Medical Management
- Managed Care Information Systems
- Case Management related to outpatient and inpatient assurance programs administration
- Case Management related to outpatient and inpatient discharge planning
- Eligibility/benefits analysis and verification
- Quality Management, administration of grievance procedures
- Provider referral processes and authorization requirements
- Utilization review and management process
- Health plan audits
- Regulatory compliance
- Credentialing and quality assurance protocols and processes
- Health plan contracting
- P4P and chronic disease management registries for mandated clinic measure
- HCC recovery team for chart review and coding compliance and training
Finance
We Can Help You Maintain the Integrity of Your Financials While You Focus on Continuing to Build Your Practice. From Liability Recovery to Provider Claims; We can provide the service you need with accuracy and consistency.
Finance
- Finance Accounting
- Capitation fund accounting and analysis
- Stop-loss identification, submission and recovery
- Third party liability recovery
- Provider claims review reimbursement administration and adjudication
- Self-reporting for pay-for-performance via Company’s registry management service
Business Development
Business Development
- Provider Network analysis and contracting
- Health Plan contracting and analysis
- IPA/ Medical Group Start-up consulting
Let’s Partner Together to Lighten the Load You Have as a Medical Care Provider
Partnership with Elite Care Health Organization enables physicians to focus on their patient clinical care while maintaining their collective practice independence.