Monthly/Quarterly MCO financial settlement review Funding/Claims analysis.
HCC funding review and reconciliation.
Medicare Risk Adjustment (MRA) analysis to optimize funding based on patient population, severity diagnosis and acuity level
IBNR analysis to ensure consistency and uniformity in MCO chosen methodology.
Assigned membership accretion and deletion review to scrutinize for unreconciled or omitted member funding
PrimeCare, LLC was founded by Raul Revello, MD and Pariksith Singh, MD for purposes of entering into global risk contracts with Medicare Advantage (MA) health plans.
Originally doing business in the Tampa Bay counties of Hillsborough, Pinellas, Pasco, and Hernando, PrimeCare has now expanded all across Central Florida to now include Citrus, Manatee, Indian River, Brevard, St. Lucie, Palm Beach and Martin counties.
Medicare Advantage MCO Risk-Contracting
Nurse Case Management
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