Our Approach

The right benefits. The right care. The right reimbursement.

As a quality, care and revenue management solutions partner, Altegra Health empowers Medicaid health plans to integrate key areas of financial performance and continuity of care while improving the quality of life of the individuals they serve. Our solutions enable Medicaid health plans to gain a deeper understanding of their members and provider networks in order to bring together the right benefits, the right care, and the right reimbursement. We achieve this through a comprehensive and integrated approach to member engagement, quality reporting, and risk adjustment programs.

Risk Adjustment

Continuous monitoring and reporting of risk scores to ensure members are appropriately risk-adjusted and, in turn, qualify for appropriate payment.

Quality Performance

Our Quality Performance solutions provide continuous member engagement and quality measurement tools to ensure appropriate and satisfactory levels of care. They include:

Program Assistance

Continuous monitoring of social program eligibility and enrollment status to ensure appropriate access to benefits for which members are entitled.

Reimbursement & Advisory Services

Our Reimbursement & Advisory Services Division has served as a trusted advisor to some of the nation’s most prominent healthcare organizations and health law practices, delivering proven, forward-thinking solution and real results. They include: