Catalyst’s payment integrity solution helps health plans reduce Medicare overpayments & limit compliance risk
Catalyst helps health plans effectively coordinate benefits for Medicare members. We also help identify Medicare entitled members that often go unidentified.
Catalyst’s payment integrity solution provides health plans with the ability to effectively coordinate benefits for Medicare members by significantly reducing overpayment of claims and limiting compliance risk with CMS. Catalyst helps identify Medicare entitled members that often go unidentified by using the Mandatory Insurer Reporting under section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA).
- Recoup underpaid capitation and identify under/overpayments by focusing on Medicare Secondary Payment populations
- Offer provider reconciliation solutions and methodologies to help payers navigate Medicare Secondary Payment populations and the associated capitated premiums paid by CMS
- Limit compliance risk with CMS
- Improve the accuracy of claims processing
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