Medicaid is complex, and it's constantly changing. We’ve been helping agencies like yours wrangle it for five decades — always looking and thinking ahead with innovative solutions, insightful approaches to improving how you manage your program and creating healthier outcomes.
Our CMS-certified 外围足球app solutions are modular, 智能化、云化, and they cover all your management needs. 索赔和遭遇? 检查. 提供外围足球app? 检查. Managed care, EDI clearinghouse, prior authorization, value-based care? 检查，检查，检查，检查. And much, much more, but you get the idea.
不需要那么多? 没有问题. You can take the whole bundle or just the modules you need. We’ll set things up exactly the way you want.
Our people have deep knowledge, and our systems are smart and evolved. 足球外围平台可以帮忙 to accelerate claims processing, support value-based care and control escalating costs with our comprehensive and integrated suite of solutions that orchestrates workflow and task management.
足球外围平台可以保留你的索赔, encounters and financials straight in the face of shifting healthcare needs, ever-increasing enrollment and federal policy changes. We provide enterprise-wide COTS modularity to support state-specific Medicaid needs and other health and human services programs. Enjoy the highest-level security, integrity and output to diverse trading partners and providers while meeting federal requirements.
Simplify provider Medicaid billing with comprehensive validation rules for managed care and fee-for-service transactions. Ensure your encounter data is compliant through a single point of submission.
Wrangling providers is a time-consuming endeavor that can be full of inefficient and repetitive manual processes. 足球外围平台可以减轻你的负担. Our Provider Service and Provider Credentialing tools are a flexible, cloud-based SaaS platform based on COTS software. They are aligned with industry standards to assist providers from initial enrollment through final determination letter and supports providers’ participation in fee-for-service and other programs, 包括加入mco.
We know what you’re looking for as a state agency trying to manage numerous MCOs more proactively — to contain costs, keep track of enrollment and mind the details. Our 管理式医疗 solution helps you track members’ MCO enrollment as they transition across different plans, improve capitation payment forecasting and payment processing. It’s a seamless, end-to-end administrative solution for your 管理式医疗 Program.
Experience the time-saving and satisfaction-enhancing benefits of our 事前授权规则引擎. Automate and expedite authorizations for your state with configurable rules and workflows designed to improve member and provider satisfaction.
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