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Transforming Risk Adjustment Through Insight, Transparency and Control
Transforming Risk Adjustment Through Insight, Transparency and Control
Transforming Risk Adjustment Through Insight, Transparency and Control
Call us today 855.984.1775
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icon hereMedicaid

Simplify and consolidate your State submissions.

If you’ve been in Medicaid operations for a while, you have probably heard the phrase, “If you’ve seen one State Medicaid program, you’ve seen one Medicaid program!” These days, if you’ve seen one of a State’s many Medicaid programs, you’ve seen one program only. Traditional Medicaid, Children’s health coverage, Medicaid Expansion, Integrated and Coordinated Dual programs, and targeted Special Need programs all need encounter data to validate costs and set rates. Unfortunately, the encounter reporting requirements to gather that data may differ from program to program.

 

At Babel, we envisioned a way to manage these submission variations using a single platform and process, plus a lot more. Perhaps your state compares encounter reporting acceptance rates against reported health care expenses as a contractual performance measure—we can measure that. Perhaps your state uses reported diagnoses for risk adjusted rating of managed care organization payments—we can help with actionable insight. Our suite of integrated tools provides you with immediate access to the performance and financial information you need to know whether data has been successfully filed, the impact it will have on your bottom line, and promotes targeted results improvements.

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Our fully integrated suite enables your health plan to:

  • Import any file format – from multiple sources
  • Validate data records against State edit requirements prior to submission
  • Easily manage response and error reports
  • Rank and prioritize error correction and resubmission activities
  • Identify trends and Provider/Member education opportunities
  • Measure progress to contractual performance and actuarial goals
  • Analyze data and produce ad hoc reports
  • Enable the business owner/eliminate IT reliance