The transition to a prospective bundled payment model creates new operational demands. Using standard ANSI transactions allows a seamless integration of different financial and operational systems with minimal impact to current revenue cycle processes, including those of different providers and payers. This integration, including full data security and HIPAA controls, is an essential element of our value-based care solutions.
The bundles administration platform identifies and consolidates multiple fee-for-service claims into a single bundle and then sends it electronically to a payer for payment. When the bundled payment is received, it automatically allocates and distributes the payments to each episode provider, including managing associated reserve funds.Get Started
Cedar Gate offers full credentialing services, including the initial intake of documentation, a comprehensive file review with primary source verifications, and submission of completed files to the payers. We also offer consulting services for delegated credentialing programs.
We can assist you in contracting and contract administration in value-based programs. Throughout the pre- and post-contracting processes, Cedar Gate provides ongoing provider education through the development of reference materials and the facilitation of Q&A sessions in meetings with providers.
We work with you to screen and select high-performing networks to include in your fee-for-value program. Each high-performance network is evaluated based on parameters such as cost efficiency, quality, loyalty, and other client-specific objectives.
Cedar Gate supports the patient onboarding process from initial inquiry through registration, enrollment, and payment. Our multi-pronged approach combines consistent communication, education, documentation, and technology to provide both patients and providers with the information necessary to ensure coordinated, end-to-end program navigation.
We develop communication strategies grounded in provider performance data to offer practice transformation recommendations and training for provider relations, Medical Directors, and other staff.
Cedar Gate works with clients to develop key messaging, customized presentations, and other materials needed to convey the value proposition to payer and employer audiences and to ensure continuous growth of the bundle program.
Benefit from established best practices and automated management for any risk and incentive pool scenario. Our administration system also fully automates payment distribution received to providers participating on any episode of care program.
Cedar Gate has deep experience and established best practices for the management of any incentive pool and provider payment distribution scenario that:
with pre-defined, fixed payments with a focus on budget, mitigating the fee-for-service mentality.
to look ahead on how to maximize use of available resources, with a focus on reducing variability and costs.
to determine who provides the best value for patients, thereby improving outcomes.
Cedar Gate’s enterprise performance management analytics and administration platforms reduce risk, enhance financial performance, and improve patient outcomes for healthcare organizations across the value-based care continuum.
Capture, organize, and utilize all valuable data sets securely and easily.EXPLORE
Empower your team with timely information to take action and reach performance goals.EXPLORE
Transform the way you report on your business with these intelligent tool sets.EXPLORE
Support medical management activities across the care continuum.EXPLORE
Manage patients effectively from chronic conditions to transitions of care.EXPLORE
Operate multiple lines of business with claims and benefits administration, eligibility, capitation reconciliation, financial management and more.EXPLORE
Extend your effectiveness with managed, professional, or advisory services.EXPLORE