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Medicare Advantage Analyzer software is an advanced solution designed to identify Medicare Advantage patients, addressing a critical factor in appeals involving both the SSI (Supplemental Security Income) percentage and the Medicaid fraction. By accurately distinguishing Medicare Advantage patients within hospital data, this software supports precise calculation adjustments essential for compliance and maximizing Medicare reimbursement.

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In the event that the Allina case ruling is upheld, the Medicare Advantage Analyzer will automatically adjust calculations to exclude Medicare Advantage patients from the SSI percentage, aligning with regulatory requirements. Additionally, it will include Medicare Advantage patients who are also Medicaid-eligible in the numerator of the Medicaid fraction, ensuring accurate representation and optimized reimbursement for hospitals. This powerful tool provides hospitals with a streamlined, compliant approach to handling complex Medicare Advantage criteria within their reporting and appeals processes.

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