Success Stories
How Blue Cross of Idaho Modernized Provider Communication to Improve Risk & Quality Outcomes
Blue Cross of Idaho improved provider engagement and risk documentation by delivering clinical insights directly into provider workflows.
Improving Medicare Advantage Risk Submission Accuracy Through Data Integrity Analytics
See how a Medicare Advantage plan identified $3M in suppressed risk transfer by uncovering data integrity gaps across the risk submission process.
How an ACA Plan Identified $7.7M in Suppressed Risk Transfer
ACA plan identifies millions in suppressed risk transfer by uncovering encounter data gaps impacting EDGE server submissions.
How a Health System Identified $4.7M in Financial Opportunity in Value-Based Contracts
A health system improved value-based reimbursement accuracy by identifying and fixing encounter data gaps across multiple payers and 40,000 members.
How a Blue Plan Improved Revenue Accuracy Across MA & ACA
A Blue plan serving one million Commercial, Medicare Advantage, and ACA members identified gaps in risk documentation, encounter data integrity, and payment processes for over $10M in financial impact.
Improving Medicare Advantage Premium Accuracy Through Member Status Analytics
A multi-state MA plan uncovered $11.5M in attainable financial improvement after identifying ESRD and MSP status inaccuracies affecting premium capitation payments.