Reliable, Affordable Program Integrity
Context supports Program Integrity through extensions to our Payment Integrity Platform. These extensions move beyond detection of errors and 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