No World Borders

Hospitals and Health CareCalifornia, United States11-50 Employees

We help companies become more innovative, efficient, accelerate claims payment and reduce healthcare costs for self-insured employers and health plans.  Our fastest growing markets are out of network claims processing and consulting in :


- Usual, customary and reasonable cost of care (UCR) and cost of care under the Affordable Care Act

- Usual, customary and reasonable cost of care (UCR) and cost of care under Medicaid Expansion

- Inpatient (ICD-9 and ICD-10 CM diagnosis coding and medical necessity)

- Inpatient prospective payment system (IPPS) and DRGs

- Inpatient procedure coding (ICD-9, ICD-10 PCS)

- Ambulatory reimbursement (OPPS), CPT value of care

- Mobile Health (mHealth) 

- HIPAA Privacy and Security

- Behavioral health specialty medicine regulations vs. healthcare general regulations

- Accountable Care Organizations

- Investor diligence in healthcare IT

- Health care integration, BIgData, and Analytics   

- Software as a Service (SaaS) application integration across Cloud Networks.  

    Hospital Value Based Purchasing (VPB) for Medicare

    Health plan HEDIS Star Ratings Quality Measures for Medicare Advantage

    Revenue Cycle Management for hospitals Medical Policy Management for health plans, Utilization Management, Case Management

    ARRA HITECH Act (Meaningful Use) Electronic Medical Record (EMR) / Electronic Health Record (EHR) planning implementation and selection

    Health care social media for physician and patient engagement, talent development, and organizational change management

ICD-10 Financial Reimbursment
ICD-10 Training
ICD-10 High-level review and skills inventory
ICD-10 Implementation Planning & Design
ICD-10 Risk Assessment
ICD-10 Third Party Liability

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