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
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.
Mole Removal Claim Fraud Nets Jail and Fines
08.03.2023
A recent fraud event involving a Chicagoland doctor will cost over $1 million and jail time from a mole removal scheme. The doctor submitted false claims for mole removals that were billed on multiple, separate dates of service, which allowed this doctor to receive larger reimbursements.
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.
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