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Health Plans 2017-01-06T14:55:40+00:00

Health Plans

FRG is proud to provide AccuReports® as the risk reporting portal for substantial national Health Plans clients and serve data on more than two million lives to hundreds of IPAs and MSOs across the country. Health Plan clients trust FRG to be reliable partners in data preparation, to provide audit and validation of production files before release to risk-bearing partners, and in many cases to share the expertise in developing industry standard incentive contracts and the processes, procedures, and reconciliation tools to administer them.

FRG will work directly with your IT, finance and provider network teams get you up and running quickly. We can help you identify and build the files to begin a CFR compliant Provider Incentive Plan program or simply use the feeds you are producing internally for reconciliation. Our experts will help you abstract your provider contracts to define the terms of the risk arrangements and incorporate them into a standardized feed for monthly administration. At the same time, our data team will build custom procedures to load your data consistently and efficiently each month from raw files like the MMR and MMR files or feeds that you prepare or already exist.

Health Plan clients appreciate our process-oriented approach and our laser focus on preparing a system that ties to your financials and existing management reports. New clients can be online with AccuReports® in 60 to 90 days, depending on FRG’s production queue, their data production efficiency, and the completeness of the information provided. Clients start with “Service Fund” or “Risk Contract” and can expand to integrating risk adjustment (RAPS, MRA and HCC) opportunities and quality care gaps you compute separately. Transparency is all in what you share!

Services at a Glance

  • Delivery Transparency
  • Communicate Performance
  • Engage Risk Partners
  • Leverage Experience Across the Industry
  • RAPS Equivalency Modeling
  • Benchmark vs. Actual Loss Ratio
AccuReports Who We Help

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 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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We Believe Transparency Aligns Plans and Providers

Empower Partners with Insight from the Trusted Source
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