See what CMS sees in your claims data before they audit you. Protect your shared savings with compliance intelligence built for MSSP and ACO REACH programs.
The Challenge
You discover FW&A issues when CMS tells you about them—after the damage is done to your shared savings calculation.
Millions of claim lines across your attributed population. Most ACOs lack the tools to analyze their own data and surface actionable insights.
Fraudulent billing by suppliers in your network inflates your benchmark spend and erodes shared savings before you know it's happening. The OIG actively oversees ACO compliance—without proactive monitoring, you can't demonstrate "reasonable diligence."
Hundreds of participating providers with varying coding practices. Manual review can't keep pace with claim volume.
CMS benchmarks get tighter every year. Network leakage and high-cost outliers erode the savings you've worked to achieve.
Orphan DME claims and skin substitute billing schemes inflate your costs—and you're on the hook when CMS identifies them.
Use Case
Your participating providers have different coding and billing practices. Some leave RAF on the table with unspecified diagnoses. Others may be upcoding or exceeding MUE limits. Manual review can't keep up.
Book a demo and we'll show you Pamastay with sample ACO data—or connect your own data for a pilot.
Schedule a Demo