MAXIMIZING ACA 3R PAYMENTS FOR A HEALTHCARE STARTUP
MAXIMIZING ACA 3R PAYMENTS FOR A HEALTHCARE STARTUP
1 PagesTREXIN CASE STUDY CONTACT US Healthcare Practice hc@trexin.com www.trexin.com © TREXIN CONSULTING, LLC MAXIMIZING ACA 3R PA YMENTS FOR A HEALTHCARE STARTUP Trexin led a last-minute effort for a new Healthcare Consumer-Oriented and Operated Plan to validate its Risk Adjustment and Reinsurance submissions that directly resulted in a net new payment of $4,900,000 on a project. BUSINESS DRIVER An innovative Healthcare Consumer-Oriented and Operated Plan (COOP) established under the authority of the Affordable Care Act (ACA) was weeks away from the deadline to submit their data to the Centers for Medicare and Medicaid Services (CMS), yet they did not yet have a program in place to validate and optimize their Reinsurance and Risk Adjustment data submissions. The CIO asked
