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Our Expertise

If you are a Payer, Provider, Claims Administrator, Managed Care or Insurance Services Organization, Strategic Investor or Financial Investor, our Consultants have the Knowledge, Skills and Expertise to help you accomplish your strategic goals.
Product Knowledge
Legislative & Regulatory
Strategy & Advisory

  • Legislative Strategies (pro-active and re-active)

  • Legislative Analysis & Intervention (multiple states)

  • Lobbyist Management & Industry Expert Hearing Testimony

  • Regulatory and Rule-Making Guidance & Drafting

  • Compliance Assistance including State/Federal Certifications (CHAP, URAC)

  • Medicare Secondary Payer Compliance (including CMS contacts)

 

Product Development

  • Managed Care Networks including state certified, MPNs, HCNs, and PBNs.

  • Home Health and Durable Medical Equipment & Specialty Services

  • Pharmacy Benefit Management (PBM) including Clinical Programs

  • Medicare Set-Asides (MSAs) and Mandatory Insurer Reporting

  • Provider Profiling, Credentialing and Contracting

  • Bill Review, Repricing and Payment Integrity

  • Utilization Management and Peer Review

  • Telephonic and Field Case Management

  • Independent Medical Examinations

  • Diagnostic & Radiology Services

  • Chronic Claim Management

  • Physical Therapy Carve-outs

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