Managed Care is
Complex.
We can help.
Managed Care Solutions
Seahorse Consulting is an independent consulting firm specializing in managed care solutions. Our services include obtaining new contracts that drive revenue and renegotiating existing contracts to maximize revenue opportunities. Our team of experts provide managed care strategy, policy interpretation, process implementation, technical assistance, staff training and trouble-shooting claims issues to ensure timely accurate payment.
Our Services
Seahorse Consulting has successfully provided our clients assistance with managed care policy, implementation and operations ensuring the best opportunity for .
Managed Care
Managed care continues to evolve with sophisticated
models and data requirements. CMS ACO Reach, bundles and other Medicare innovation delivery and payment models continue the evolution of managed care.
Understanding and leveraging your data is key to success.
​
​
​
​
Value Based
Contracting
Our team contracts with managed care organizations for value-based payment agreements. We can assist you with internal process improvement to maximize value-based payments.
​
​
​
​
​
​
​
Claims Trouble Shooting
Our team has successfully recovered millions of dollars in claims payments that were “stuck” in the managed care system. Because of our 30+ years of experience of being on the inside having worked for all the major payors, we understand how the systems work to uncover the reason for the denial errors.
​
​
Contracting
Our team obtains contracts with all managed care and insurance payors for all lines of business nationally. We offer you the opportunity of additional revenue streams for your organization including value-based payment. Our focus area includes post-acute(SNF), hospice and home and community based (HCBS) providers.
Contract Implementation
We ensure the contract is fully implemented from start-to-finish. Our team assists with the credentialing and full documentation required to complete the contracting process. We follow the contract through the entire system to ensure it is fully and correctly loaded in the payor’s system.
​
​
​
​
Training
Understanding and implementing policy requirements are key to ensuring timely payment. We train your staff on managed care policy and process requirements to ensure accurate and timely payment.
​
​
​
​
​
​
​
