OPTIMIZATION SERVICEs

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Facets Optimization

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End-to-end health assessment of gaps in existing organizational, business processes, tools and technologies both within and those surrounding a Facets Implementation, recommendations to mitigate those gaps, and a pragmatic roadmap to implement them to reduce operational costs, increase automation and the business effectiveness and efficiency of critical business activities such as member/group enrollment, product configuration a, provider management and claims payment.

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Medicare Advantage Optimization

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End-to-end health assessment of gaps in existing Medicare Advantage Operations across organizational, business processes, tools and technologies across member enrollment, management of daily transactions with CMS, financial reconciliation and recommendations to mitigate those gaps, and a pragmatic roadmap to implement them to increase operational integrity and CMS compliance, reduce operational costs and financial discrepancies that may impact revenue.