In-house Operations: Claims, Benefit Loads, Authorizations, Credentialing, STARS Quality Measures, HEDIS, RAF, Referral Management, Provider Education, Appropriate Physician Compensation, Fee Schedule Configuration, Capitation, Contracting, Audit Management, Finance Reporting, Recovery, Compliance.
Independent Physician Association (IPA) Growth, Business Development, Strategic Planning, Client Onboarding, Transitions.
Contract analysis and Negotiation, Full/Shared Risk Savings Agreements, Total Cost of Care Analysis, Knox-Keene Understanding.
Data Manipulation, Data Analytics, Data Report Writing, Encounter Management. Cloud Computing Technology.
Healthcare Databases: Microsoft SQL, Ezcap, Eznet, Ezcare, Cerecons.
Recovery
Business Continuity, Disaster Recovery, Incident Management Planning.
If you are looking to
-Diversify and build your physician and member network
-Improve Broker relationships and Association
-Prepare for Annual Enrollment Period and/or Open Enrollment Period
-Gain more clients
-Grow and develop your existing clients
-Increase your provider STAR and RAF Ratings
-Correct HCC Coding and Encounter Optimization
-Identify Care Gaps
-Manage out-of-network care
-Expand your services to include more in-house operations
-Develop structured Utilization and Quality Management Programs
-Learn new healthcare systems and databases
-Create your own Provider Portal or Dashboard
-Improve compliance
-Other services
We can help you! Our team is comprised of healthcare specialists whose priority is to help you reach your goals.