claims data analysis

of page Changing lives and transforming healthcare.achi creates healthier communities by addressing social drivers.Human Care Services for All Our ultimate goal is to help the community. A community comprised of your employees, your patients, your students, and your families. We’re passionate about connecting the dots between the numbers and the conditions that influence your target population’s overall health to establish initiatives that better meet their needs and provide whole-person care, sequentially creating healthier communities.Learn More Our Services Through assisting organizations with understanding the social determinants of health, achi can coordinate holistic care utilizing value-based models to help you keep your target populations healthy and thriving. ​ We specialize in servicing the healthcare and insurance industries, self-insured businesses, as well as educational.

Community Health / Engagement Contact CentersFinancial Analytics and Strategy for Value-Based ProgramsHealthcare Spend Data AnalyticsLeadership Coaching and Change ManagementSocial Determinants of Health (SDoH) Screenings & ProgramsValue-Based Care Program Monitoring and Infrastructure

Clarity Pharma Research LLC is a scientific research organization (SRO) serving pharmaceutical, medical device, and biomedical companies. It is a specialty pharmaceutical market research supplier focused on patient chart audit and treating physician studies, specializing in rare diseases. It provides custom primary pharmaceutical market research pre- and post-launch, including market sizing, product uptake, treatment patterns, and clinical utility.

patient chart auditprimary market researchqualitative researchrepresentative samplingstatisticstreating physician studies

DRG Claims Management is a payment integrity and claims auditing company serving healthcare payers such as Medicare Advantage, Medicaid, and Commercial insurers. It provides end-to-end services including audits, data mining, clinical reviews, and overpayment recovery, with a credentialed team of clinical auditors and healthcare veterans.

APR-DRG validationclinical reviewsdata miningDRG auditingMS-DRG reviewoutpatient auditingoverpayment recoverypost-payment auditingprepayment auditing

Founded in 2013, Salud Actuarial Consulting specializes in actuarial, financial, and health policy consulting for publicly funded health programs. The firm helps clients understand complex regulatory issues and solve financial matters associated with designing and administering managed care programs, with extensive experience in acute care and long-term care program design, financing decisions, and managed care rate setting in Medicare and Medicaid product lines.

actuarial consultingcapitation rate settingdata analytics (SQL/WPS/SAS)expert witness testimonyfinancial reportingIBNP analysisrisk adjustment