Insurance Contracting & Management

Doctors can rely on EPIC’s negotiating power with health plans to help them bring in the most revenue possible. As a result of working with one of the oldest and most respected medical groups in Southern California, EPIC Management has developed strong working relationships with national and local health plans.

In addition, doctors can provide better care to patients while increasing their revenue with Pay for Performance and Medicare Senior Risk programs supported by EPIC. The staff at EPIC provides guidance to doctors and makes sure that patient care is accurately documented and codes reported correctly. This ensures that physicians receive additional revenue for providing high quality patient care and compliance with regulations.

EPIC offers the full range of business services related to managing insurance patients including:

  • Health Plan Contract Negotiations
  • Health Plan Contract Auditing
  • Pay for Performance Reporting & Planning
  • Membership Reporting (rosters and activity)
  • Referral Management
  • Billing Abuse Detection & Recovery
  • Claims Management & Cost Containment Consulting
  • Third Party Benefits Recovery
  • Medicare Senior Risk Monitoring & Compliance
  • Contract Performance Analysis
  • Specialty & Ancillary Provider Contracting
  • Provider Relations
  • Eligibility & Capitation Revenue Reconciliation
  • Sub-capitation Contracting & Management
  • Claims Administration
  • Encounter Data Submission Management
  • HCC Reporting and Coding Review
  • Risk Pool Administration
  • Hospital Capitation Management
  • Hospital Risk Pool Administration