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Average Ratings 0 Ratings

Total
ease
features
design
support

No User Reviews. Be the first to provide a review:

Write a Review

Description

Safeguard the reliability of your health plan while pinpointing precise pricing with the Context4 Health Plans Suite, our versatile and cloud-centric technological framework. Experience immediate and actionable insights for detecting Fraud, Waste, and Abuse (FWA), developed by our skilled team of certified experts in clinical, dental, and health benefits. By leveraging accurate data and state-of-the-art cloud technology, we deliver a robust and defensible Medicare reference-based pricing (RBP) solution. Our platform comprises over 100 healthcare data sets, complemented by professional guidance to enhance operational efficiency and ensure regulatory compliance. Additionally, our sophisticated medical coding software is tailored to streamline claim submissions and reduce the likelihood of denials. Furthermore, the cloud-based Payment Integrity Platform harnesses our unique analytics engine to uncover coding mistakes, assess medical necessity, address unbundling, detect fraud, waste, and abuse, evaluate audit risks, and identify pricing discrepancies, all of which can significantly influence your organization's performance. This comprehensive approach not only safeguards your financial health but also positions you for sustainable success in the ever-evolving healthcare landscape.

Description

The Risk Manager software leverages Microsoft SQL Server, enabling the development of tailored views and queries for effective reporting. Additionally, it supports ODBC-compliant applications, eliminating the need for reliance on ERIC Systems. The system is perpetually being improved, with updates being rolled out on a regular basis. Our approach to delivering these updates is straightforward: we provide new versions at no extra charge as part of the standard technical support agreement. Each user login is assigned specific dollar limits for check and reserve transactions, ensuring that any amounts exceeding these limits are subject to acknowledgment controls for total amounts paid to date and total incurred thresholds set at the enterprise level. Furthermore, our strategy for enhancing program features and standard reports is driven by the feedback and suggestions of our clients, ensuring that the software evolves to meet their needs effectively. This commitment to client collaboration ensures that the Risk Manager remains relevant and useful in a changing business environment.

API Access

Has API No 

API Access

Has API No 

Screenshots View All

Screenshots View All

Integrations

Virtual Benefits Administrator (VBA) Yes 

Integrations

Virtual Benefits Administrator (VBA) No 

Pricing Details

No price information available.
Free Trial No 
Free Version No 

Pricing Details

$19995.00/one-time
Free Trial No 
Free Version No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Deployment

Web-Based No 
On-Premises No 
iPhone App No 
iPad App No 
Android App Yes 
Windows Yes 
Mac No 
Linux No 
Chromebook No 

Customer Support

Business Hours No 
Live Rep (24/7) No 
Online Support No 

Customer Support

Business Hours Yes 
Live Rep (24/7) No 
Online Support Yes 

Types of Training

Training Docs No 
Webinars No 
Live Training (Online) No 
In Person No 

Types of Training

Training Docs No 
Webinars No 
Live Training (Online) No 
In Person No 

Vendor Details

Company Name

Context4 Healthcare

Founded

1988

Country

United States

Website

www.context4healthcare.com

Vendor Details

Company Name

ERIC Systems

Founded

1982

Country

United States

Website

www.ericsys.com

Product Features

Claims Processing

Adjustor Management No 
Case Management No 
Claim Resolution Tracking No 
Co-Pay & Deductible Tracking No 
Compliance Management No 
Customer Management No 
Electronic Claims No 
Forms Management No 
Paper-Based Claims No 
Payor Management No 
Policy Administration No 

Insurance Claims Management

CRM No 
Claims tracking No 
Customer portal No 
Document management No 
EDI data exchange integrations No 
Electronic claims No 
Fraud management No 
Reporting No 

Product Features

Claims Processing

Adjustor Management Yes 
Case Management No 
Claim Resolution Tracking Yes 
Co-Pay & Deductible Tracking Yes 
Compliance Management Yes 
Customer Management Yes 
Electronic Claims Yes 
Forms Management Yes 
Paper-Based Claims Yes 
Payor Management Yes 
Policy Administration Yes 

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