Found 462 results

Coding Training and Compliance Review Services

Coding and documentation requirements, along with compliance regulations, change all too frequently. To keep our clients abreast of changes in coding, documentation, and compliance, PCG has developed a series of training and compliance tools that can be tailored to meet your needs. Our team includes...

/health/for-state-health-medicaid-agencies/coding-training-and-compliance-review-services/

Healthcare Access and Markets

States turn to PCG to organize their commercial health insurance regulatory compliance. They work with us to establish managed care procurement and contract oversight. States regulate their private insurance markets and operate Medicaid managed care and fee-for-service programs to assure healthcare ...

/health/for-state-health-medicaid-agencies/healthcare-access-and-markets/

Delivery System Reform, Performance Management, And Quality Improvement

PCG provides Medicaid departments expertise in reducing cost and improving program quality across several major Medicaid reform efforts enabled through Section 1115 Waiver authority. Learn more about our current program work in New Jersey, Massachusetts, and New York below. New Jersey Beyond managin...

/health/for-provider-organizations/delivery-system-reform-performance-management-and-quality-improvement/

Delivery System Reform, Performance Management, And Quality Improvement

PCG provides Medicaid departments expertise in reducing cost and improving program quality across several major Medicaid reform efforts enabled through Section 1115 Waiver authority. Learn more about our current program work in New Jersey, Massachusetts, and New York below. New Jersey Beyond managin...

/health/for-state-health-medicaid-agencies/delivery-system-reform-performance-management-and-quality-improvement/

Institutional Rate Setting and Support

Institutional Rate Setting Services and Support Services Institutional services, such as inpatient and outpatient hospital, skilled nursing facility, and nursing facility services are a significant spend and driver of healthcare costs. Medicaid and other state agencies need, and should adopt, paymen...

/health/for-health-plans/institutional-rate-setting-and-support/

Healthcare Access and Markets

States turn to PCG to organize their commercial health insurance regulatory compliance. They work with us to establish managed care procurement and contract oversight. States regulate their private insurance markets and operate Medicaid managed care and fee-for-service programs to assure healthcare ...

/health/for-health-plans/healthcare-access-and-markets/

Third Party Administrator Services

Third Party Administrator (TPA) Services PCG serves as an expert and trusted third party administrator (TPA) providing end to end claims processing services and solutions on behalf of government agencies and health plans. Our team works with Medicare and Medicaid health plans, as well as other gover...

/health/for-health-plans/third-party-administrator-services/

Data Intermediary Services

Data Intermediary Solution - Hospital All Payer Claims Reporting System PCG has developed proprietary web-based technology to support government agencies in the collection of inpatient and outpatient hospital claims data to inform public health officials about important healthcare trends. With PCG’s...

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Administrative Service Organization Services

PCG has expertise in the creation, implementation, and management of Administrative Services Organizations (ASO). This service provides the first line of defense between a provider and fiscal intermediaries to ensure that submitted claims meet federal, state, and local Medicaid claiming policies. We...

/health/for-health-plans/administrative-service-organization-services/

Administrative Service Organization Services

PCG has expertise in the creation, implementation, and management of Administrative Services Organizations (ASO). This service provides the first line of defense between a provider and fiscal intermediaries to ensure that submitted claims meet federal, state, and local Medicaid claiming policies. We...

/health/for-provider-organizations/administrative-service-organization-services/