Here are some little known facts-the government pays commercial health insurance companies nearly $200 billion a year to provide medicare benefits to the 20 million people enrolled in medicare advantage plans. These advantage plans have an incentive to spend as little as possible on their members as what they don’t spend they get to keep. Could this be related to the increasing number of denials from medicare advantage plans?? Surely I am not suggesting a large for profit corporation would have anything but the member’s best interest at heart! Also, these plans often operate in a ” cloud of secrecy” making it difficult for CMS to accurately detect improper payments- but a rough estimate is 20 billion annually. It usually takes a whistleblower working at one of these companies to expose the fraud- meet said whistleblower.


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