Our Services

Payer Administrative

Precision Coding, Enhanced Compensation, Comprehensive Payer Support!

In today's complex healthcare landscape, payers face escalating challenges including rising costs, intricate regulations, and heightened regulatory scrutiny. Navigating these responsibilities requires precise compensation, improved operations, and enhanced member satisfaction for success.

At Global Healthcare, we're dedicated to getting it right — consistently improving processes, refining operations, and placing customers' health and well-being at the forefront of our healthcare payment solutions. Our innovative Payer Administrative Services leverage advanced technologies to automate tasks, enhancing efficiency across the board.

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Our Services

Our Services

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    Risk Adjustment Coding Services

    Navigate the complexities of risk adjustment coding with confidence. Our seasoned experts meticulously analyze member health records to ensure precise health condition documentation. Through retrospective, concurrent, and prospective reviews, we validate coding accuracy, enhancing the integrity of risk scores and ensuring fairness in reimbursement.

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    Provider & Member Communication Services

    Forge seamless interactions between providers and members. Our strategic solutions facilitate accurate information exchange, streamline appointment scheduling, and enhance care coordination. Elevate provider-member relationships to drive improved care delivery and bolster member satisfaction.

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    Member Engagement and Health Monitoring

    Empower members on their health journey. Our personalized engagement and health monitoring programs empower informed decision-making, proactive health management, and significant reduction in healthcare costs. Insurance companies or government healthcare programs, are in a unique position to facilitate member engagement and monitor the health of their covered individuals.

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    Provider Outreach and Collaboration

    Cultivate comprehensive care through provider collaboration. Our outreach initiatives promote data sharing, disseminate best practices, and drive effective care coordination. These platforms can also include health and wellness resources, educational materials Elevate patient outcomes by optimizing the utilization of available resources.

Empowering Payer Administration

Empowering Payer Administration Through Technology

We firmly believe that by integrating cutting-edge solutions, we can empower payers to achieve operational excellence, streamline processes, and provide exceptional services to both members and providers. Our technology solutions.

Efficient Provider Contract Management : Our system facilitates smooth data exchange between payers and providers, making communication and collaboration seamless. This boosts decision-making, care coordination, and efficiency by providing clearer access to vital information.

Enhancing Collaboration and Accountability : Our technology encourages collaboration among payers, providers, and stakeholders. Easy-to-use platforms, shared workflows, and real-time updates foster transparency, efficiency, and responsibility in operations.

Achieving Operational Excellence : We use technology to streamline processes, cut down on repetition, and reduce errors. Through automation and smart frameworks, we ensure consistent, efficient operations, enabling better resource allocation and improved performance metrics.

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OUR Management

Payor Portfolio Management

Strategic Payor Negotiations : Leverage our negotiation expertise to secure advantageous contracts and reimbursement rates aligned with your practice's goals.

Comprehensive Contract Analysis : Our team meticulously reviews contracts for clarity, accuracy, and compliance with industry regulations.

Ongoing Performance Monitoring : Continuously track payor performance, monitor key indicators, and pinpoint areas for enhancement.

Tailored Reimbursement Strategies : Develop personalized reimbursement approaches that align with your practice's financial objectives and growth ambitions.

Our Management

Efficient Pharma Rebate Management

Efficient Management : Streamline the intricate processes of managing pharmaceutical rebates, ensuring accuracy and compliance.

Accurate Tracking : Monitor and track rebate programs meticulously, ensuring timely submissions and maximizing returns.

Effective Negotiations : Leverage our expertise to engage in strategic negotiations, securing favorable rebate terms and agreements.

Compliance Assurance : Ensure adherence to industry regulations and requirements, avoiding penalties and legal complications.

Enhanced Financial Performance : Maximize revenue through well-managed rebate programs and improved financial outcomes.

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Reasons to choose

10 reasons to choose us

Industry Experts : Our seasoned professionals offer expertise in risk adjustment coding, HEDIS reporting, member engagement, and provider collaboration for navigating complex healthcare landscapes.

Tailored Solutions : We customize services for payers, providers, and pharma companies, integrating seamlessly into your operations.

Cutting-edge Technology : Our advanced platforms enhance data exchange, communication, and operational efficiency.

Proactive Care : We prioritize proactive care management, driving cost reduction and improved outcomes for high-risk members.

Compliance and Accuracy : Our services ensure regulatory adherence and revenue maximization.

Reasons to choose

Reasons to choose us

Seamless Integration : We integrate smoothly into your systems, minimizing disruption.

Personalized Communication : Elevate member and provider satisfaction through tailored communication plans.

Comprehensive Support : From coding to payor management, we enhance operational efficiency and financial performance.

Value-Based Focus : Aligning with value-based care goals, we ensure quality outcomes and member satisfaction.

Empowering Partnerships : Join us in reshaping healthcare administration through collaborative partnerships.

  • - Contact us now to learn more and get started on transforming your payer administration!
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