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Accountable Care Organizations 2017-01-06T14:53:59+00:00

Accountable Care Organizations (ACOs)

AccuReports® gives the Accountable Care Organization’s Chief Financial Officer a tool to measure the success of performance improvement initiatives. Care management and disease management programs abound, but tools to help the CFO know what efforts are working are uncommon. AccuReports completes a toolbox of analytic tools to measure the Return on Care™ for your initiatives.

What is return on care? Return on Care™ is the change in overall performance, both financial and quality, yielded from all the activities that go into care management: scheduling, office visits, RAPS coding, HEDIS gap closing, utilization management, transportation, coordination and all of it.

AccuReports® cleanly organizes Claim and Claim Line (CCLF) files into an interactive matrix so that you can discover adverse utilization trends and act on them. FRG’s extensive experience with Medicare Advantage plans gives us unique expertise to help you quantify and apply all the other costs of doing business in a way that gives you the power to see what works and what doesn’t work.

FRG can help you in a variety of ways. Measure and Improve Preferred Network Practice Patterns with AccuReports® Network Markups. Communicate Attribution Efficiently with AccuReports® Patient List Report. Evaluate Server Relationships with AccuReports® Claims with Rendering Provider. Identify High Cost Members AND Prioritize Outreach Efforts. Let FRG apply Completion Factors to help your Month-End Close process. Monitor your exposure and coordinate your Third Party Reinsurance file feeds. Apply risk adjustment to SEGMENT And FOCUS on your high risk members.

Reconciliation Clarity

  • CCLF file data-warehousing
  • Claims Consolidation
  • IBNR Estimation
  • Stop Loss Monitoring
  • Attribution vs. Server Analysis
  • Leakage Analysis
  • RAPS Equivalency Modeling
  • Benchmark vs. Actual Loss Ratio
AccuReports for Accountable Care Organizations

AccuReports®

FRG has helped health plans and physician groups manage risk by presenting their operational and financial data concisely for analysis through AccuReports®. Crisp & drillable formats enable users to spot trends, understand drivers, and improve financial performance.

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Audit Services for Accountable Care Organizations

Audit Recovery

FRG provides ad hoc and ongoing claims audit and recovery services across the spectrum of claim types. We have recovered tens of millions of dollars for national Medicare plans and across as many as ten managed Medicaid states.

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