Health Plan Services

MRA (Medicare Risk Adjustment).

Full cycle encounter process enhancement to ensure complete and accurate documentation.

TPA (Third Party Administrator) Services and claim re-pricing.

Medical coding and Quality Reporting Initiative education.

Provider/Physician office recurring educational in-services.

Care Coordination, Authorization, Notification and Referrals.

Call / Data Center.

Securing the best possible risk arrangements with payors.

Increase a provider’s population, through intense marketing and financial support.

Consistent monitoring of all payor capitation contracts.

Financially optimizing the payor contracts by sub-contracting high cost level health services.

Ceding risk with outside financial partners.

Covering liability issues on a group basis to reduce the financial liability to the individual provider.

Provide technology support to the provider’s offices.