Why You Shouldn’t Settle for Partial Duals
Josh Weisbrod from Network Health and Keslie Crichton and Sean Libby from BeneLynk join Eric to discuss opportunities and challenges in identifying and converting members to full dual status, including specific examples and an outlined roadmap into this additional revenue stream.
After listening to this episode, you will understand:
- Why identifying members as “full or partial” matters
- How much revenue you may be leaving on the table
- What components need to be in place to convert members
Josh Weisbrod, Vice President, Risk Adjustment, Network Health
Over 20 years of healthcare, health insurance, healthcare analytic and human service experience working with local and national companies, and state and federal agencies. Specializing in health plan operations and data analytics.
Sean Libby, President and Co-founder, Benelynk
Sean has worked at the intersection of managed care and government benefit programs for the past 19 years. Prior to BeneLynk, Sean served as the President of Freedom Disability and Alpha Disability, one of the nation’s largest Social Security Disability and Veterans Advocacy companies. Before that, Sean served as Vice President, Sales for SSC Disability, providing government program benefit services for Managed Care Organizations.
Keslie Crichton, Chief Revenue Officer, Benelynk
Keslie has over 25 years of comprehensive managed care and healthcare technology experience.Prior to Benelynk She spent 13 years as Vice President of Sales at Change Healthcare and its predecessor companies Altegra Health and Social Service Coordinators, helping plans improve risk-adjusted revenue and quality performance scores through dual enrollment and retention, as well as health education campaigns.
MSP – Medicare Savings Programs
ABD- Age Blind and Disabled
MAPP – Medicaid Purchase Plan
SSI – Supplemental Security Income
QMB – Qualified Medicare Beneficiary
SLMB – Specified Low-Income Medicare Beneficiary
QI-1 – Qualifying Individual
SNAP – Supplemental Nutrition Assistance Program
LIS – Low-Income Subsidy
SSA – Social Security Administration
CMS – Center for Medicare and Medicaid Services
MAO – Medicaid Add On
MA – Medicare Advantage
HCC – Hierarchical Condition Category
FPL – Federal Poverty Level
MAGI – Modified Adjusted Gross Income
PMPM – Per Member Per Month
HRA – Health Risk Assessment
D-SNPs – Dual Eligible Special Needs Plans
This Episode of Bright Spots in Healthcare is sponsored by BeneLynk
BeneLynk is arguably the most innovative Dual Advocacy organization in the country. Benelynk’s mission is to improve people’s lives and positively impact social determinants of health barriers by granting their healthcare partners the necessary information while providing healthcare consumers with the advocacy they deserve. They use innovative technology that enables their people to have a dynamic conversation that flows organically to meet social determinants of health challenges and, as such, can build stronger human connections. This carefully planned combination generates exceptional results. Visit their website at www.benelynk.com