Medicare Advantage Services
Cost Containment
- Provider Contracting
- Network Development
- Billing Error & Abuse
- Repricing
Customer Service
- 9.4 Avg Speed of Answer
- In-House Customer Service Team
- Beneficiary and Provider
- Fluent in English and Spanish
- Call Recording
Claims Processing
- Claims File Intake
- Process Claim
- Capitation, Refunds, Adjustments
- Claims Repricing
Reporting
- Analytics
- IBNR
- Performance Standards
- Audit and Compliance Assistance
Mailings
- Less Than 1% Returned Mail
- Beneficiary Mailings
- HIPAA Compliant Printer
- HEDR Mailings
Provider Payments
- Weekly Claims Payments
- Capitation and Care Management
- Shared Savings
- 835, EOP, ACH
With more than 28 million beneficiaries enrolled in Medicare Advantage plans, payers increasingly need reliable and experienced organizations to administer their benefits. Our leadership team has owned and operated HMOs and TPAs, so we know the dedication it takes to properly run a health plan. We have been administering solutions for Medicare, Medicaid, commercial, and self-funded for over 12 years as SMG. We offer our full catalog of services to Medicare Advantage plans and providers taking risk who are in Medicare Advantage contracts. And with all our services, everything we do is flexible and customizable to fit your specific needs.