Medicare Advantage

More than a third of Medicare beneficiaries are enrolled in Medicare Advantage plans. As Medicare Advantage enrollments continue to grow, providers face increasing revenue cycle complexity when coordinating benefits between Medicare and those commercial payers providing Medicare Advantage Plans.

Medicare beneficiaries have more choice than ever before when it comes to selecting a Medicare Advantage plan. Providers must navigate new hurdles that may vary by Advantage plan in order to get paid.

With the powerful combo of our eligibility and claims processing tools, you can submit, track and manage your Medicare Advantage claims for quick, accurate reimbursement. 

Using eSolutions to process Medicare Advantage claims, providers can:

  • Identify claims submitted to original Medicare that have been denied or rejected because the beneficiary has enrolled in an Advantage plan

  • Identify the status of “No Bill” claims submitted to Medicare related to Advantage plans

  • Automatically submit an eligibility inquiry to the Advantage plan when a Medicare eligibility response indicates a patient has an Advantage plan

  • Recertify a patient’s Medicare or Medicare Advantage eligibility during the Open Enrollment period

  • Manage claim and remittance advice data for all of your payers in one interface

  • Ensure accurate billing to each of your Medicare Advantage payers with payer-specific scrubber edits 

Eliminate the complexity of billing Medicare Advantage plans


Cut through the daily complexities so you can grow and improve your business.