For Health Plans

Health Plans

Managed care plans are under more regulatory scrutiny than ever before. Meanwhile, they face the business challenge of controlling Medicaid costs without sacrificing patient outcomes. At PCG, we’ve worked in the Medicaid program integrity environment for more than three decades. Our team will work with you to better define quality and system goals and develop compliance and outcomes measures to optimize your plan’s performance.

Services include


  • Compliance Consulting
  • Network Provider Screening, Enrollment, and Management
  • Pre-Payment Claims and Case File Reviews
  • Post-Payment Reviews and Investigations
  • TPA