Medicare Advantage MCO Risk-Contracting

Affiliation opportunities to participate in favorable global-risk contracts and Analysis of risk-taking…

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Financial Analysis

Monthly/Quarterly MCO financial settlement review and HCC funding review and reconciliation…

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Software/EDI Support

Access to specialized category indicators (i.e., Hospice, dual-eligible, Medicaid Medicare, ESRD…

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Nurse Case Management

Our staff nursing personnel available with extensive managed care experience…

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Claims Analysis

PMPM claims expense peer comparison (retrospective and concurren…

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Quality Management

Quality of patient care has always been an important concept in the medical and…

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Utilization Management

Medicine has become goal-based with well-defined indicators of success, and pay-for-performance…

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Compliance

Each provider or organization not only has to follow the law, but they must become their own…

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Quality Management

Quality of patient care has always been an important concept in the medical and…

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