Our Services are available for Medicare and Medicaid lines of business. We work directly with Physician Practices, IPAs, MSOs, and Large Groups. We have the ability to design, manage, and execute all programs.
MRA Management
MRA drives premiums and is vital to your funding. If your score is too low you could incur large deficits. Our programs are designed to ensure you have the opportunity to assess, document, and bill your patients conditions twice per year to improve and maintain your scores.
HEDIS® Management
Your HEDIS score is a big portion of each contracted Health Plan's CMS Star Rating. Poor HEDIS scores will result in the termination of your contract and transfer of your patients. Our programs are designed to encompass patient tracking through screening completion.
Medication Adherence
Are your patient's taking their medications. Do you know if they filled their script? Did you know most chain pharmacies no longer contact physicians for refills? Our programs are designed to identify truly non-compliant patients and the reasons for non-compliance while ensuring all other patients are not filling late.
Patient Outreach Programs
Patient Outreach Programs are essential to achieving many goals within a practice. Let us design, manage, and execute on your ongoing programs behalf. We can also manage execute outbound calling projects such as Child Health Checkup Lists, Access to Care lists, and Appointment Follow Up.
Flat Rate Billing
Flat rate billing allows you to keep more of what you make in your pocket as your organization grows. Wrap only the services you need into a single monthly per provider fee. No percentages, submission limits, or surprise fees. Corrected claims, Denial Management, and Appeals submissions are never excluded. Our 30 day track back makes your transition seamless and reduces financial losses. Rates are discounted for most allied professionals and providers that submit less than 250 claims per month.
Patient Management Programs
How does your patient feel? Did they use the referral you provided them? Did the specialist submit his notes? Patient management is vital to managed care practices. While IPAs and Health Plans provide Case Management Services, they typically monitor only your very sick patients. These patients typically have multiple hospital visits, multiple chronic diseases, or on the MTM program. But how about your other patients? The ones at risk? We design our programs to help you keep track of your patients and their issues BEFORE they go to the hospital! Our Care Coordinators follow all patients receiving services outside of your care, to ensure they are compliant with appointments, meds, and orders so that you can keep them out of the hospital and allowing you provide the highest quality of care.
Custom Projects
Whether it is a one time project or ongoing, we are here to help!
Coming Soon..........
Case Management Services.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)