We specialize in providing specialized risk management solutions for health plans, ensuring their success in today’s dynamic healthcare landscape. Our comprehensive services encompass various areas, including:
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Star Rating: We help health plans improve their Star Ratings by implementing strategies and interventions that enhance overall quality and performance.
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HEDIS (Healthcare Effectiveness Data and Information Set): Our team is well-versed in HEDIS measures and works closely with health plans to ensure compliance and accurate reporting.
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MRA (Medicare Risk Adjustment): We assist health plans in optimizing their Medicare Risk Adjustment processes, ensuring accurate and complete documentation for proper reimbursement.
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Complete and Accurate Documentation: We emphasize the importance of thorough and precise documentation, helping health plans maintain compliance and avoid potential audit risks.
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HIPAA (Health Insurance Portability and Accountability Act of 1996): We ensure that health plans adhere to HIPAA regulations, safeguarding the privacy and security of sensitive patient information.
Health Plan Integration and Collaboration
We understand that seamless integration and collaboration are crucial for health plan success. Regardless of the systems employed by the health plan, we dynamically integrate our delivery infrastructure to improve end customer satisfaction and outcomes through our care programs and preventive management.
Our dedicated team goes beyond the scope of provider relations and case management, ensuring that the cycle of care is complete for the health plan. This approach guarantees the long-term viability of products for the health plan and the well-being of healthcare beneficiaries.
With over 20 years of experience in Medicare, Medicaid, and commercial insurance risk management, we have the expertise to support your health plan’s unique needs. Let our experience work for you and help you achieve your goals.
Want to Know More?
Contact us today to learn more about our specialized risk management solutions for health plans. We are here to answer any questions you may have and provide personalized guidance tailored to your specific requirements.
If you prefer to send us a letter describing the needs of your healthcare plan, you can easily upload a document directly to us via our secure upload page. We prioritize the security and confidentiality of your information.