Health Insurance Administration Services
The SMG team provides quality and cost-effective services to Medicaid and Medicare HMOs, MCOs, ACOs, IPAs, and providers who take risk. We work with each of our clients on healthcare administration service solutions to best fit your needs and the needs of those we serve on your behalf.
Services Offered by SMG Include:
Cost Containment
“A dollar is a dollar” is one of our guiding principles. A dollar saved, a dollar earned, a dollar avoided or a dollar recovered is a dollar. We specialize in helping companies reduce their spending.
Provider Contracting & Network Development
BEAF – Billing Error Abuse & Fraud
Repricing
Claims Processing
Our claims payment accuracy and turnaround times are some of the best in the business! Our team can help with:
Claims Adjudication
Subrogation Recoveries
Provider Payments
Provider Appeals
Reporting
Other Services Include
Customer Service
Database Management
Enrollment Management
Voluntary Alignment
CMS Reporting
SVA Submission
SVA Response File Intake
Capitation Payments
Insurance Billing
Mailing Service
Member & Provider Portals
Membership Support
Consulting
Compliance Assistance
Credentialing Assistance
Shared Savings Payments
Provider Contracting
Provider Relations
State Reporting
BPO Conversions
Fee Schedules
Benefit Plan Builds
Claims Analytics Platform
Care Management Platform
Outsourcing can be a cost effective way to handle temporary overflow situations as well as provide an integrated, ongoing solution for handling entire departments. SMG is experienced with commercial, self-funded, Medicare and Medicaid, Medicare ACO Reach and Medicare Advantage Plan administration, and Medicaid HMO insurance plans and operations. In addition, our services are highly transferable to many other industries. If you don’t see a service listed – Ask Us!
The Best Customer Service Backed by Technology
SMG has partnered with VBA as our technology partner. In choosing SMG as your claims administrator, you can have the confidence in knowing that your plan will be administered on VBA’s secure, cloud-based technology platform. Our companies together will take your claims administration to the next level! Download our one-sheeter on SMG and VBA’s Medicaid Plan Administration Solutions
