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Expert Services

Managed, Advisory, and Professional Services

Cedar Gate supports the delivery of high-value, high-performance healthcare across all sides of the payer-provider-employer equation through full-service strategic, analytical, actuarial, and operational consulting. We serve as an extension of your staff, helping to keep you focused, fill gaps where needed, and ensure optimal efficiency. Whether you use our services as a full Managed Service Organization (MSO) or simply choose a customized assortment of solutions to suit your needs, we are here to help you every step of the way.

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Managed Services

Our Managed Services offerings provide an effective way for you to off-load one or more operational functions on an ongoing basis. They include:

Provider Credentialing

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.

Advisory
Services

Our Advisory Services give you direct access to Cedar Gate experts for a range of contracted consulting services—available both long- and short-term—providing specific, valuable insights about your business. Offerings include:

Actuarial and Ongoing Performance Improvement and Analytics

By combining deep, detailed analysis of healthcare performance and financial data, including actuarial performance and projections, with the insight of our Cedar Gate industry experts, we enable you to continuously define opportunities to improve and take timely effective action.

Cedar Gate can work with you to design and customize your own Executive Dashboard and Playbook. You’ll get a tailored Playbook that measures and showcases the specific actions that an at-risk health organization needs to be successful. The Playbook allows your leaders to assign, monitor, and project performance of each prescriptive action put into play.

We’re there at your side to help you navigate every step of your value-based care journey. Continuously assessing and optimizing performance along the way, we support you through the evaluation of individual bundle, provider, and portfolio performance.

At Cedar Gate, we’re skilled at poring over your claims-related reimbursement data to identify opportunities in selected markets by line of business. The final product is your own optimal portfolio of service line/market-specific bundles and associated pricing.

We’ll collaborate with you to develop customized strategic and operational roadmaps for risk contract performance and evolution based on risk maturity, internal capabilities, and the market. 

Professional Services

Our Professional Services put Cedar Gate experts at your disposal to perform project-based assignments that address specific business or software challenges. These on-call professionals are available to help you overcome resource issues and increase speed to market. Our services span the full range of client needs:

Create

  • Pre-Implementation Business Process Assessment
  • Implementation Program & Project Management Oversight
  • Configuration for Any Line of Business
  • EZ-Suite Pre-Built Templates to Accelerate Time-to-Value
  • Upgrades & Conversions
  • Migration Support, Including Data Clean-Up
  • Customized, Automated Training on a Learning Management Platform
  • Product, Functional & Operational Training
  • Infrastructure Review
  • EZ-Suite Application Maintenance
  • System Optimization
  • Client/Line-of-Business Custom Test Plans
  • Scripts for Reporting, Compliance & Audit
  • Data Management & Database Development
  • Report Development (Crystal Reports, SQL Server)
  • Technical Documentation
  • Business Processes
  • Architecture
  • Policies & Procedures
  • Workflow Analysis & Documentation
  • Eligibility & Enrollment
  • Benefits & Fee Schedules
  • Provider & Contracts Management
  • Claims Administration
  • Utilization, Case & Care Management

Serving

payers

Payers

Manage risk more effectively and obtain greater value for every healthcare dollar.

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providers

Providers

Act on emerging opportunities to transform operations and improve financial performance.

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employers

Employers / ASOs

Recognize high-value innovation opportunities in healthcare with our help.

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EXPLORE
SOLUTIONS

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.

Enterprise Data Management

Capture, organize, and utilize all valuable data sets securely and easily.

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Empower your team with timely information to take action and reach performance goals.

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Transform the way you report on your business with these intelligent tool sets.

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Support medical management activities across the care continuum.

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Manage patients effectively from chronic conditions to transitions of care.

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Administer retrospective and prospective bundled payment arrangements with clinical excellence.

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Operate multiple lines of business with claims and benefits administration, eligibility, capitation reconciliation, financial management and more.

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