Payer Operations - Omega Healthcare

Creating Optimal Member Engagement While Delivering Compliant Outcomes & Financial Results

Improve engagement and attain compliant financial results.

Empowering Your Organization for Success

Maintain compliance with tech-enabled, cost-effective resources aimed at generating accurate and complete results

Achieving compliant and optimal financial results requires successfully navigating the complex and evolving regulatory requirements associated with Medicare Advantage, Medicaid, and Commercial ACA.

Omega Healthcare simplifies the process with intelligent, industry-leading, end-to-end tech-enabled solutions. We provide the tools you need to strengthen member/provider engagement for optimal outcomes and financial results.

800

Risk adjustment coding and HEDIS abstraction specialists

60%

Estimated savings on each HCC medical chart review and/or HEDIS abstraction

98%

Coding accuracy

Value-based care

Communicate with providers and members in a way to support clinical outcomes and member satisfaction.

Risk management & quality improvement

Ensure compliant HCC capture and optimize source data quality for accurate HEDIS and Star reporting.

Administrative Support

Streamline processes for membership management, provider network and data management, and claims auditing.

Outcome

Payers operate with greater efficiency and foster meaningful connections with members and providers.

Intelligent Payer
Operations Solutions

Value-based Care

We facilitate compliant and optimal financial results for risk adjustment and quality of care across all manner of engagement models (i.e., prospective, concurrent, and retrospective).

Risk Adjustment Documentation and Coding Review
HEDIS Chart Abstraction

Provider & Member Engagement

We provide resources to support your provider and member interaction needs, including health monitoring, provider outreach, and more.

Care Coordination
Provider & Member Communication
Utilization Management

Administrative Support

Our team provides claims processing support and coordinates administrative tasks like credentialing while identifying opportunities to increase utilization within your network.