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

Medicare and Maine Medicaid Healthcare Fraud Settlement Case

05.17.2023

A Maine family practitioner used false claims billed to Medicare and Medicaid for services that were either not provided or not medically necessary, which provides reasons for the need of Fraud, Waste, and Abuse (FWA) protection.

Dental Fraud in Medicaid

05.09.2023

A multi-million dollar scheme provides an example to the benefits of having fraud, waste, and abuse (FWA) protection.

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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