We’re putting healthcare
Protect the integrity of your health plan and determine accurate pricing with the Context4 Health Plans Suite, our modular, cloud‑based technology platform.
to empower your organization
Immediate, actionable, and defensible Fraud, Waste, and Abuse (FWA) detection built by our team of certified clinical, dental, and health benefits experts.
Accurate data and cutting-edge cloud technology combine to create a proven and defensible medicare reference-based pricing (RBP) solution.
More than 100 healthcare data sets, with professional support to optimize efficiency and compliance.
Advanced medical coding software designed to expedite claim submission and minimize denials.
from our team of experts
Audits of Telehealth Services During COVID-19
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
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.
Impact of the COVID-19 Pandemic on Healthcare Fraud
During the pandemic, healthcare claim fraud prevails as new fraud schemes develop and adapt to the changes in healthcare guidelines enacted, so providers can continue to treat patients. Two major areas of FWA expansion during the pandemic include Telehealth and COVID-19 related laboratory testing add-on services.