Revenue Realization®

Medicare Revenue Realization® is a service to assist Plans in using MMC best-in-class software to identify and submit for underpayments for MA and Part D members. MMC provides gap analyses, operational training and assistance, policy and procedure creation, and support to set up and manage reconciliation departments.

MMC Revenue Realization services combine proven process innovation, data analysis and technology to identify payment errors and secure correct payments for MA and Part D members. Our approach, which applies best practice innovation and software to address all aspects of Plan payment from CMS, reduces missed opportunities due to undiscovered errors, poor documentation, or late notification to CMS. Prompt research and resolution allows Plans to recover payments retroactively, while increasing on-going (PMPM) revenue.