We’re putting healthcare

in context

Protect the integrity of your health plan and determine accurate pricing with the Context⁴ Health Plans Suite, our modular, cloud‑based technology platform.

Solutions

to empower your organization

Payment Integrity

Immediate, actionable, and defensible Fraud, Waste, and Abuse (FWA) detection built by our team of certified clinical, dental, and health benefits experts.

Pricing

Accurate data and cutting-edge cloud technology combine to create a proven and defensible medicare reference-based pricing (RBP) solution.

Healthcare Data

More than 100 healthcare data sets, with professional support to optimize efficiency and compliance.

Medical Coding

Advanced medical coding software designed to expedite claim submission and minimize denials.

Insights

from our team of experts

Overutilized High-level Drug Testing: Small Fees, Large Overpayments

11.17.2023

Dr. Steve Nesnidal presented at the 2023 NHCAA Annual Training Conference on Overutilized High-level Drug Testing, focused on Small Fees with Large Overpayments. Click the link to view our latest vlog!

Monitor Potential FWA: Overutilization of High-Level Codes

09.13.2023

In our latest blog, we discuss a recent OIG report that found Medicare could have saved millions of dollars by monitoring providers who billed the highest reimbursable codes. It shows how certain code descriptions were miscounted by providers, causing higher reimbursements that weren't owed.

Success

stories from our clients

“The extensive and up-to-date UCR database provided by Context⁴ Healthcare is complimented by their fast and knowledgeable customer service.”

“Amazing customer service! Thanks so much for the quick feedback and for resolving the issue so quickly, you knew just how to help.”

“Context⁴ Healthcare’s Claims Editor is a one-of-a-kind solution. The real-time edits and ability to create in-house rules have played a major part in reducing our denial rate.”

“When asked by a potential client recently who we used for our UCR Fee data, we told them Context⁴ Healthcare. The potential client was very pleased and it gave us one up on the competition.”

We’re putting healthcare

in context

Protect the integrity of your health plan and determine accurate pricing with the Context⁴ Health Plans Suite, our modular, cloud‑based technology platform.

Solutions

to empower your organization

Payment Integrity

Pricing

Healthcare Data

Medical Coding

Insights

from our team of experts

Overutilized High-level Drug Testing: Small Fees, Large Overpayments

11.17.2023

Monitor Potential FWA: Overutilization of High-Level Codes

09.13.2023

Success

stories from our clients

“The extensive and up-to-date UCR database provided by Context⁴ Healthcare is complimented by their fast and knowledgeable customer service.”

“Amazing customer service! Thanks so much for the quick feedback and for resolving the issue so quickly, you knew just how to help.”

“Context⁴ Healthcare’s Claims Editor is a one-of-a-kind solution. The real-time edits and ability to create in-house rules have played a major part in reducing our denial rate.”

“When asked by a potential client recently who we used for our UCR Fee data, we told them Context⁴ Healthcare. The potential client was very pleased and it gave us one up on the competition.”

Let's innovate together.

Find out how our cutting‑edge, industry‑leading solutions can empower your organization.

Proudly Affiliated with:

We’re putting healthcare

in context

Protect the integrity of your health plan and determine accurate pricing with the Context4 Health Plans Suite, our modular, cloud‑based technology platform.

Solutions

to empower your organization

Payment Integrity

Pricing

Healthcare Data

Medical Coding

Insights

from our team of experts

Overutilized High-level Drug Testing: Small Fees, Large Overpayments

11.17.2023

Monitor Potential FWA: Overutilization of High-Level Codes

09.13.2023

Success

stories from our clients

“The extensive and up-to-date UCR database provided by Context4 Healthcare is complimented by their fast and knowledgeable customer service.”

“Amazing customer service! Thanks so much for the quick feedback and for resolving the issue so quickly, you knew just how to help.”

“Context4 Healthcare’s Claims Editor is a one-of-a-kind solution. The real-time edits and ability to create in-house rules have played a major part in reducing our denial rate.”

“When asked by a potential client recently who we used for our UCR Fee data, we told them Context4 Healthcare. The potential client was very pleased and it gave us one up on the competition.”

Let's innovate together.

Find out how our cutting‑edge, industry‑leading solutions can empower your organization.

Proudly Affiliated with:

Protect the integrity of your health plan and determine accurate pricing with the Context⁴ Health Plans Suite, our modular, cloud‑based technology platform.

“The extensive and up-to-date UCR database provided by Context⁴ Healthcare is complimented by their fast and knowledgeable customer service.”

“Context⁴ Healthcare’s Claims Editor is a one-of-a-kind solution. The real-time edits and ability to create in-house rules have played a major part in reducing our denial rate.”

“When asked by a potential client recently who we used for our UCR Fee data, we told them Context⁴ Healthcare. The potential client was very pleased and it gave us one up on the competition.”