Embedded Files
Payers
For Medicare Advantage, Medicaid, and commercial plans that need fewer findings and stronger vendor oversight.
We prepare you for audits, tune appeals and grievances timeliness controls, support RADV and documentation, and keep vendors on track. We align privacy and interoperability with practical workflows.
Key points:
Audit readiness for CMS elements
Appeals and grievances controls and monitoring
RADV support and documentation uplift
Vendor/delegation oversight and provider data accuracy
How it works:
Baseline; CMS mapping in Build Lab.
Field Teams run sprints for RADV, A&G, and vendor oversight.
Quarterly Index updates and leadership briefs.
What you get:
Audit‑ready evidence packs
Timeliness dashboards and alerts
RADV prep and response playbooks
Vendor oversight files and reviews
Good fit if:
You have audit pressure or recent findings.
Delegated entities need tighter oversight.
Provider data accuracy is affecting members.
FAQs
Do you sign BAAs?
Yes. We integrate training and workflows around your current systems.
Do you work with delegates and vendors?
Yes. We include them in scope and align deliverables..
Do you handle prior authorization workflows?
Yes. We assess and implement practical changes.
Page updated
Google Sites
Report abuse