CARA-Rx is an end-to-end solution through which MedAssurant applies its proprietary algorithms to analyze Medicare Advantage Part D clients’ medical informatics data. This analysis provides the ability to efficiently and accurately identify, document and report the medical risk characteristics of the health plan’s enrollees to enable full and optimal reimbursement from CMS.

In addition to  providing the health plan with a file for submission to CMS to facilitate optimal retrospective rate reimbursement or future factor reimbursement rate setting, the CARA-Rx Solution also delivers extensive analytical tools to identify the critical offenders/drivers of coding losses, guide practitioner-coding education needs, and highly valuable analytics to assist in budgeting and financial forecasting. In short, CARA-Rx uses the data that health plans already have to pinpoint optimal reimbursement while also aiding in the ongoing improvement of coding practices.

Whether to maximize prospective risk factors for future reimbursement rates or to ensure that full reimbursement is recaptured in final reconciliation processes, the potential revenue impact of CARA’s core analytic and intervention services is substantial.