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Capitation Adjudication

Alternative payment models are the future. Our capitation adjudication software helps you manage the complexities in APMs with efficient, flexible, proven claims processing tools.


Our Solution, Your Way

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Our fully integrated and composable design allows you to build the software that meets your needs today, and the flexibility to evolve in the future.

What's Included:

  • Capitation Calculation & Management
  • Capitation Claims Administration
  • Payment Processing
  • Provider Contract Administration
  • FFS Claims Administration

Add-On Modules:

  • Capitation Care Management
  • Claims Editing
  • Code Sets
  • Eligibility Management
  • Payment Reconciliation
  • Provider Portal

Watch a Quick Overview

Discover what makes our Capitation Adjudication software the only tool you need to seamlessly administer capitation contracts, process payments, manage utilization, and boost financial performance in APMs.

Request a Call  Book a Demo

IPA Grows MA & Medicaid Business by 12% with Payment & Utilization Tools

When a West Coast IPA wanted to expand their Medicare and Medicaid business lines, they turned to Cedar Gate. Our advanced claims processing, care management, and utilization management tools helped streamline operational efficiency by automating complex administrative processes and identify care opportunities.

The Enterprise Data Management Difference

What sets us apart? Every client receives access to data tools that integrate virtually any source into a single, unified data lake. We automatically cleanse, normalize, and enrich the information so you get high-quality data warehoused securely in the cloud and accessible from anywhere. It’s the ultimate source of truth to power all activities in a value-based care world.

Client-First Approach

We believe in true partnership to be successful. That’s why we focus on a client-first approach including:

  • Skilled Team to Guide Implementation
  • Dedicated Client Success Manager to Meet Goals
  • Training Team Delivering New Learning Opportunities
  • “Always On” Support Team When Obstacles Arise

More Solutions from Our Complete, Composable Platform

Get the right technology for wherever you are on a value-based care journey. Our composable platform end-to-end capabilities for analytics, population health, and payment technology – and it’s all integrated with our world-class enterprise data management system. Check out solutions other clients use alongside Capitation Adjudication and start building your ideal VBC software today.
Comprehensive predictive and prescriptive analytics to maximize payer and provider performance in alternative payment and care delivery models.
  • Identify and mitigate variations in cost and quality to meet value-based care goals
  • Pinpoint high-performing providers and quality drivers with advanced benchmarking tools
  • Create condition-based patient cohorts to reduce costly omissions or gaps in care
  • Model VBC contracts to ensure you can meet clinical and financial performance goals
  • Share insights with anyone using customizable dashboards and automated reports
A comprehensive tool to organize timely and appropriate outreach to your target populations so patients get the right care, at the right time, in the right place.
  • Align analytics insights with care plans to identify interventions
  • Create custom cohorts based on clinical or financial risk factors
  • Surface actions for care teams to reduce risk & improve outcomes
  • Individualize care plans, incentives & rewards to increase engagement
  • Monitor & report on activities with custom templates & dashboards

Explore the Platform

The right solution for your value-based journey is only a click away. Our modular technology is quickly and easily integrated into current systems and complements existing IT investments so that we can grow with you.

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