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Health Plan Management

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Presentation on theme: "Health Plan Management"— Presentation transcript:

1 Health Plan Management
Patty Bailey, CEO Peak Health Plan Management Services

2 About Us Located in St. Louis, MO – Central Time
Incorporated July 1, 2009 by Altitude Edge Began serving clients March 1, 2010 Acquired by Tabula Rasa May 1, 2018 Service of Capstone Performance Systems Provide Full Services 44 PACE organizations with over 10,000 total members Provide Part D Services 12 additional PACE organizations

3 Peak Offers Industry specific experience Flexible service packages
Versatile reporting mechanisms Comprehensive support User friendly software

4 Industry Specific Experience
Patty Bailey, CEO Began PACE career in 1999 Bill Wieher, Senior Director of Plan Operations Began at OnLok in Jennifer Hodge, Director of Technology & Client Development Began at TriHealth Senior Link in 1999

5 Comprehensive Services
Enrollment Management Services Accounts Receivable Claims Adjudication and Payment Incurred But Not Reported (IBNR) Calculation Risk Adjustment Submission Encounter Data Submission Part D Services

6 Software and Reporting
A Version of Cognify’s PACElogic software User friendly Easy navigation Data imports & exports Library of standard reports Utilization by type of service Cost by participant RAPS PDE Part D reserve reports

7 Part D Services Partner with CareKinesis PDE Submission
Plan to Plan (P2P) reporting TrOOP Notifications to participants upon disenrollment Audit Support

8 Questions Peak Health Plan Management pbailey@peakpacesolutions.com
Patty Bailey, CEO 345 Marshall Ave. Ste. 101, St. Louis, MO 63119


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