Proven Technology for Medicare Advantage Revenue Realization

Implemented in 2000 and currently in use to reconcile payments for over 35% of the Medicare Advantage enrollees, AccuTraq enables Plans to efficiently process monthly data required for recovery efforts and meet the required CMS submission timelines for resolving discrepancies identified through the comparison of monthly membership reports, transaction reply listings, and Plan membership data. AccuTraq streamlines the research and verification process, automates submissions, and tracks all payment adjustments at the member level. Standard financial reporting enables the Plan to monitor the process at a member level and easily identify and report overall financial impact.

AccuTraq Key Features

  • Identification and full reconciliation of all the factors that affect payment
  • Automation of CMS submissions within required submission time frames
  • Calculation of impact for multiple risk adjusted payment periods including changes in the data collection period and final reconciliation
  • Calculation of income and receivables at the member specific level
  • Complete revenue calculations for all payment methodologies including the new bid process, Regional PPO, SHMO and Demonstration Plans