Highlights

We have a proven track record of offering highly scalable solutions that maximize results.

$2.0B+
Healthcare
Payer Savings
200M+
Health Plan
LIves
90+
Managed Medicaid
Plans in 45 States

Our Services

Audit Advantage

Unparallelled clinical and audit expertise supported by segment specialists, state-of-the-art predictive analytics, and top-tier customer service

From regional and Blues plans to large national health plans and government agencies, Performant delivers scalable, tailored solutions aligned to each client’s specific goals.

  • Inpatient & Facility Audits
  • Outpatient Audits
  • Provider Recovery
  • Post-Acute & Home Care Audits
  • High Risk & Specialty Audits

Data Mining Advantage

Innovative technology designed to help health plans perform through data management and analytics and implement best practices to improve cost containment

Our fully customizable approach, bolstered by a robust library of concepts and proprietary data processing audit workflow platform, identifies and fixes breaks in adjudication systems.

  • Provider Billing & Coding
  • System Limitations, Benefits & Policy Rules
  • Contract Compliance Reviews
  • Coordination of Benefits & Eligibility

Eligibility Advantage

Scalable, versatile solution suite for premium enhancement, led by eligibility experts and backed by sophisticated analytics, with unmatched other coverage impact

Our tailored solutions, backed by a deep proficiency with regulatory requirements and a commitment to full transparency, offer accelerated premium revenue and/or program savings.

  • MSP Advantage
  • TPL Advantage