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Average Ratings 0 Ratings

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features
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support

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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

Utilize our exclusive Claims Analysis tool to efficiently save both time and financial resources by identifying bundled codes alongside the Medicare allowable amounts. Eliminate the frustration of navigating through numerous online resources, as we consolidate everything you need in a single platform, including fee schedules, drug lookup, CMS transmittals, and additional resources. Each claim undergoes a meticulous review with over 30 specific code edits to ascertain whether CMS considers the code bundled to the SNF. Our comprehensive database encompasses more than 16,000 Medicare billing codes along with data for 112 geographical locations. We provide detailed reports reflecting the Medicare allowable amounts tailored to your specific zip code. Our service includes fees from all relevant CMS fee schedules, covering areas such as physician services, ambulance, ambulatory surgery centers, DMEPOS, drugs, laboratories, PEN, and hospital outpatient settings. We also provide carrier-priced codes for those carriers that report their prices to ensure transparency. Any CMS coding inaccuracies are promptly corrected on our platform as they are discovered, and you can conveniently save all your reports for future reference. This way, you can streamline your claims process and enhance your operational efficiency.

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

$340 per year
Free Trial Yes 
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 Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
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 Yes 

Vendor Details

Company Name

Context4 Healthcare

Founded

1988

Country

United States

Website

www.context4healthcare.com

Vendor Details

Company Name

Consolidated Billing Services

Founded

1998

Country

United States

Website

www.billing-services.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

Nursing Home

Billing & Invoicing No 
Charting No 
Electronic Signature No 
Incident Management No 
Meal / Nutrition Management No 
Medication Tracking No 
Patient Intake No 
Referral Management No 
Scheduling No 

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