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Cost Containment & Care Quality
Care optimization meets cost reduction: A continuum-wide strategy for states and healthcare organizations

Care optimization meets cost reduction: A continuum-wide strategy for states and healthcare organizations

Published Date June 17, 2022

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Pre-payment Solutions - COB Revalidation for Government Programs

Our COB Revalidation feature works seamlessly with a CAV deliverable to revalidate TPL segments every six months, ensuring a client's OHI files are as up-to-date as possible. Avoid cost proactively.
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Pre-payment Solutions

Gainwell's pre-payment solutions are comprehensive, compliant & configurable. See how we can help your organization minimize abrasion, alleviate administrative burden, and reduce claim spend.

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Residency Verification - Eligibility Verifications

Our residency verification solution prevents future erroneous payments through the identification of non-residents. Learn how.

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Pre-pay Clinical Claim Reviews for State Employee Health Plans Brief

Identify improper payments before a claim is paid, and avoid payment errors related to DRG coding and validation, readmissions, level of care, medical pharmacy and more.

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Pre-payment Solutions - COB Data Management for Government Programs

Our COB Pre-payment Solutions offer comprehensive, CMS-certified and configurable features to advance your data management. Reduce administrative burden and proactively avoid cost.

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Pre-payment Solutions - COB On-demand Technology for Government Programs

Gainwell's COB On-demand Technology allows you to move your cost avoidance upstream. Learn how this feature pairs with our CAV Match and Delivery offering to help your organization avoid cost.

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Pre-payment Solutions - COB Self-service Portal for Government Programs

Our Self-service Portal allows clients 24/7 access to a user interface where they can submit ad-hoc verification requests, returning verified results to the user within 48 hours. Learn more.

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Pre-payment Solutions - COB Performance Analytics for Government Programs

Our Performance Analytics feature equips clients with transparency into the health of their TPL data by delivering metrics & reports, ensuring data-driven actions are taken for continuous improvement.

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Pre-payment Solutions - Cost Avoidance Match & Delivery for Government Programs

Our CAV Match & Delivery offering identifies members' existing other coverage, so healthcare organizations can proactively avoid cost, reduce administrative burden & alleviate provider abrasion.

Read Flipbook
Pre-payment Solutions - COB Call Center Support for Government Programs

Our call center representatives can verify COB information on the spot and provide near real-time results, ensuring providers can coordinate benefits effectively and members have access to care.

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Pre-payment Solutions - COB Revalidation for Government Programs

Our COB Revalidation feature works seamlessly with a CAV deliverable to revalidate TPL segments every six months, ensuring a client's OHI files are as up-to-date as possible. Avoid cost proactively.

Read Flipbook
Pre-payment Solutions - Cost Avoidance Match & Delivery

Our CAV Match & Delivery offering identifies, verifies, and communicates members' existing other coverage so plans can proactively avoid cost, reduce administrative burden & reduce provider abrasion.

Read Flipbook

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