A CalOptima Talk: Maximize Accuracy and Operational Efficiencies in the Payer World

Thursday, 5/20/2021
11:00 AM CT – 12:00 PM CT (60 minutes)
Vendor Spotlight Host: HealthEdge, CalOptima, The Burgess Group LLC

This vendor spotlight is hosted on our BigMarker platform you must use Google Chrome or Firefox when participating in the webinar.

Health plan payers understand that manual processes tied to configuring contracts, rework, and other “pay and chase” activities lead to out-of-control administrative costs. But complicated benefit and provider contracts, disjointed solutions with various update cycles, increasingly complex claims, and overwhelming IT maintenance make process improvement seem nearly impossible.

Solutions that are specifically designed to minimize internal IT lift while delivering accurate, up-to-date data can increase accuracy while minimizing manual efforts.

CalOptima is achieving just that. CalOptima, a public agency and Orange County’s single largest health insurer is rooted in their community, delivering health insurance programs to low-income members. Join this webinar to hear from Nora Onishi, Director of Information Services at CalOptima, on how they are leveraging Burgess products to maximize claims accuracy, increase operational efficiencies, and improve workflow.

Learning Objectives:

• Learn how CalOptima is achieving accurate claims pricing for their Medicare Advantage, California Medicaid (Medi-Cal), and PACE claims.
• Understand how CalOptima is transforming their payment operations.
• Dive deeper into how CalOptima has freed up IT and other resources to focus on important business needs.
• See which key stakeholders at CalOptima are involved in the transformation of their payer operations.

About HealthEdge

HealthEdge provides modern, disruptive healthcare IT solutions that health insurers use to leverage new business models, improve outcomes, drastically reduce administrative costs, and connect everyone in the healthcare delivery cycle. Its next-generation enterprise solution suite, HealthRules, is built on modern, patented technology and is delivered to customers via the HealthEdge Cloud or onsite deployment.

Notice to Participants:
Please note that this webinar is a Vendor Spotlight and will be a capabilities-focused presentation. While this vendor is not under contract with the Health Plan Alliance, we believe this webinar will provide you the opportunity to learn more about this vendor and the programs and services it provides. Offering this webinar does not imply that the Health Plan Alliance endorses this vendor. The webinar is merely for informational purposes only. Should you wish to share feedback and/or have questions about this vendor, please contact Jaime González, the Alliance’s Chief Business Development Officer, at jaime.gonzalez@healthplanalliance.org or 972-830-6355.