPL Services for Performant.
About Performant Financial Corporation
Performant helps government and commercial organizations enhance
revenue and contain costs by preventing, identifying and recovering
waste, improper payments and defaulted assets. Performant is a
leading provider of these services in several industries, including
healthcare, student loans and government. Performant has been
providing recovery audit services for over ten years to both
commercial and government clients, including serving as a Recovery
Auditor for the Centers for Medicare and Medicaid Services.
Powered by a proprietary analytic platform and workflow
technology, Performant also provides professional services related
to the recovery effort, including reporting capabilities, support
services, customer care and stakeholder training programs meant to
mitigate future instances of improper payments. Founded in 1976,
Performant is headquartered in Livermore, California.
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Richard Zubek Investor Relations 925-960-4988
investors@performantcorp.com
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