BLOGS. March 19, 2025
Operational Strategies for Successful D-SNPs – Claims and Benefits
This is the second installment of our 3-part blog series discussing challenges and opportunities for health plans to administer Dual Special Needs Plans (D-SNPs), which are an emphasis for both the Centers for Medicare and Medicaid Services (CMS) and individual states. Part 2 of our series dives into the process of claims and benefit adjudication—the importance of coordination between Medicare and Medicaid, which affects benefit packages, integration of services, pricing, encounter reporting and which CMS D-SNP model a plan offers for this unique population.
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