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

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Payment Integrity

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

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Pricing

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

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Healthcare Data

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

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Medical Coding

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

Insights

from our team of experts

Impact of Policy Adjustments on Telehealth Fraud

09.10.2021

In May 2021, MedPac provided feedback to Congress regarding their opinions on the effectiveness of the overwhelming 200 healthcare policy changes that Congress and CMS instituted during the interval of January through July 2020, in response to the coronavirus public health emergency. Aside from the obvious and necessary benefits of these changes in response to the pandemic, MedPac raises concerns about the detrimental impact in the realm of fraud in healthcare: “…not all actors in the healthcare system are well-intentioned”.

Audits of Telehealth Services During COVID-19

06.29.2021

Relaxed telehealth restrictions is a necessary step to limit potential COVID-19 exposure in physician offices in the emergency period. With this change, unfortunately, the US Justice Department estimates telehealth-related fraud has expanded significantly since early 2020 – approximated at 4.5 billion dollars.

Fighting Fraud in Medical Nutrition Therapy

04.27.2021

Payers who bear significant long-term healthcare utilization burdens due to obesity and cardiovascular risk factors may determine that Medical Nutrition Therapy (MNT) preventative coverage is a cost-effective policy approach for their beneficiaries. 

Success

stories from our clients

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

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

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“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.”

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“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:

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