Found 462 results

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-provider-organizations/healthcare-access-and-markets/

Health Information Technology (HIT)

PCG's Health Information Technology (HIT) team works with state and government agencies, with a focus on Medicaid, Exchanges and health information technology, to help further the advancement of technology in the world of health care. Services include Medicaid Enterprise Systems (MES) IT Strategy Co...

/health/for-provider-organizations/health-information-technology-hit/

Physician Services Supplemental Payment Strategies

Physician Upper Payment Limit (UPL) Supplemental Payment Strategies Medicaid agencies across the country grapple with ensuring sufficient access to primary, specialty, and dental care services to the Medicaid population. By implementing a Physician Medicaid Supplemental Payment strategy, Medicaid ag...

/health/for-provider-organizations/physician-services-supplemental-payment-strategies/

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...

/health/for-state-insurance-departments/data-intermediary-services/

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-state-insurance-departments/institutional-rate-setting-and-support/

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-state-insurance-departments/third-party-administrator-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-state-insurance-departments/administrative-service-organization-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-insurance-departments/healthcare-access-and-markets/

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-state-health-medicaid-agencies/institutional-rate-setting-and-support/

Provider Management and Program Integrity

Each year, hundreds of millions of Medicaid dollars go to personal care services, home health, community behavioral health, hospice, non-emergency transportation, and other in-home care services. Managing these services – and their providers – requires a unique and innovative approach that is not tr...

/health/for-state-health-medicaid-agencies/provider-management-and-program-integrity/