Integrated with Johns Hopkins ACG® System, our proprietary analytics solutions help you identify risk-score discrepancies and substantiate undocumented diagnoses and conditions for comprehensive retrospective reviews.
Core Claims Administration
Our solutions meet the administrative requirements of virtually any line of business and help lessen the risks, costs and disruptions of core system modernization.
Provider Network Administration
Reduce the time and cost associated with provider maintenance with flexible, advanced tools that manage provider financial arrangements and reimbursement, quality and grievance, and specialty referrals.
Leverage our people, processes, and technology to develop effective, consumer-focused programs that help you adapt as the market evolves.
Health Plan Compliance and Program Integrity
Our comprehensive governance, risk management, and compliance programs deliver mechanisms to monitor and manage the complex and evolving regulations from federal and state agencies.