Dual Eligibles
Although beneficiaries who qualify for both Medicare and Medicaid benefits are a small percentage of your health plan’s member base, they consume a disproportionately high percentage of program costs – and coordinating payments between the two programs can be a challenge.
HealthEdge® dual eligibles solutions can help your health plans provide high-quality care to Dual-Eligibles members at every stage and deliver positive health outcomes while keeping costs low. Our integrated dual eligibles solution suite enhances claims processing with payment integrity and feeds data to an end-to-end care management solution. Together, these solutions enable regulatory compliance, lower administrative costs, higher-quality care, and improved patient outcomes.
FAQ
What are the characteristics of a dual eligible beneficiary?
Dual-eligible beneficiaries are individuals who receive both Medicare and Medicaid benefits. The two programs cover many of the same services, but Medicare pays first for the Medicare-covered services that are also covered by Medicaid. Medicaid covers services that Medicare does not cover.