About

We deliver premium solutions in risk adjustment, medical billing, coding, support staff and provider education, and clinical documentation for both Medicare Replacement and ACA programs. Our services span the full revenue cycle, with proven success in reducing utilization costs, optimizing pharmacy spend, and strengthening compliance across all lines of business.

With more than 25 years of experience in risk adjustment, clinical operations, administrative management, billing, coding, utilization review, ancillary services, and vendor oversight, we bring an end-to-end understanding of the healthcare ecosystem — from data capture to final revenue reconciliation.

Our team possesses deep technical expertise in EDGE server submissions, MAO4 reporting, and 277CA/999 reconciliation workflows, managing crosswalk logic that ensures seamless alignment between encounter, claim, and risk-adjustment data. We also maintain full RADV readiness, with audit-defensible documentation and reporting frameworks that meet all state and federal regulatory guidelines.

We operate with precision and integrity — aligning compliance, operations, and analytics to deliver accuracy, transparency, and sustainable revenue performance. Whether supporting provider networks, payers, or ACOs, we help clients build efficient, compliant, and financially resilient operations that drive measurable, long-term outcomes.