No World Borders

We help companies become more innovative, efficient, accelerate claims payment and reduce healthcare costs for self-insured employers and health plans. Our fastest growing markets are out of network claims processing and consulting in - Usual, customary and reasonable cost of care (UCR) and cost of care under the Affordable Care Act - Usual, customary and reasonable cost of care (UCR) and cost of care under Medicaid Expansion - Inpatient (ICD-9 and ICD-10 CM diagnosis coding and medical necessity)- Inpatient prospective payment system (IPPS) and DRGs - Inpatient procedure coding (ICD-9, ICD-10 PCS)- Ambulatory reimbursement (OPPS), CPT value of care - Mobile Health (mHealth)- HIPAA Privacy and Security - Behavioral health specialty medicine regulations vs. healthcare general regulations - Accountable Care Organizations - Investor diligence in healthcare IT - Health care integration, BIgData, and Analytics - Software as a Service (SaaS) application integration across Cloud Networks. Hospital Value Based Purchasing (VPB) for Medicare Health plan HEDIS Star Ratings Quality Measures for Medicare Advantage Revenue Cycle Management for hospitals Medical Policy Management for health plans, Utilization Management, Case Management ARRA HITECH Act (Meaningful Use) Electronic Medical Record (EMR)/ Electronic Health Record (EHR) planning implementation and selection Health care social media for physician and patient engagement, talent development, and organizational change management ICD-10 Financial Reimbursment ICD-10 Training ICD-10 High-level review and skills inventory ICD-10 Implementation Planning & Design ICD-10 Risk Assessment ICD-10 Third Party Liability