Innovative operations management solution designed specifically to optimize workflows, processes and monitoring

Improve retrospective Risk Adjustment from gap and chase analytics to coding and audit support. Our solutions drive accuracy, boost coding efficiency, enhance suspecting with AI-assisted platforms and multi-certified coders, and streamline submissions with flexible options

Purpose-built digital service center that delivers optimal customer experience by integrating payer Core Administration platform with best-in-class consumer engagement point solutions for a comprehensive service platform

Build a complete prospective Risk Adjustment program or a targeted approach with options for provider engagement, encounter processing, certified coding, and reporting and analytics. Put actionable data into the hands of providers at the point of care to close Risk Adjustment and Stars gaps

Own and control your Star ratings with flexible consulting options from one-time analysis through full action plans with access to a suite of Stars improvement initiative expertise and reporting, modeling, and forecasting tools

Assess the complete clinical state of every member, manage regulatory reporting and more with highly configurable tools and dashboards that give you the power to streamline workflows, develop programs with impact and create a cycle of performance evaluation

Automate eligibility verification, export and in-load files and rosters and easily export enrolled members into their core claims system, and generate correspondence—all while maintaining compliance, decreasing costs, and improving member retention

End-to-end software as a service solution that allows you to integrate, scale and adapt with reduced implementation and development costs

Leading-edge business intelligence and reporting solution designed specifically for health plan operations and performance