Our Offering
Cost Optimization Solutions
What sets MCCO apart is our direct integration with existing MCO infrastructures, allowing for near-real-time interventions and adjustments.
Conventional solutions offer delayed reports and retrospective data analysis, while our approach enables immediate actionable insights, drastically reducing the time for implementation and enhancing the effectiveness of cost-containment measures.
Healthcare Cost Management
- Facility-Based Services: Automatically notifies care managers about patient admissions to facilities such as emergency rooms, inpatient acute care, or Skilled Nursing Facilities (SNFs), allowing for timely interventions and oversight.
- Pre- and Post-Authorizations: Displays inbound pre-authorizations for procedures, specialist visits, and prescriptions, providing administrators with the ability to intervene before inefficient or unnecessary healthcare services are approved.
- Claims: Facilitates monitoring and analysis of claims, helping to expedite insights and identify discrepancies early.
- Referrals: Facilitates monitoring and analysis of referrals, enhancing insights on patterns in out-of-network activities and identifying network leakages early.
Near-Real-Time Data Analytics Platform
Utilizing advanced algorithms built by veteran industry operators, our platform provides MCOs and MSOs with real-time insights into spending patterns, patient care metrics, and potential inefficiencies. This tool aids in proactive decision-making and cost containment.
Actionable Chase Lists
Directly integrated with MCO systems, our service generates detailed chase lists for patient and provider follow-ups. These lists come equipped with suggested actions tailored to specific scenarios, helping MCOs enforce network compliance and improve cost management strategies.
Technology reimagined
Technology solutions enhance business oversight. We develop practical methods for managed care providers.
Copyright MCCO 2024