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< Healthcare

Fiscal Agent Services

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Fiscal Agent Services

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Leveraging our 30-plus years of experience in delivering highly efficient and reliable Medicaid fiscal agent services, we bring the expertise needed to transform fiscal agent operations so that agencies can provide successful outcomes and seamless experiences. Ranked as a Leader in managing payer operations (Everest PEAK Matrix 2020), we have delivered new innovations to claims processing, provider and member services, and mailroom operations for several leading Medicaid and commercial payers.

Our Fiscal Agent module and financial operations transformation strategy are focused on delivering:

  • Increased auto-adjudication rates.
  • Enhanced provider and member experiences.
  • Improved services .
  • The adoption of self-service and electronic submissions.
  • Reduced program and operational costs
  • Improved compliance

Our Fiscal Agent services include:

  • Provider Management, Support, and Education
  • Recipient/Member Services & support
  • Claim processing and payment administration
  • Prior authorizations
  • Utilization review and quality assurance
  • Early and Periodic Screening, Diagnosis and Treatment (EPSDT)
  • Financial services and reimbursements
  • Mailroom and fulfillment services 
  • Drug rebates
  • Third-party liability services
  • Contact Center Services
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