What We Do
HIGH IMPACT GROWTH SOLUTIONS
MRA/Version 28
Achieves best outcome for patient, provider & plan
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Provides expert guidance on the implementation and optimization of CMS MRA/Version 28 guidelines
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Audits clinical documentation to ensure accurate alignment with updated ICD-10-CM codes and reporting requirements
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Offers training for providers, coders, and clinical staff on V28 updates, clinical specificity, and compliance best practices
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Identifies documentation gaps and improvement opportunities to reduce claim denials and enhance audit readiness
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Ensures organizations remain current with evolving CMS policies impacting value-based care
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Strengthens clinical accuracy and reimbursement integrity
Subrogation
Guiding Organizations Toward Financial Integrity
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Identifies opportunities for cost recovery when third parties are responsible for a patient’s medical expenses
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Manages subrogation from identification through recovery for the client
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Works closely with payers, legal teams, and healthcare organizations to streamline communication and documentation
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Improves net operating margin by recovering funds that would otherwise be written off as medical expenses
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Mitigates client risk by ensuring proper follow-through on claims involving accidents, liability, or third-party responsibility
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Monitors performance outcomes and identifies additional opportunities to strengthen recovery strategies over time
Medications Import
Improving Access and Affordability Through Safe, Compliant Medication Sourcing
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Dramatically reduces pharmacy spend in compliance with all federal and state regulations
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Identifies cost-saving opportunities through safe and approved international sourcing channels
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Conducts risk assessments to ensure imported medications meet quality, safety, and efficacy standards
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Develops policies and workflows that ensure proper documentation, tracking, and storage of imported medications
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Enhances affordability for patients and healthcare systems through strategic procurement solutions
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Provides education for clinicians, pharmacists, and administrative teams on compliance, and best practices
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Continuously evaluates regulatory changes to ensure compliance
Prior Authorization Tech-Enabled Solution
Streamlining Approvals for Faster, More Efficient Access
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Reduces administrative burden and denial rate (less than 10%)
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Avoids patient and provider friction
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Identifies gaps or missing details that commonly lead to denials
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Leverage the payor policies to expedite approvals
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Tracks performance metrics through transparent reporting
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Helps organizations reduce denial rates, improve cash flow, and enhance patient satisfaction
Our Other Offerings:
5pm-8pm
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5pm-8pm
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5pm-8pm
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