Fraud, Waste, and Abuse Detection & Prevention

Improve Effectiveness, Oversight, and Efficiency

IT-Partner
State Medicaid agencies must properly appropriate tax payers’ dollars they spend for healthcare, whether those dollars are spent on fee-for-service claims, managed care plans, or through new and evolving value-based payment programs.
Our solutions help states utilize Medicaid funds to ensure fiscal integrity, prevent fraud, waste, abuse and comply with CMS regulations

Our goal is to provide maximum support and help to the states so that they can analyze all of their Medicaid dollars. By using the analytic tools we help to keep both the fiscal and program integrity intact. Our custom solutions minimizes wastes, abuses, and frauds to comply with the latest CMS regulations.

Fraud, Waste, and Abuse Services

Because our concern is the clinical value of the data exchange that takes place among healthcare agencies, providers, plans, and healthcare systems, we develop analytics tools that make this possible.

The analytics tools will provide will help Medicaid agencies to understand how they spend every dollar – managed care plans, fee-for-service claims, or other novel value-based payments. The understanding of how they spend each dollar will help them identify any inefficiencies (or fraud) in their operations.

The nature of Medicaid means integrity and fiscal accountability is a primary objective. Through these analytics tools, Medicaid agencies can achieve that goal as they identify inefficiencies (and fraud) and develop strategies to block the hole (especially in light of new Centers for Medicare and Medicaid Services [CMS] regulation).

Analytics Tools that ensure efficiency

Because our concern is the clinical value of the data exchange that takes place among healthcare agencies, providers, plans, and healthcare systems, we develop analytics tools that make this possible.

The analytics tools will provide will help Medicaid agencies to understand how they spend every dollar – managed care plans, fee-for-service claims, or other novel value-based payments. The understanding of how they spend each dollar will help them identify any inefficiencies (or fraud) in their operations.

The nature of Medicaid means integrity and fiscal accountability is a primary objective. Through these analytics tools, Medicaid agencies can achieve that goal as they identify inefficiencies (and fraud) and develop strategies to block the hole (especially in light of new Centers for Medicare and Medicaid Services [CMS] regulation).

Electronic Visit Verification

To comply with 21st Century Cures Act, Yetira offers Electronic Visit Verification (EVV) solution to electronically document the personal care services offered to home healthcare participants. Our web and mobile solution enables
Realtime Verification of Visits,
Automated Missed Visit Notification
Elimination of Costs and Risks of Paper Timesheets
Better Control and Documentation of Service Delivery
Elimination of Payroll and Billing Data Entry
Audit Readiness and Lesser Danger of Having to Repay Billing, and
Favorable Billing and Payroll Outcomes

Home Healthcare Management

As a full service partner, Yetira bridges the gaps in collaborative care for medicare patients in their own home. With 24×7 access to care from clinical staff, medication and treatment planning with reminders, comprehensive care plan and health evaluation, and facilitated day-to-day living.

Yetira Home Healthcare Management provides full spectrum services including health evaluation oversight, professional support services, short-term nursing services, collaborative care with health aide services, community and health resources.

Yetira offers HIPAA compliant user friendly web, mobile, and analytic solutions on high security cloud to enable active oversight of patients and proactive non face-to-face care between clinical visits.

We are passionate about your success!

Just Get In Touch

As a company with deep insights in the communities around you, we understand the challenges of the everyday human and the obstacles faced by healthcare organizations looking to improve every touch point in this delicate sector.

We empower your health IT transformation with data, technologies, strategy, acquisitions, and analytics to deliver customer value.

Together, We can make a difference. Reach out to us today.