Automated, End-to-End Capitation Adjudication

Time to eliminate manual management of capitated payments and fee-for-service components. This user-friendly, complete solution delivers a purpose-built suite of tools that administer any payment model with ease—from contract configuration and eligibility management through adjudication and payment.

Say goodbye to overhead costs and hello to streamlined workflows with:

• Robust electronic data interchange (EDI) capabilities
• Support for standard and proprietary data formats
• Continuity between existing systems and the partner ecosystem
• Self-service functionality and easy configuration
• Single-platform claims processing, provider payment, and contract management

Client Success Story

You set the goal. We make it happen.

An independent physician association (IPA) client faced a challenge connecting and supporting a large, geographically dispersed provider network—comprised of 3,550 physicians and 1,300 Medicare Advantage (MA) providers—with a very diverse patient population. This IPA’s goal was to remain profitable, while improving administrative and care management efficiency in state Medicaid and Medicare programs, and to grow in market share.

The Future is Now 

Capitation payment models are on the rise. Read our latest eBook to discover how providers and payers who prepare for this industry shift can position themselves for greater long-term success.

An Expert Team with Deep Experience