Independent and Affordable Program Integrity
Context supports Program Integrity through extensions to our Payment Integrity Platform. These extensions move beyond detection of errors and Fraud, Waste, and Abuse (FWA) to allow a full lifecycle approach to compliance governance.
Our real-time, cloud based Program Integrity solutions include:
- Medicare Prospective Payment Systems (16 PPS)
- Advanced Medicaid, Medicare and Commercial analytics logic to assess payment compliance at a granular level
- FWA logic and reporting at the member and provider levels
- Case management system extensions to pass potential aberrations detected into a functional workflow system in the cloud or your SIU
- Special investigation business partnerships to facilitate resolution of aberrations for your CMIP