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.
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
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.
Impact of the COVID-19 Pandemic on Healthcare Fraud
04.07.2021
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.
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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