We understand the challenges associated with ensuring quality patient care, managing a network of providers, and maintaining a healthy Medical Cost Ratio (MCR). We offer a complete suite of payment integrity services designed for payers looking to get more from their outsourcing partners. Whether you're a large national health plan, local regional plan, or government agency – we have the experience to deliver a payment integrity program tailored to your unique goals and requirements.
Our audit and recovery services offer:
- Experience from national CMS RAC programs and commercial payers representing more than 90 million covered lives
- Fast program implementation for accelerated recovery and ROI
- High accuracy and customer service ratings, with a focus on protecting critical provider relationships
- Proprietary technology, online program reporting and dedicated teams focused on building long-term partnerships