Situation A large Managed Care Organization (MCO) was experiencing inappropriate payments related to non-covered benefits and for services with improper prior authorizations associated with paid claims. The organization approached AArete to develop a solution to ensure their configuration was appropriately capturing payments for current benefit requirements from the state and health plan. Approach AArete reviewed…
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This website uses cookies to improve site functionality, provide you with a better browsing experience, and serve more relevant content to you. These cookies collect information on your interactions with our site including the pages you visit, the links you click on and how long you are on our site. This website also uses cookies to help us deliver more targeted ads and assess the performance of ad campaigns.
AArete may collect, store or accumulate data about your usage of this website. This data may be shared or transferred to third parties, as defined in the Third Parties section of our Privacy Policy. Some cookies used on this site are from Third Parties. These Third Party cookies are used to provide us with analytics and intelligence about usage of our site. By continuing to use this website you are consenting to our use of cookies.