Capitation Reconciliation & Financial Management

Cedar Gate’s Cap Check™ is an essential tool for medical groups with capitated contracts to verify that they are receiving correct payments. By reconciling actual payments with expected payments on a member/month basis, you can verify whether you are being paid correctly, and make corrections when you are not.

Immediate Return on Investment

Are you being paid properly–or leaving money on the table? Cap Check is an essential tool for medical groups with capitated contracts to verify that they are receiving correct payments. By reconciling actual payments with expected payments on a member/month basis, you can verify whether you are being paid correctly, and make corrections when you are not.

Clients have reported immediate returns on investment due to substantial recouped payments as a result of using Cap Check.

Capabilities

• Easily load member/month payment and expected payment data
• Automatically calculate expected payments based on current and historical eligibility data and rate tables
• Automatically prorate payments for partial months
• Automatically reconcile retroactive payments or eligibility changes
• Generate easy-to-read reports presenting payment exceptions in detail and summary formats
• View or export all payment data from an audit screen
• Define field mappings for importing eligibility and cap data
• Select standard and custom conversions for dealing with date and currency formats and other needs
• Enable custom processes to handle special processing needs