THE EYE OPENER TO RISK MANAGEMENT OPERATIONS

MCAR – MANAGED CARE REPORTS

Timely solutions to funding, claims, pharmacy & distributions


We are proud to introduce MCAR REPORTS a complete set of management reports for IPAs, MSOs and PCP Practices that have Risk Agreements with HMOs Plans. The MCAR Reports give you complete awareness over what is happening with every HMO Plan that your organization participates in risk operations.


MCAR - MANAGED CARE REPORTS is an online service available created from data files downloaded from HMOs servers. Within 24 to 48 hours our team produces all reports needed to manage your risk business. MCAR Reports are viewed from our secured HIPPA compliant servers however most reports are downloadable in EXCEL format files.


MCAR Reports services can range from only generating reports to having our management team assisting clients in managing the risk operations.


Clients can select MCAR Report services “A LA CARTE” choosing monthly reports needed and/or consulting services they prefer.

Here are some of the options available:


  •           Control over HEDIS requirements, alerting what measures apply to each member of the HMO panel and most importing identifying what measures are pending per member in the reporting period.
  •           Summary analysis of funding and expenses including expected distributions, in minutes you know what is going on with your risk operation.
  •           A PCP Analysis that shows performance for each PCP in the network from funding, expenditures to net amount after medical expenses. A simple and easy report that enables you to identify and compare all PCP’s performance.
  •           MCAR produces a detailed analysis of charges payments and adjustments from Institutional, Professional and Pharmacy claims.
  •           A key report - Summary Report showing what each member is costing the panel, a brief breakdown of medical expenses also showing when was the last time the patient came to the office, if ever.
  •           A detailed analysis showing all activities for every member - HEDIS measure status, diagnosis codes with MRA evaluation plus each line item of expenses – YOU CAN VIEW THE PRECISE COST OF EACH MEMBER OF THE PANEL.
  •           STOP LOSS verification.
  •           MCAR Reports claims module – “The ADJUDICATOR” scrubs your professional, institutional and pharmacy claims and also prepares a contestation report requesting adjustments from the Plan.

The ADJUDICATOR module employs the most sophisticated scrubbing techniques following CMS and AMA guidelines in processing professional and pharmacy claims.


FOR MORE INFORMATION PLEASE CONTACT:

HPP Management Group, Corp.

Developers of the AccuChecker Product Line


Phone: (305) 227-2383

Email: sales@accuchecker.com

Website: http://www.accuchecker.com