SOURCE: Altegra Health

Altegra Health

May 28, 2013 12:08 ET

Altegra Health Launches Solutions to Help Health Plans Navigate the 2014 Commercial Market and New Healthcare Exchange

Services Designed to Improve Financial Performance and Enrollee Retention

MIAMI LAKES, FL--(Marketwired - May 28, 2013) - Altegra Health Inc., a leading provider of technology-enabled business solutions for healthcare organizations, announced the launch of a customized suite of products and services to help health plans navigate the new commercial health insurance market reforms affecting enrollment and revenue.

Altegra Health's integrated solutions give commercial health plans the ability to immediately implement risk adjustment capabilities required by the Affordable Care Act (ACA), enabling them to manage the financial impact of reform-driven payment transfers while also retaining enrollees in a commercial marketplace now open to an unprecedented degree. The suite of Altegra Health services works to guide commercial health plans through proactive and targeted enrollee interventions now necessary as a result of the 2014 ACA requirements affecting individual and small group products, both inside and outside the Health Insurance Marketplace, also known as "the Exchange." 

"The combination of the new commercial risk model, payment transfer formula, annual audits and the upcoming transition to ICD-10 emphasize the need for accurate coding, claims and eligibility data, as well as powerful data analytics and a deep understanding of all risk adjustment models and enrollee populations," said Altegra Health President and CEO Kevin Barrett. "Altegra Health's risk adjustment solutions are ideally suited for commercial plans to achieve greater financial predictability, positive audit results and superior clinical outcomes."

Implementation of the open market with completely new insurance products, technology-driven eligibility and enrollment processes, and low-income subsidies presents complex consumer choices, places higher demands on customer service and presents new enrollee retention challenges. Altegra Health's outreach and engagement solutions complement and enhance commercial health plan operations and customer service teams by economically supporting large numbers of new enrollee needs through technology-enabled, enrollee-centric outreach and targeted interventions designed to meet the unique needs of this market's demographics.

Altegra Health's commercial market solutions encompass a full spectrum of revenue cycle, risk adjustment and related data analytics and management services to address financial forecasting, Centers for Medicare & Medicaid Services audit support, and provider education for documentation and coding. When combined with Altegra Health's multichannel communications service for enrollee onboarding, management and retention, commercial health plans can optimize internal resources and ensure readiness for significant changes beginning with open enrollment in October 2013. 

For more information, along with a complete list of Altegra Health's commercial health plan services and solutions, visit

About Altegra Health

Altegra Health™ is a leading provider of technology-enabled business and consulting services that improve health plan and provider organization performance by aligning proven revenue, quality and care management solutions with clients' existing capabilities. Altegra Health enhances enrollee and provider experience, strengthens compliance, and improves operations through integrated solutions focused on program assistance, risk adjustment and healthcare enhancement, as well as reimbursement and advisory services. For more information, visit

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