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CalOptima is one of five County Organized Health Systems (COHS) in the country, and is authorized by federal law to administer Medi-Cal benefits. Through the efficient use of available state and federal funds and the assessing of needs on a local community basis, CalOptima has the ability to provide its members wider access to healthcare providers.
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Under the renewed contract, CalOptima will continue to be a licensed user of the Burgess Reimbursement System (BRS), integrating solutions for Inpatient Hospital (DRG-based) and Home Health provider payments and adding BurgessGroup's automated BRS BatchPricer. BurgessGroup will also continue to provide ongoing technical and Medicare payment policy support and education. Historically, CalOptima has utilized BRS for fee schedule creation, Medicare Advantage claims reimbursement, and provider relations purposes. BRS is the only Medicare-based pricing and analysis software in the industry covering all major prospective payment systems.
"One of the primary reasons we are continuing to work with Burgess is the ease of their tool. It's very user friendly, which is a huge asset for claims processing," stated Cara Chastain, Strategic Communications Manager, CalOptima. "Their BatchPricer solution will allow us the ability to build and improve auto-adjudication of claims."
"We are pleased and excited to continue working with CalOptima," commented Greg Burgess, Managing Partner, BurgessGroup. "BurgessGroup prides itself on delivering best-of-breed solutions and developing lasting, extraordinary relationships with our clients."
BurgessGroup specializes in the focused design and delivery of Medicare-based data, software, consulting and educational solutions for managing healthcare reimbursement needs with clarity and ease. BurgessGroup offers such solutions for healthcare organizations ranging from insurers and managed-care companies, to provider organizations, pharmaceutical companies and medical device manufacturers. For more information, visit: www.burgessgroup.com.
SOURCE BurgessGroup
