Drawing on our experience, we have developed the methodologies and technology that directly address the issues, regulations and pitfalls involved in MA and Medicaid Managed Care administration. All of these processes and services are compliant with CMS regulations and, in many cases, are already approved by CMS.

As a result, our clients are remarkably successful in managing their MA contracts. Our clients realize over $500 million in additional revenue using our Revenue Realization processes and software tools and demonstrate compliance by implementing MMC 20/20 solutions. In addition to our Revenue Realization® services, we have developed solutions and services that further streamline and maximize your Plan’s results. These services address each aspect of your MA operation from enrollment to claims processing, as well as outreach strategies to maximize MA revenue and membership. Our services include the following revenue opportunities:

  • Revenue Realization
  • Claims Recovery
  • Risk Adjuster
  • Compliance
  • Medicaid Reconciliation
  • Enrollment Solutions
  • Product Development
  • Cost Reporting
  • Medicaid Contracts