Claims Payment and Integrity
MedAssurant’s comprehensive Risk Adjustment solutions provide an industry-leading approach to the efficient determination and substantiation of disease and comorbid condition data delivering high return-on-investment improvements in risk score accuracy. Our clinically-driven algorithms leverage billions of known medical events to provide superior effectiveness in identifying gaps in assessment, documentation, and care. More Info
MedAssurant utilizes advanced analytics across member and provider activity, incorporating comparisons to highly-specific peer-matched cohorts, to identify likely instances of fraud, waste or abuse. Leveraging the data insight of billions of medical events, MedAssurant goes far beyond standard claims analytics, giving clients the benefit of sophisticated clinical analytics and standards of care considerations. More Info