Health Plan

HMS helps commercial, Medicare Advantage, and Medicaid Managed Care health plans contain costs, minimize risks, and improve quality — from pre-service through post-pay.

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Health Plan 6
1

Coordination of Benefits Solutions

With U.S. healthcare spending reaching more than $3 trillion a year, it’s more important than ever to coordinate benefits. HMS is the innovator in this field, beginning with our pioneering identification and recovery for Medicaid. Today, we recover billions of dollars a year for customers plus save billions more through improper payment prevention.

2

Payment Integrity Solutions

HMS helps you identify and recover overpayments, detect and prevent fraud, ensure compliance with regulations, and increase cost savings through process improvements. We also find ineligible dependents on your health plan, as well as employees’ spouses with access to coverage.

3

Total Population Management Solutions

Proactive population management through risk identification, member engagement and population health technology to improve health outcomes.

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