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Innovative solutions and expert services to
reduce waste and improve your bottom line.
Click to learn more about this market and view white papers, case studies and more.
Our solutions combine predictive analytics, innovative technologies and experienced leaders in order to enable commercial health plans to significantly reduce waste and improve the bottom line. Through managing medical costs, improving member and provider satisfaction, strengthening payment accuracy and measuring the quality of care, we can mitigate your risk and help guide your healthcare strategy.
To reduce waste and control rising healthcare spending, we partner with payers to target preventable and costly inefficiencies across the enterprise. Our solutions identify care management opportunities, practice variation, fraudulent providers, gaps in care and service coordination and quality compliance issues.
Lost to Fraud, Waste & Abuse
Lost to Preventable Conditions and Avoidable Care
Analyze and predict risk for Commercial, Medicare, and Medicaid populations with this comprehensive collection of...
A highly flexible, web-based platform that combines powerful online analytics with the ability to support diverse...
Reduce your facility claims with our expertise in editing and negotiation.
Prospectively identify new and emerging fraud schemes with next generation technology and clinical review.
Apply clinical and predictive modeling with clinical validation to increase accuracy and minimize false positives.
Generate NCQA certified HEDIS rates, drill to member detail, perform chart review and generate IDSS submission.
Identify and stratify populations at the group or individual levels with this highly scalable, easy to use,...
Capture additional revenue while maintaining strict compliance with the help of our certified clinician coders.
Deliver superior payment recommendations by combining sub-second processing with transparent, open-source edits.
